Mawson Infrastructure (MIGI) Form 3 Wize Pharma / MARK M SIECZKAREK ownership change

SEC Form 3

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

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1. Name and Address of Reporting Person^*

SIECZKAREK MARK M

(Last) (First) (Middle)

24 HANAGAR STREET

(Street)

HOD HASHARON L3 4527708

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
04/23/2019

3. Issuer Name and Ticker or Trading Symbol
Wize Pharma, Inc. [ WIZP ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
X	Officer (give title below)	Other (specify below)
Chairman

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
Restricted Stock Units	(1)	(1)	Common stock	202,399	(1)	D
Stock Option (right to buy)	(2)	04/22/2029	Common stock	102,222	2	D

Explanation of Responses:

1. Includes 202,399 restricted stock units ("RSUs") which represent a continent right to receive one share of common stock for each RSU. The RSUs vest 1/8 on April 23, 2019 and subsequently in seven equal quarterly installments beginning July 1, 2019. Upon a change of control, the RSUs shall automatically vest in full as of the date of the change of control.

2. Includes 102,222 options ("Options") to purchase one share of common stock for each option. The Options vest 1/8 on April 23, 2019 and subsequently in seven equal quarterly installments beginning July 1, 2019. Upon a change of control, the Options shall automatically vest in full as of the date of the change of control.

	/s/ Mark Sierczkarek	05/01/2019
	** 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 5 (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).
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