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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 | ||||||||
Stock Option (right to buy) | (1) | 04/13/2014 | A | 166,666 | 04/30/2014(2) | 04/13/2024 | Common Stock | 166,666 | $ 0 | 166,666 | D | ||||
Stock Option (right to buy) | (1) | 04/13/2014 | A | 133,334 | 04/30/2014(3) | 04/13/2024 | Common Stock | 133,334 | $ 0 | 133,334 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Israeli Avi C/O BRAINSTORM CELL THERAPEUTICS INC., 605 THIRD AVENUE, 34TH FLOOR NEW YORK, NY 10158 |
X |
/s/ Thomas B. Rosedale (pursuant to Power of Attorney) | 04/13/2014 | |
**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) | Exercise price is $0.00005. |
(2) | Option vests and becomes exercisable in 12 consecutive, equal monthly installments at the end of each calendar month commencing on April 30, 2014 until fully vested and exercisable on March 31, 2015, unless the agreement dated April 13, 2010 by and among the reporting person, Hadasit Medical Research Services and Development Ltd. and Brainstorm Cell Therapeutics Inc. (the "Hadasit Agreement") is terminated prior to April 13, 2015, in which case no further shares underlying the option shall vest on or after the date of such termination. |
(3) | Option vests and becomes exercisable in 12 consecutive, equal monthly installments at the end of each calendar month commencing on April 30, 2014 until fully vested and exercisable on March 31, 2015, unless the Hadasit Agreement is terminated prior to April 13, 2015 or the reporting person ceases to serve as Chairman of the Board of Directors of Brainstorm Cell Therapeutics Inc. prior to April 13, 2015, in which case no further shares underlying the option shall vest on or after the date of such termination. |