<SEC-DOCUMENT>0001178913-17-000080.txt : 20170113
<SEC-HEADER>0001178913-17-000080.hdr.sgml : 20170113
<ACCEPTANCE-DATETIME>20170113160201
ACCESSION NUMBER:		0001178913-17-000080
CONFORMED SUBMISSION TYPE:	3/A
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20161109
FILED AS OF DATE:		20170113
DATE AS OF CHANGE:		20170113

ISSUER:		

	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

	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

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			Darivoff Philip
		CENTRAL INDEX KEY:			0001690551

	FILING VALUES:
		FORM TYPE:		3/A
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-54785
		FILM NUMBER:		17527823

	MAIL ADDRESS:	
		STREET 1:		1 FARMSTEAD ROAD
		CITY:			SHORT HILLS
		STATE:			NJ
		ZIP:			07078
</SEC-HEADER>
<DOCUMENT>
<TYPE>3/A
<SEQUENCE>1
<FILENAME>zk1719376.xml
<DESCRIPTION>OWNERSHIP DOCUMENT
<TEXT>
<XML>
<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0206</schemaVersion>

    <documentType>3/A</documentType>

    <periodOfReport>2016-11-09</periodOfReport>

    <dateOfOriginalSubmission>2016-11-18</dateOfOriginalSubmission>

    <noSecuritiesOwned>0</noSecuritiesOwned>

    <issuer>
        <issuerCik>0001506983</issuerCik>
        <issuerName>Integrity Applications, Inc.</issuerName>
        <issuerTradingSymbol>IGAP</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001690551</rptOwnerCik>
            <rptOwnerName>Darivoff Philip</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>C/O INTEGRITY APPLICATIONS, INC.</rptOwnerStreet1>
            <rptOwnerStreet2>19 HA'YAHALOMIM ST. P.O. BOX 12163</rptOwnerStreet2>
            <rptOwnerCity>ASHDOD</rptOwnerCity>
            <rptOwnerState>L3</rptOwnerState>
            <rptOwnerZipCode>7760049</rptOwnerZipCode>
            <rptOwnerStateDescription>ISRAEL</rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>1</isDirector>
            <isOfficer>0</isOfficer>
            <isTenPercentOwner>0</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle></officerTitle>
            <otherText></otherText>
        </reportingOwnerRelationship>
    </reportingOwner>

    <nonDerivativeTable>
        <nonDerivativeHolding>
            <securityTitle>
                <value>Common Stock, par value $0.001 per share</value>
            </securityTitle>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>414372</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>By Vayikra Capital, LLC</value>
                    <footnoteId id="F1"/>
                </natureOfOwnership>
            </ownershipNature>
        </nonDerivativeHolding>
    </nonDerivativeTable>

