Statement of Changes in Beneficial Ownership (4)
24 Januar 2019 - 9:46PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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
*
Maimon Arik
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2. Issuer Name
and
Ticker or Trading Symbol
Cuentas Inc.
[
CUEN
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Chairman of the Board and CEO
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(Last)
(First)
(Middle)
WEST FLAGLER STREET, SUITE 507
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3. Date of Earliest Transaction
(MM/DD/YYYY)
9/13/2018
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(Street)
MIAMI, FL 33130
(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
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12/20/2018
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P
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2191
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A
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$3.05
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174875
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D
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Common Stock
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12/20/2018
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P
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300
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A
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$2.50
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175175
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D
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Common Stock
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12/20/2018
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P
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100
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A
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$3.70
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175275
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D
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Common Stock
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12/28/2018
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J
(1)
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63771
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A
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$0.00
(1)
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239046
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D
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Common Stock
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1/2/2019
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P
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100
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A
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$3.95
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239146
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D
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Common Stock
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1/17/2019
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P
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218
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A
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$4.35
(2)
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239364
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D
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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)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Option to purchase Common Stock
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$3
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9/13/2018
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A
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60000
(3)
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(4)
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9/12/2023
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Common Stock
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60000
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$0.00
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60000
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D
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Explanation of Responses:
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(1)
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The 63,771 shares of the Issuer's common stock, par value $0.001 (the "Common Stock") were issued to the Reporting Person pursuant to a settlement of stock based liabilities.
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(2)
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The price reported in Column 4 is a weighted average price. The shares of Common Stock were purchased on the open market at prices ranging from $4 to $4.7 per share. The Reporting Person undertakes to provide the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares of Common Stock purchased at each separate price within the ranges set forth in Footnote (2).
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(3)
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The 60,000 options to purchase the Issuer's common stock were issued in connection with a grant under the Issuer's 2018 Equity Stock Incentive Plan.
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(4)
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One-third of the options (20,000) have been exercisable since 9/13/2018; one-third of the options (20,000) become exercisable on 9/13/2019; and one-third of the options (20,000) become exercisable on 9/13/2020.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Maimon Arik
WEST FLAGLER STREET, SUITE 507
MIAMI, FL 33130
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X
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X
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Chairman of the Board and CEO
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Signatures
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/s/ Arik Maimon
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1/24/2019
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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