Statement of Changes in Beneficial Ownership (4)
27 März 2020 - 9:01PM
Edgar (US Regulatory)
FORM 4
[X]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
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3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Puttagunta Sailaja |
2. Issuer Name and Ticker or Trading Symbol
BiomX Inc.
[
PHGE
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chief Medical Officer |
(Last)
(First)
(Middle)
C/O BIOMX LTD., 7 PINHAS SAPIR ST., FLOOR 2 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/25/2020 |
(Street)
NESS ZIONA, L3 7414002
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security (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) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Common Stock Options - Right to Buy | $6.21 | 3/25/2020 | | A | | 67500 | | (1) | 3/25/2030 | Common Stock | 67500 | $0 | 67500 (2) | I | See Footnote (3) |
Explanation of Responses: |
(1) | The options vest and become exercisable over four years, with 25% of the shares subject to the option vesting on March 25, 2021, and the remainder vesting in 12 equal quarterly installments over three years. |
(2) | Does not include 263,576 additional options previously granted to the Reporting Person which have different exercise prices and which vest on different schedules. |
(3) | The options are held by SPB Consulting LLC. The Reporting Person is the sole member of SPB Consulting LLC and may be deemed the indirect beneficial owner of the securities held by SPB Consulting LLC. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Puttagunta Sailaja C/O BIOMX LTD. 7 PINHAS SAPIR ST., FLOOR 2 NESS ZIONA, L3 7414002 |
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| Chief Medical Officer |
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Signatures
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/s/ Sailaja Puttagunta | | 3/27/2020 |
**Signature of Reporting Person | Date |
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