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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Options (4) | $ 5.06 | 05/08/2018(1) | A | 70,187 | (5) | 02/27/2028 | Ordinary Shares | 70,187 | $ 0 | 70,187 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Domzalski David C/O FOAMIX PHARMACEUTICALS LTD. 2 HOLZMAN STREET, WEIZMANN SCIENCE PARK REHOVOT, L3 76704 |
X | CEO |
/s/ Ilan Hadar as attorney-in-fact for David Domzalski | 05/10/2018 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The equity incentive grants were approved by the Issuer's board of directors on the recommendation of a committee of the board on February 27, 2019, subject to shareholder approval as required under the Israeli Companies Law. The Issuer's shareholders approved the equity incentive grants on May 8, 2018. |
(2) | The ordinary shares underlying this restricted share unit award vest over a period of four years (25% on February 27, 2019 and 6.25% every three months thereafter) ending February 27, 2022. |
(3) | This security represents restricted share units. Each restricted share unit represents a contingent right to receive one ordinary share of the issuer. |
(4) | Each option represents a contingent right to purchase one ordinary share of the issuer. |
(5) | The ordinary shares underlying these options vest over a period of four years (25% on February 27, 2019 and 6.25% every three months thereafter) ending February 27, 2022. |