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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 01/01/2023 |
3. Issuer Name and Ticker or Trading Symbol
Vascular Biogenics Ltd. [ VBLT ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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) |
Ordinary Shares | 39,000 | I(1) | By Marc D. Kozin Irrevocable Trust |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 | ||||
Stock Option (Right to Buy) | (2) | 05/05/2036 | Ordinary Shares | 50,000 | 3.3 | D | |
Stock Option (Right to Buy) | (3) | 11/24/2040 | Ordinary Shares | 125,000 | 1.17 | D | |
Stock Option (Right to Buy) | (4) | 07/20/2041 | Ordinary Shares | 125,000 | 2.38 | D | |
Stock Option (Right to Buy) | (5) | 12/07/2041 | Ordinary Shares | 79,406 | 2.31 | D | |
Stock Option (Right to Buy) | (6) | 01/02/2042 | Ordinary Shares | 52,937 | 2.12 | D |
Explanation of Responses: |
1. These shares are held by the Marc D. Kozin Irrevocable Trust, of which the Reporting Person's spouse is one of the beneficiaries. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, if any. |
2. These options were granted on 05/05/16 under the Issuer's Employee Share Ownership and Option Plan (2014) (the "2014 Plan") and are fully vested and exercisable. |
3. These options were granted on 11/24/20 under the 2014 Plan, with 25% of the shares underlying these options vesting on November 24, 2021 (the one year anniversary of the grant date), and the remainder vesting quarterly thereafter for three years such that they are vested in full on the four-year anniversary of the grant date. |
4. These options were granted on 07/20/21 under the 2014 Plan, with 25% of the shares underlying these options vesting on July 20, 2022 (the one year anniversary of the grant date), and the remainder vesting quarterly thereafter for three years such that they are vested in full on the four-year anniversary of the grant date. |
5. These options were granted on 12/07/21 under the 2014 Plan and vest over two years commencing on the grant date such that 50% vest on the first anniversary of the date of grant and the remainder vest quarterly thereafter for one year such that they are vested in full on the two-year anniversary of the grant date. |
6. These options were granted on 01/02/22 under the 2014 Plan and vest over two years commencing on the grant date such that 50% vest on the first anniversary of the date of grant and the remainder vest quarterly thereafter for one year such that they are vested in full on the two-year anniversary of the grant date. |
Remarks: |
Exhibit 24 - Power of Attorney |
/s/ Samuel Backenroth, Attorney-in-Fact | 01/03/2023 | |
** 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). | ||
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. |