Major Shareholding Notification • Jul 27, 2021
Major Shareholding Notification
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COMMISSION
Washington, D.C. 20549
OMB APPROVAL OMB Number: 3235-0104 Estimated average burden hours per response 0.5
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
| 1. Name and Address of Reporting Person* Shalev Varda |
2. Date of Event Requiring Statement (Month/Day/Year) |
3. Issuer Name and Ticker or Trading Symbol PLURISTEM THERAPEUTICS INC [ PSTI ] |
|||||||
|---|---|---|---|---|---|---|---|---|---|
| (Last) PARK |
(First) MATAM ADVANCED TECHNOLOGY |
(Middle) | 07/15/2021 | to Issuer X |
4. Relationship of Reporting Person(s) (Check all applicable) Director |
10% Owner | 5. If Amendment, Date of Original Filed (Month/Day/Year) |
||
| BUILDING NO. 5 | Officer (give title below) |
Other (specify below) |
6. Individual or Joint/Group Filing (Check Applicable Line) |
||||||
| (Street) | X | Form filed by One Reporting | |||||||
| HAIFA | L3 | 3508409 | Person | ||||||
| (City) | (State) | (Zip) | 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 |
5. Ownership Form: |
6. Nature of Indirect Beneficial |
|||||||
| Date Exercisable |
Expiration Date |
Title | Amount or Number of Shares |
Price of Direct (D) Derivative or Indirect Security (I) (Instr. 5) |
Ownership (Instr. 5) |
Explanation of Responses:
Remarks:
No securities are beneficially owned.
/s/ Varda Shalev 07/26/2021
** 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.
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