Form 4 - Statement of changes in beneficial ownership of securities

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

1. Name and Address of Reporting Person^*

Hurvitz Chaim

(Last)

(First)

(Middle)

C/O DROR ORTHO-DESIGN, INC.,

SHATNER STREET 3

(Street)

JERUSALEM

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
Dror Ortho-Design, Inc. [ DROR ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
08/14/2023

4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)		5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Series A Convertible Preferred Stock	$0.011	08/14/2023		A		592,150.79		⁽¹⁾	⁽²⁾	Common Stock	59,215,079	⁽³⁾	592,150.79	I	See footnote⁽⁴⁾
Common Warrants	$0.033	08/14/2023		A		42,417,309		⁽⁵⁾	⁽⁶⁾	Common Stock	42,417,309	⁽⁷⁾	42,417,309	I	See footnote⁽⁴⁾

Explanation of Responses:

1. Shares of Series A Convertible Preferred Stock, par value $0.0001 per share and with a stated value of $1.10 per share (the "Preferred Stock") of Dror Ortho-Design, Inc. (formerly Novint Technologies, Inc.) (the "Company") shall be convertible, at any time and from time to time at the option of the Holder thereof, into shares of the company's common stock, par value $0.0001 per share (the "Common Stock") from and after the date the Company has reserved shares of Common Stock on behalf of the holders of the Preferred Stock.

2. The Preferred Stock is perpetual and therefore has no expiration date.

3. Pursuant to a Share Exchange Agreement, dated July 5, 2023 (as amended, the "Share Exchange Agreement"), by and among the Company, Dror Ortho-Design Ltd. ("Private Dror"), and the shareholders of Private Dror, Shirat Hachaim Ltd ("Shirat Hachaim") transferred 16,103 ordinary shares of Private Dror, representing all ordinary shares of Private Dror beneficially owned by the reporting person, to the Company in exchange for shares of Preferred Stock (the "Share Exchange").

4. The securities are held by Shirat Hachaim, an entity of which the reporting person is the sole owner and over whose shares the reporting person has sole voting and dispositive power .

5. Warrants will be exercisable from and after the date the Company has reserved shares of Common Stock on behalf of the holders of the warrants (the "Initial Exercise Date").

6. Warrants expire on the fifth anniversary of the Initial Exercise Date.

7. Pursuant to a Warrant Exchange Agreement, dated August 14, 2023, between the Company and the reporting person, simultaneously with the Share Exchange, warrants to purchase 7,109 ordinary shares of Private Dror held by Shirat Hachaim, representing all warrants to purchase ordinary shares of Private Dror beneficially owned by the reporting person, were cancelled, and the Company issued to Shirat Hachaim warrants to purchase shares of the Company's Common Stock with an exercise price of $0.033 per share.

	/s/ Chaim Hurvitz	09/27/2023
	** 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 4 (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).
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