Initial Statement of Beneficial Ownership (3)
March 25 2021 - 9:12AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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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Aharon Arnon |
2. Date of Event Requiring Statement (MM/DD/YYYY)
3/16/2021
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3. Issuer Name and Ticker or Trading Symbol
Chemomab Therapeutics Ltd. [CMMB]
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(Last)
(First)
(Middle)
12 YAVNE ST. |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) Chief Medical Officer / |
(Street)
TEL AVIV, L3 6579116
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 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 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) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: 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 |
Option to purchase American Depositary Shares | (1) | 12/3/2027 | American Depositary Shares (2) | 13274 | $1.49 | D | |
Option to purchase American Depositary Shares | (3) | 12/16/2029 | American Depositary Shares (2) | 61958 | $1.62 | D | |
Explanation of Responses: |
(1) | 10,779 of these options to purchase American Depositary Share (ADSs) have vested and are exercisable as of the date hereof, and the remaining 2,495 of these options will vest and become exercisable in three remaining installments, with 1/3 of such options vesting on each three month anniversary commencing on of June 4, 2021, subject to the Reporting Person's continued service. |
(2) | Each ADS represents twenty (20) ordinary shares, no par value, of the Issuer. |
(3) | 30,973 of these options to purchase ADSs have vested and are exercisable as of the date hereof, and the remaining 30,985 of these options will vest and become exercisable in eight remaining installments, with 12.5% of such options vesting on each three month anniversary commencing on May 28, 2021, subject to the Reporting Person's continued service. |
Remarks: Exhibit 24.1: Power of Attorney |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Aharon Arnon 12 YAVNE ST. TEL AVIV, L3 6579116 |
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| Chief Medical Officer |
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Signatures
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/s/ Matthew Rudolph, Esq., Attorney-in-Fact for Arnon Aharon | | 3/25/2021 |
**Signature of Reporting Person | Date |
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