Initial Statement of Beneficial Ownership (3)
August 25 2016 - 4:32PM
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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Brosh Yigal
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2. Date of Event Requiring Statement (MM/DD/YYYY)
6/13/2016
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3. Issuer Name
and
Ticker or Trading Symbol
BLUE SPHERE CORP. [BLSP]
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(Last)
(First)
(Middle)
301 MCCULLOUGH DRIVE,, 4TH FLOOR
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4. 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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(Street)
CHARLOTTE, NC 28262
(City)
(State)
(Zip)
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5. 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 Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock, par value $0.001 per share
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245833
(1)
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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. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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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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Stock Award
(2)
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(2)
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(2)
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Common Stock, par value $0.001 per share
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204167
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(2)
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D
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Stock Options
(3)
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(3)
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2/24/2020
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Common Stock, par value $0.001 per share
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175000
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(3)
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D
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Explanation of Responses:
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(
1)
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The 245,833 shares of Common Stock owned by the reporting person were issued on June 13, 2016. The 245,833 shares include (a) 100,000 shares awarded pursuant to a one-time grant under the issuer's Global Share Incentive Plan (2010) and (b) 145,833 shares awarded pursuant to a stock award under the issuer's Global Share and Options Incentive Enhancement Plan (2014) (the "2014 Incentive Plan"). The stock award under the 2014 Incentive Plan was granted on February 24, 2015 for 350,000 shares of Common Stock and vests in quarterly installments. As of the date of this report, 145,833 of such shares have vested and been issued and 204,167 of such shares remain to be vested and/or issued. The 204,167 shares that have not yet vested and/or been issued are not included in the number of securities beneficially owned in Table I, Column 2 of this report.
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(
2)
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The stock award under the 2014 Incentive Plan was granted on February 24, 2015 for 350,000 shares of Common Stock and vests in quarterly installments. As of the date of this report, 145,833 of such shares have been issued and 204,167 shares have not been issued (of which, 87,500 shares have vested and 116,667 shares are unvested).
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(
3)
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The stock options were granted under the 2014 Incentive Plan. The options have not been issued by the company, but if issued, they will vest on a quarterly basis over a two-year period and have an exercise price of $0.14 per share.
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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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Brosh Yigal
301 MCCULLOUGH DRIVE,
4TH FLOOR
CHARLOTTE, NC 28262
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X
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Signatures
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/s/Yigal Brosh _
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8/25/2016
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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 5(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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