<SEC-DOCUMENT>0001178913-16-005595.txt : 20160531
<SEC-HEADER>0001178913-16-005595.hdr.sgml : 20160530
<ACCEPTANCE-DATETIME>20160531153646
ACCESSION NUMBER:		0001178913-16-005595
CONFORMED SUBMISSION TYPE:	SD
PUBLIC DOCUMENT COUNT:		1
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FILED AS OF DATE:		20160531
DATE AS OF CHANGE:		20160531

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			Integrity Applications, Inc.
		CENTRAL INDEX KEY:			0001506983
		STANDARD INDUSTRIAL CLASSIFICATION:	SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
		IRS NUMBER:				980668934
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		SD
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-54785
		FILM NUMBER:		161685654

	BUSINESS ADDRESS:	
		STREET 1:		19 HA'YAHALOMIM ST
		STREET 2:		P.O. BOX 12163
		CITY:			ASHDOD
		STATE:			L3
		ZIP:			L3 7760049
		BUSINESS PHONE:		972 (8) 675-7878

	MAIL ADDRESS:	
		STREET 1:		19 HA'YAHALOMIM ST
		STREET 2:		P.O. BOX 12163
		CITY:			ASHDOD
		STATE:			L3
		ZIP:			L3 7760049
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<div style="TEXT-ALIGN: center; FONT: bold 14pt/1.25 'Times New Roman', Times, serif">UNITED STATES</div>

<div style="TEXT-ALIGN: center; FONT: bold 14pt/1.25 'Times New Roman', Times, serif">SECURITIES AND EXCHANGE COMMISSION</div>

<div style="TEXT-ALIGN: center; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt; FONT-WEIGHT: bold">WASHINGTON, D.C.&#160;&#160;20549</div>

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<div style="TEXT-ALIGN: center; FONT: bold 14pt/1.25 'Times New Roman', Times, serif">FORM SD</div>

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<div style="TEXT-ALIGN: center; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt; FONT-WEIGHT: bold">SPECIALIZED DISCLOSURE REPORT</div>

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<div style="TEXT-ALIGN: center; FONT: bold 16pt/1.25 'Times New Roman', Times, serif"><u>INTEGRITY APPLICATIONS, INC.</u></div>

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<div style="TEXT-ALIGN: center">(State or other jurisdiction of incorporation or organization)</div>
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<div style="TEXT-ALIGN: center; LINE-HEIGHT: 1.25; FONT-WEIGHT: bold">19 Ha'Yahalomim Street</div>

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<div style="TEXT-ALIGN: center; LINE-HEIGHT: 1.25; FONT-WEIGHT: bold">Eran Hertz, Chief Financial Officer</div>
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<div style="TEXT-ALIGN: left; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">Rule 13p-1 under the Securities Exchange Act (17 CFR 240.13p-1) for the reporting period from January 1 to December 31, 2015.</div>
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<div style="TEXT-ALIGN: left; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt; FONT-WEIGHT: bold">Item 1.01. Conflict Minerals Disclosure and Report</div>

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<div style="TEXT-ALIGN: left; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt; FONT-WEIGHT: bold">Conflict Minerals Disclosure</div>

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<div style="TEXT-ALIGN: justify; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">This Specialized Disclosure Report on Form SD of Integrity Applications, Inc. (the &#8220;Company&#8221; or &#8220;Integrity&#8221;) is filed pursuant to Rule 13p-1 promulgated under the Securities Exchange Act of 1934 (the &#8220;Rule&#8221;) for the reporting period January 1, 2015 to December 31, 2015.</div>

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<div style="TEXT-ALIGN: justify; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">Integrity is a medical device company focused on the design, development and commercialization of non-invasive glucose monitoring devices for use by people with diabetes. We have developed a non-invasive blood glucose monitor, the GlucoTrack&#174; model DF-F glucose monitoring device, which is designed to help people with diabetes obtain blood glucose level readings without the pain, inconvenience, cost and difficulty of conventional (invasive) spot finger stick devices. The GlucoTrack&#174; model DF-F utilizes a patented combination of ultrasound, electromagnetic and thermal technologies to obtain blood glucose measurements in less than one minute via a small sensor that is clipped onto one&#8217;s earlobe and connected to a small, handheld control and display unit, all without drawing blood.</div>

