Filing Details

Accession Number:
0001181431-11-024257
Form Type:
4
Zero Holdings:
No
Publication Time:
2011-04-15 17:27:20
Reporting Period:
2011-04-13
Filing Date:
2011-04-15
Accepted Time:
2011-04-15 17:27:20
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1138776 Medgenics Inc. MDGN Biological Products, (No Disgnostic Substances) (2836) 980217544
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
905536 Isaac Blech 75 Rockefeller Plaza, 29Th Floor
New York NY 10019
No No Yes No
1514430 Blech Isaac F/B/O Trust Remainder Charitable Liberty 75 Rockefeller Plaza, 29Th Floor
New York NY 10019
No No No Yes
1514431 Blech Isaac F/B/O Unitrust Remainder Charitable River 75 Rockefeller Plaza, 29Th Floor
New York NY 10019
No No Yes No
1518076 Unitrust Remainder Charitable West 75 Rockefeller Plaza, 29Th Floor
New York NY 10019
No No No Yes
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock, Par Value $0.00001 Per Share Acquisiton 2011-04-13 1,000,000 $5.00 1,000,000 No 4 P Indirect By Trust
Common Stock, Par Value $0.00001 Per Share Acquisiton 2011-04-13 644,053 $3.41 1,644,053 No 4 C Indirect By Trust
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Indirect By Trust
No 4 C Indirect By Trust
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock 2010 Convertible Debenture Disposition 2011-04-13 1 $0.00 644,053 $3.41
Common Stock Stock Option (right to buy) Acquisiton 2011-03-23 19,068 $0.00 19,068 $6.65
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 2010-09-22 No 4 C Indirect
19,068 2020-12-10 No 4 A Direct
Footnotes
  1. The $2,150,000 Convertible Debenture, together with accrued interest thereon, automatically converted into shares of common stock of Medgenics, Inc. (the "Issuer") upon the closing of the Issuer's initial public offering at a conversion price of $3.405, which was related to the price that the Issuer's common stock was sold in the initial public offering. The Convertible Debenture had no stated expiration date.
  2. The Stock Option vests in three (3) equal annual installments commencing on December 10, 2011.
  3. Liberty Charitable Remainder Trust FBO Isaac Blech UAD 01/09/87 ("Liberty Trust") and West Charitable Remainder Unitrust ("West Trust") are the beneficial owners of less than 10% of the Issuer's common stock. Isaac Blech is the sole trustee of the Liberty Trust and the West Trust.