Statement of Changes in Beneficial Ownership (4)
27 März 2020 - 9:04PM
Edgar (US Regulatory)
FORM 4
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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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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
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GROSSMAN JONAS |
2. Issuer Name and Ticker or Trading Symbol
BiomX Inc.
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PHGE
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(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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Common Stock, par value $0.0001 | | | | | | | | 6500 | D | |
Common Stock, par value $0.0001 | | | | | | | | 1707500 | I | See Footnote (1) |
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 | | 16000 | | (2) | 3/25/2030 | Common Stock | 16000 | $0 | 16000 | D | |
Warrants | $11.5 | | | | | | | 11/27/2019 | 10/28/2024 | Common Stock | 50129 | | 50129 | D | |
Explanation of Responses: |
(1) | Consists of shares of common stock owned by Chardan Investments, LLC, for which Mr. Grossman is the managing member. Mr. Grossman disclaims beneficial ownership of the shares except to the extent of his pecuniary interest in the shares. |
(2) | 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. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
GROSSMAN JONAS C/O BIOMX LTD. 7 PINHAS SAPIR ST., FLOOR 2 NESS ZIONA, L3 7414002 | X |
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Signatures
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/s/ Jonas Grossman | | 3/27/2020 |
**Signature of Reporting Person | Date |
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