SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
SQUINTO STEPHEN P

(Last) (First) (Middle)
930 5TH AVE, APT 18A

(Street)
NY NY 10021

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/16/2021
3. Issuer Name and Ticker or Trading Symbol
Chemomab Therapeutics Ltd. [ CMMB ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
American Depositary Shares(1) 47,938 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Option to purchase American Depositary Shares (2) 11/18/2025 American Depositary Shares(1) 424 0.67 D
Option to purchase American Depositary Shares (2) 09/13/2026 American Depositary Shares(1) 2,109 0.8 D
Option to purchase American Depositary Shares (3) 11/19/2027 American Depositary Shares(1) 21,095 1.49 D
Option to purchase American Depositary Shares (2) 10/21/2028 American Depositary Shares(1) 32,928 1.49 D
Option to purchase American Depositary Shares (4) 11/19/2030 American Depositary Shares(1) 40,362 1.48 D
Explanation of Responses:
1. Each American Depositary Share (ADS) represents twenty (20) ordinary shares, no par value, of the Issuer.
2. These options have vested and are exercisable as of the date hereof, subject to the Reporting Person's continued service.
3. 14,059 of these options to purchase ADSs have vested and are exercisable as of the date hereof, while the remaining 7,036 of these options will vest and become exercisable in three installments, with 1/3 of the options vesting on each three month anniversary commencing on May 16, 2021, subject to the Reporting Person's continued service.
4. 5,042 of these options to purchase ADSs have vested and are exercisable as of the date hereof, while the remaining 35,320 of these options will vest and become exercisable in seven installments, with 1/7 of the options vesting on each three month anniversary commencing on May 19, 2021, subject to the Reporting Person's continued service.
Remarks:
Exhibit 24.1: Power of Attorney
/s/ Matthew Rudolph, Esq., Attorney-in-Fact for Stephen Squinto 03/25/2021
** Signature of Reporting Person Date
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, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 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, see 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.