Assaf Cohen - Dec 2, 2021 Form 4 Insider Report for ON TRACK INNOVATIONS LTD (OTIVF)

Role: Chief Financial Officer
Signature: /s/ Assaf Cohen
Stock symbol: OTIVF
Transactions as of: Dec 2, 2021
Transactions value $: $0
Form type: 4
Date filed: 12/6/2021, 11:22 AM
Next filing: Jun 13, 2022

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	OTIVF	Ordinary Shares	Award		+400K			400K	Dec 2, 2021	Direct	F1, F2

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Underlying Class	Amount	Exercise Price	Ownership	Footnotes
transaction	OTIVF	Stock Option (right to buy)	Disposed to Issuer	$0	-15K	-100%	$0.00^*	0	Dec 2, 2021	Ordinary Shares	15K	$1.21	Direct	F3
transaction	OTIVF	Stock Option (right to buy)	Disposed to Issuer	$0	-20K	-100%	$0.00^*	0	Dec 2, 2021	Ordinary Shares	20K	$0.84	Direct	F3
transaction	OTIVF	Stock Option (right to buy)	Disposed to Issuer	$0	-100K	-100%	$0.00^*	0	Dec 2, 2021	Ordinary Shares	100K	$0.38	Direct	F3
transaction	OTIVF	Stock Option (right to buy)	Disposed to Issuer	$0	-50K	-100%	$0.00^*	0	Dec 2, 2021	Ordinary Shares	50K	$0.22	Direct	F3

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	Upon vesting of such ordinary shares, as described in Note 2 below, the Reporting Person shall be required to pay the par value of the shares no longer subject to restriction of NIS 0.1.
F2	The ordinary shares vest as follows: (i) 50,000 shares will vest in two equal instalments on each of 12/02/2022 and 12/02/2023; and (ii) 350,000 shares will vest in three equal instalments on each of 12/02/2022, 12/02/2023 and 12/02/2024, all subject to the terms and provisions of the Issuer's 2021 equity incentive plan.
F3	The options were disposed of to the Issuer according to the Reporting Person's consent to the cancellation thereof in connection with the grant of the ordinary shares listed in Table I.