SEC Form 3 filed by new insider Izraeli Tomer
$PLRZ
Biotechnology: Pharmaceutical Preparations
Health Care
| 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*
(Street)
(Country) | 2. Date of Event Requiring Statement
(Month/Day/Year) 03/18/2026 | 3. Issuer Name and Ticker or Trading Symbol
Polyrizon Ltd. [ PLRZ ] | |||||||||||||||
| 3a. Foreign Trading Symbol
| 5. If Amendment, Date of Original Filed
(Month/Day/Year) | ||||||||||||||||
| 4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
| 6. Individual or Joint/Group Filing (Check Applicable Line)
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| 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) |
| Ordinary Shares | 79 | D | |
| Ordinary Shares | 53(1) | D | |
| Ordinary Shares | 35,780(2) | 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 Ordinary Shares | 10/01/2021 | 10/07/2026 | Ordinary Shares | 5(3) | $1,699.3 | D | |
| Option to Purchase Ordinary Shares | 07/05/2023 | 06/05/2028 | Ordinary Shares | 83(3) | $1,700.3 | D | |
| Explanation of Responses: |
| 1. These ordinary shares represent restricted ordinary shares, of which (1) 17 ordinary shares are vested and (2) 36 restricted ordinary shares vest in 8 equal monthly installments on a quarterly basis beginning on March 30, 2026, subject to the Reporting Person's continued service. |
| 2. These ordinary shares represent restricted ordinary shares, of which (1) 5,780 ordinary shares are vested and (2) 30,000 restricted ordinary shares vest in 6 equal quarterly installments on a quarterly basis beginning on March 31, 2026, subject to the Reporting Person's continued service. |
| 3. To qualify for certain tax benefits under Section 102 of the Israeli Tax Ordinance, securities issued to an employee in connection with the Polyrizon Ltd. Amended and Restated Equity Incentive Plan must be registered in the name of a trustee. |
| /s/ Tomer Izraeli | 03/18/2026 | |
| ** 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. | ||
| * Form 3: SEC 1473 (03-26) | ||