Israel Niv - 12 May 2022 Form 3 Insider Report for ACTELIS NETWORKS INC (ASNS)

Role: Director
Signature: /s/ Israel Niv
Issuer symbol: ASNS
Transactions as of: 12 May 2022
Net transactions value: $0
Form type: 3
Filing time: 17 May 2022, 17:36:52 UTC
Next filing: 19 Sep 2022
SEC: View on sec.gov

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
holding	ASNS	Common Stock						597,944	12 May 2022	See Footnote	F1

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
holding	ASNS	Option							12 May 2022	Common Stock	70,109	$0.0644	Direct	F2

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

Explanation of Responses:

Id	Content
F1	Consists of (i) 458,557 shares of common stock held by The Niv Family Trust, for which the Reporting Person and his spouse serve as trustees, (ii) 139,387 shares of common stock held by Sharon Hava Niv 2015 Family Trust for which the Reporting Person and his spouse serve as trustees. The Reporting Person may be deemed to have beneficial ownership of the shares held by the aforementioned entities.
F2	This Option grant vested in full on 06/29/2019.