Close

Form 3 ACTELIS NETWORKS INC For: May 12 Filed by: Aharon Eyal

FREE Breaking News Alerts from StreetInsider.com!

E-mail Address

StreetInsider.com Top Tickers, 4/18/2024

1. UAL
2. JBHT
3. TSLA
4. SAGE
5. TRV
6. LVS
7. ASML
8. SPY
9. SLG
10. PLD


May 17, 2022 5:31 PM EDT
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0104
Expires: December 31, 2014
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person *
Aharon Eyal
(Last) (First) (Middle)
47800 WESTINGHOUSE DRIVE
(Street)
FREMONT CA 94539
(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/12/2022 		3. Issuer Name and Ticker or Trading Symbol
ACTELIS NETWORKS INC [ ASNS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Vice President R&D
 5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Option   (1) 06/30/2025 Common Stock 10,978 0.0644 D  
Option   (2) 01/21/2026 Common Stock 1,098 0.0644 D  
Option   (3) 06/08/2027 Common Stock 4,093 0.1058 D  
Option   (4) 02/08/2028 Common Stock 8,696 0.1058 D  
Option   (5) 03/06/2029 Common Stock 10,870 0.1058 D  
Option   (6) 05/27/2031 Common Stock 4,348 1.3616 D  
Explanation of Responses:
1. This Option grant was vested in full on 06/29/2019.
2. This Option grant was vested in full on 01/20/2020.
3. This Option grant was vested in full on 06/07/2021.
4. This Option grant was vested in full on 02/07/2022.
5. This Option grant is approximately 83% vested as of May 12, 2022, with the remaining 17% of the Option grant vesting at a rate of 226 options per month until December 31, 2022, at which point the Option grant shall be fully vested, subject to Mr. Aharon remaining continuously employed through the final vesting date.
6. This Option grant is approximately 27% vested as of May 12, 2022, with the remaining 73% of the Option grant vesting at a rate of 91 options per month until March 31, 2025, at which point the Option grant shall be fully vested, subject to Mr. Aharon remaining continuously employed through the final vesting date.
/s/ Eyal Aharon 05/17/2022
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.

Serious News for Serious Traders! Try StreetInsider.com Premium Free!

You May Also Be Interested In





Related Categories

SEC Filings