0001671513-16-000003.txt : 20160418 0001671513-16-000003.hdr.sgml : 20160418 20160418134617 ACCESSION NUMBER: 0001671513-16-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160418 DATE AS OF CHANGE: 20160418 EFFECTIVENESS DATE: 20160418 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Integrity Applications, Inc. CENTRAL INDEX KEY: 0001506983 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 980668934 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-261550 FILM NUMBER: 161576575 BUSINESS ADDRESS: STREET 1: 19 HA'YAHALOMIM ST STREET 2: P.O. BOX 12163 CITY: ASHDOD STATE: L3 ZIP: L3 7760049 BUSINESS PHONE: 972 (8) 675-7878 MAIL ADDRESS: STREET 1: 19 HA'YAHALOMIM ST STREET 2: P.O. BOX 12163 CITY: ASHDOD STATE: L3 ZIP: L3 7760049 D 1 primary_doc.xml X0707 D LIVE 0001506983 Integrity Applications, Inc. 19 HA'YAHALOMIM ST, P.O. BOX 12163 ASHDOD L3 ISRAEL L3 7760049 972 (8) 675-7878 DELAWARE None None Corporation true Avner Gal c/o Integrity Applications, Inc. 19 Ha'Yahalomim St., P.O. Box 12163 Ashdod L3 ISRAEL L3 7760049 Executive Officer Director Chairman of the Board and Chief Executive Officer David Malka c/o Integrity Applications, Inc. 19 Ha'Yahalomim St., P.O. Box 12163 Ashdod L3 ISRAEL L3 7760049 Executive Officer Director Executive Vice President of Operations and Director Eran Hertz c/o Integrity Applications, Inc. 19 Ha'Yahalomim St., P.O. Box 12163 Ashdod L3 ISRAEL L3 7760049 Executive Officer Chief Financial Officer Eran Cohen c/o Integrity Applications, Inc. 19 Ha'Yahalomim St., P.O. Box 12163 Ashdod L3 ISRAEL L3 7760049 Executive Officer Chief Operating Oficer Robert Fischell c/o Integrity Applications, Inc 19 Ha'Yahalomim St., P.O. Box 12163 Ashdod L3 ISRAEL L3 7760049 Director Leslie Seff c/o Integrity Applications, Inc 19 Ha'Yahalomim St., P.O. Box 12163 Ashdod L3 ISRAEL L3 7760049 Director Angela Strand c/o Integrity Applications, Inc 19 Ha'Yahalomim St., P.O. Box 12163 Ashdod L3 ISRAEL L3 7760049 Director Other Health Care $1 - $1,000,000 06b false 2016-04-08 false true true true false 0 Andrew Garrett, Inc. 29931 None None 52 Vanderbilt Ave., 5th Fl. New York NY NEW YORK 10017 CA CALIFORNIA FL FLORIDA MA MASSACHUSETTS NJ NEW JERSEY NY NEW YORK ND NORTH DAKOTA SD SOUTH DAKOTA TX TEXAS WA WASHINGTON false 12000000 1133000 10867000 false 17 147290 0 Includes a 6% sales commission, 4% management fee & 3% expense allowance. Placement agent will also receive warrants equal to 10% of the common stock issuable upon conversion of the Preferred Stock plus 10% of warrants issued to investors in the offering. 0 false Integrity Applications, Inc. /s/ Avner Gal Avner Gal Chief Exexutive Officer 2016-04-15