5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Officer (give title below)
Other (specify below)
3. Date of Earliest Transaction
4. If Amendment, Date of Original Filed
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr.
2. Transaction Date
2A. Deemed Execution Date, if any
3. Transaction Code (Instr.
4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr.
7. Nature of Indirect Beneficial Ownership (Instr.
(A) or (D)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr.
2. Conversion or Exercise Price of Derivative Security
3. Transaction Date
3A. Deemed Execution Date, if any
4. Transaction Code (Instr.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
6. Date Exercisable and Expiration Date
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
8. Price of Derivative Security (Instr.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
10. Ownership Form: Direct (D) or Indirect (I) (Instr.
11. Nature of Indirect Beneficial Ownership (Instr.
Amount or Number of Shares
Explanation of Responses:
1. Shares acquired are shares of restricted stock awarded on November 30, 2018 pursuant to the Brainstorm Cell Therapeutics Inc. Second Amended and Restated Director Compensation Plan. The shares of restricted stock vest in 12 consecutive, equal monthly installments commencing on December 30, 2018 until fully vested on the first anniversary of the date of grant, provided that the reporting person remains a director of Brainstorm Cell Therapeutics on each vesting date.
/s/ Thomas B. Rosedale (pursuant to Power of Attorney)
** Signature of Reporting Person
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,
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
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,
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.