    <derivativeTable>
        <derivativeHolding>
            <securityTitle>
                <value>Series B Preferred Stock</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>4.50</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F2"/>
            </exerciseDate>
            <expirationDate>
                <footnoteId id="F3"/>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock, par value $0.001 per share</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <footnoteId id="F4"/>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>By Vayikra Capital, LLC</value>
                    <footnoteId id="F1"/>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Series B-1 Warrant</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>5.80</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2014-08-29</value>
            </exerciseDate>
            <expirationDate>
                <value>2019-08-29</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock, par value $0.001 per share</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <footnoteId id="F5"/>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>By Vayikra Capital, LLC</value>
                    <footnoteId id="F1"/>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Series B-1 Warrant</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>5.80</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2015-01-01</value>
            </exerciseDate>
            <expirationDate>
                <value>2020-01-01</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock, par value $0.001 per share</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <footnoteId id="F6"/>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>By Vayikra Capital, LLC</value>
                    <footnoteId id="F1"/>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Series B-2 Warrant</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>10.00</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2014-08-29</value>
            </exerciseDate>
            <expirationDate>
                <value>2019-08-29</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock, par value $0.001 per share</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <footnoteId id="F7"/>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>By Vayikra Capital, LLC</value>
                    <footnoteId id="F1"/>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Series B-2 Warrant</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>10.00</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2015-01-01</value>
            </exerciseDate>
            <expirationDate>
                <value>2020-01-01</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock, par value $0.001 per share</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <footnoteId id="F8"/>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>By Vayikra Capital, LLC</value>
                    <footnoteId id="F1"/>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeHolding>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">The securities are held by Vayikra Capital, LLC, of which the Reporting Person is the sole member. The Reporting Person disclaims beneficial ownership of these securities, except to the extent of any pecuniary interest therein and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.</footnote>
        <footnote id="F2">Each share of Series B Preferred Stock may be converted into Common Stock at any time at the option of the Reporting Person.</footnote>
        <footnote id="F3">The Series B Preferred Stock has no expiration date.</footnote>
        <footnote id="F4">The Reporting Person owns shares of Series B Preferred Stock convertible into 138,890 shares of Common Stock. The conversion of such Series B Preferred Stock is limited by the beneficial ownership limitation included in the certificate of designations for the Series B Preferred Stock which provides that Vayikra Capital, LLC will not be permitted to convert such securities if such conversion would cause such holder to beneficially own more than 9.99% of the outstanding number of shares of Common Stock outstanding after giving effect to such conversion. The amount of shares of Common Stock of which such Series B Preferred Stock is convertible into was calculated without giving effect to any ownership limitation of the Reporting Person.</footnote>
        <footnote id="F5">The Reporting Person owns Series B-1 Warrants exercisable into 43,104 shares of Common Stock. The exercise of such Series B-1 Warrants is limited by the beneficial ownership limitation included in Vayikra Capital, LLC's Series B warrants which provides that Vayikra Capital, LLC will not be permitted to exercise such securities if such exercise would cause such holder to beneficially own more than 9.99% of the outstanding number of shares of Common Stock outstanding after giving effect to such exercise. The amount of shares of Common Stock of which such Series B-1 Warrants is exercisable into was calculated without giving effect to any ownership limitation of the Reporting Person.</footnote>
        <footnote id="F6">The Reporting Person owns Series B-1 Warrants exercisable into 64,655 shares of Common Stock. The exercise of such Series B-1 Warrants is limited by the beneficial ownership limitation included in Vayikra Capital, LLC's Series B warrants which provides that Vayikra Capital, LLC will not be permitted to exercise such securities if such exercise would cause such holder to beneficially own more than 9.99% of the outstanding number of shares of Common Stock outstanding after giving effect to such exercise. The amount of shares of Common Stock of which such Series B-1 Warrants is exercisable into was calculated without giving effect to any ownership limitation of the Reporting Person.</footnote>
        <footnote id="F7">The Reporting Person owns Series B-2 Warrants exercisable into 43,104 shares of Common Stock. The exercise of such Series B-2 Warrants is limited by the beneficial ownership limitation included in Vayikra Capital, LLC's Series B warrants which provides that Vayikra Capital, LLC will not be permitted to exercise such securities if such exercise would cause such holder to beneficially own more than 9.99% of the outstanding number of shares of Common Stock outstanding after giving effect to such exercise. The amount of shares of Common Stock of which such Series B-2 Warrants is exercisable into was calculated without giving effect to any ownership limitation of the Reporting Person.</footnote>
        <footnote id="F8">The Reporting Person owns Series B-2 Warrants exercisable into 64,655 shares of Common Stock. The exercise of such Series B-2 Warrants is limited by the beneficial ownership limitation included in Vayikra Capital, LLC's Series B warrants which provides that Vayikra Capital, LLC will not be permitted to exercise such securities if such exercise would cause such holder to beneficially own more than 9.99% of the outstanding number of shares of Common Stock outstanding after giving effect to such exercise. The amount of shares of Common Stock of which such Series B-2 Warrants is exercisable into was calculated without giving effect to any ownership limitation of the Reporting Person.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Philip Darivoff</signatureName>
        <signatureDate>2017-01-13</signatureDate>
    </ownerSignature>
</ownershipDocument>
</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
