0001493152-23-039530.txt : 20231106
0001493152-23-039530.hdr.sgml : 20231106
20231106161529
ACCESSION NUMBER: 0001493152-23-039530
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231102
FILED AS OF DATE: 20231106
DATE AS OF CHANGE: 20231106
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Burell Scott R
CENTRAL INDEX KEY: 0001399318
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-19871
FILM NUMBER: 231380144
MAIL ADDRESS:
STREET 1: 6500 HARBOUR HEIGHTS PKWY #303
CITY: MUKILTEO
STATE: WA
ZIP: 98275
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Microbot Medical Inc.
CENTRAL INDEX KEY: 0000883975
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 943078125
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 25 RECREATION PARK DR SUITE 108
CITY: HINGHAM
STATE: MA
ZIP: 02043
BUSINESS PHONE: 908-938-5561
MAIL ADDRESS:
STREET 1: 25 RECREATION PARK DR SUITE 108
CITY: HINGHAM
STATE: MA
ZIP: 02043
FORMER COMPANY:
FORMER CONFORMED NAME: STEMCELLS INC
DATE OF NAME CHANGE: 20000524
FORMER COMPANY:
FORMER CONFORMED NAME: CYTOTHERAPEUTICS INC/DE
DATE OF NAME CHANGE: 19930328
4
1
ownership.xml
X0508
4
2023-11-02
0
0000883975
Microbot Medical Inc.
MBOT
0001399318
Burell Scott R
C/O MICROBOT MEDICAL INC.
288 GROVE STREET, SUITE 388
BRAINTREE
MA
02184
1
0
0
0
0
Stock Option (Right to Buy)
1.28
2023-11-02
4
A
0
74218
0.0
A
2033-11-02
Common Stock, par value $0.01 per share
74218
74218
D
The options vest as follows and in accordance with the terms of the Issuer's 2020 Omnibus Performance Award Plan, as amended: (a) on May 2, 2024, the option shall vest and shall become exercisable with respect to 25% of the common stock; and (b) on a quarterly basis over the next 30 months, the option shall equally vest and become exercisable with respect to the remaining 75% of the common stock.
/s/ Scott Burell
2023-11-06