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<div style="TEXT-ALIGN: justify; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">Integrity does not have commercial manufacturing facilities and currently utilizes a third party manufacturer in Israel to manufacture the GlucoTrack&#174; model DF-F. Most of the parts and materials used in the manufacturing process of the GlucoTrack&#174; model DF-F are purchased directly by the third party manufacturer based on the Company&#8217;s discrete material requirements.&#160; Certain critical parts are purchased directly by Integrity primarily from Israeli vendors and are then delivered to the third party manufacturer to be embedded in the manufacturing process of the GlucoTrack&#174; model DF-F.</div>

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<div style="TEXT-ALIGN: justify; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">Integrity has concluded that conflict minerals, as defined in Section 1502(e)(4) of the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010 (&#8220;Conflict Minerals&#8221;), are necessary to the functionality or production of the GlucoTrack&#174; model DF-F. As a result of such conclusion, the Company conducted a reasonable country of origin inquiry designed to determine if such Conflict Minerals originated in the Democratic Republic of Congo or an adjoining country (the &#8220;Covered Countries&#8221;) or is from recycled or scrap resources.<font style="FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">&#160; This good faith reasonable country of origin inquiry was reasonably designed to determine whether any of the Conflict Minerals originated in the Covered Countries and whether any of the Conflict Mineral may be from recycled or scrap sources. The process that the Company utilized to determine the country of origin for the Conflicts Minerals&#160;included: (1) contacting suppliers that provide component parts for the </font>GlucoTrack&#174; model DF-F<font style="FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">, (2) soliciting survey responses from such relevant suppliers using the Conflict Minerals Reporting Template developed by the Electronic Industry Citizenship Coalition &#8211; Global eSustainability Initiative (EICC/GeSI), (3) reviewing conflict mineral declarations posted on the websites of certain of those suppliers, including those who did not respond to our survey request; (4) assessing the responses from the relevant suppliers, and (5) conducting follow-up with the relevant suppliers, if necessary, due to the responses.</font></div>

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<div style="TEXT-ALIGN: justify; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt"><font style="FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">Based on the above referenced reasonable country of origin inquiry and other due diligence described herein (including with respect to the use of Conflict Minerals that are necessary to the functionality or production of the GlucoTrack&#174; model DF-F), the Company determined that the Conflicts Minerals&#160;that are necessary to the functionality or production of the </font>GlucoTrack&#174; model DF-F<font style="FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt"> were derived from recycled or scrap sources.</font></div>

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<div style="TEXT-ALIGN: left; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">A copy of this Specialized Disclosure Report on Form SD is available on Integrity&#8217;s website at www.integrity-app.com.</div>

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<div style="TEXT-ALIGN: center; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">SIGNATURES</div>

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<div style="TEXT-ALIGN: left; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the duly authorized undersigned.</div>

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<div style="TEXT-ALIGN: left; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; MARGIN-LEFT: 1.5pt; FONT-SIZE: 10pt">Integrity Applications, Inc.</div>
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<div style="TEXT-ALIGN: left; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; MARGIN-LEFT: 1.5pt; FONT-SIZE: 10pt">May 31, 2016</div>
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<div style="TEXT-ALIGN: left; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; MARGIN-LEFT: 1.5pt; FONT-SIZE: 10pt">/s/ Eran Hertz</div>
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<div style="TEXT-ALIGN: left; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; MARGIN-LEFT: 1.5pt; FONT-SIZE: 10pt">Eran Hertz</div>

<div style="TEXT-ALIGN: justify; LINE-HEIGHT: 1.25; FONT-FAMILY: 'Times New Roman', Times, serif; FONT-SIZE: 10pt">Chief Financial Officer</div>
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