<SEC-DOCUMENT>0001213900-22-027733.txt : 20220517
<SEC-HEADER>0001213900-22-027733.hdr.sgml : 20220517
<ACCEPTANCE-DATETIME>20220517173025
ACCESSION NUMBER:		0001213900-22-027733
CONFORMED SUBMISSION TYPE:	3
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20220512
FILED AS OF DATE:		20220517
DATE AS OF CHANGE:		20220517

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			Aharon Eyal
		CENTRAL INDEX KEY:			0001928627

	FILING VALUES:
		FORM TYPE:		3
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-41375
		FILM NUMBER:		22936057

	MAIL ADDRESS:	
		STREET 1:		C/O ACTELIS NETWORKS, INC.
		STREET 2:		47800 WESTINGHOUSE DRIVE
		CITY:			FREMONT
		STATE:			CA
		ZIP:			94539

ISSUER:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			ACTELIS NETWORKS INC
		CENTRAL INDEX KEY:			0001141284
		STANDARD INDUSTRIAL CLASSIFICATION:	COMMUNICATIONS EQUIPMENT, NEC [3669]
		IRS NUMBER:				522160309
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	BUSINESS ADDRESS:	
		STREET 1:		47800 WESTINGHOUSE DR
		CITY:			FREMONT
		STATE:			CA
		ZIP:			94539
		BUSINESS PHONE:		510-545-1040

	MAIL ADDRESS:	
		STREET 1:		47800 WESTINGHOUSE DR
		CITY:			FREMONT
		STATE:			CA
		ZIP:			94539
</SEC-HEADER>
<DOCUMENT>
<TYPE>3
<SEQUENCE>1
<FILENAME>ownership.xml
<TEXT>
<XML>
<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0206</schemaVersion>

    <documentType>3</documentType>

    <periodOfReport>2022-05-12</periodOfReport>

    <noSecuritiesOwned>0</noSecuritiesOwned>

    <issuer>
        <issuerCik>0001141284</issuerCik>
        <issuerName>ACTELIS NETWORKS INC</issuerName>
        <issuerTradingSymbol>ASNS</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001928627</rptOwnerCik>
            <rptOwnerName>Aharon Eyal</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>47800 WESTINGHOUSE DRIVE</rptOwnerStreet1>
            <rptOwnerStreet2></rptOwnerStreet2>
            <rptOwnerCity>FREMONT</rptOwnerCity>
            <rptOwnerState>CA</rptOwnerState>
            <rptOwnerZipCode>94539</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>0</isDirector>
            <isOfficer>1</isOfficer>
            <isTenPercentOwner>0</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle>Vice President R&amp;D</officerTitle>
            <otherText></otherText>
        </reportingOwnerRelationship>
    </reportingOwner>

    <derivativeTable>
        <derivativeHolding>
            <securityTitle>
                <value>Option</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.0644</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F1"/>
            </exerciseDate>
            <expirationDate>
                <value>2025-06-30</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>10978</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Option</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.0644</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F2"/>
            </exerciseDate>
            <expirationDate>
                <value>2026-01-21</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>1098</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Option</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.1058</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F3"/>
            </exerciseDate>
            <expirationDate>
                <value>2027-06-08</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>4093</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Option</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.1058</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F4"/>
            </exerciseDate>
            <expirationDate>
                <value>2028-02-08</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>8696</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Option</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.1058</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F5"/>
            </exerciseDate>
            <expirationDate>
                <value>2029-03-06</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>10870</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Option</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>1.3616</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F6"/>
            </exerciseDate>
            <expirationDate>
                <value>2031-05-27</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>4348</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">This Option grant was vested in full on 06/29/2019.</footnote>
        <footnote id="F2">This Option grant was vested in full on 01/20/2020.</footnote>
        <footnote id="F3">This Option grant was vested in full on 06/07/2021.</footnote>
        <footnote id="F4">This Option grant was vested in full on 02/07/2022.</footnote>
        <footnote id="F5">This Option grant is approximately 83% vested as of May 12, 2022, with the remaining 17% of the Option grant vesting at a rate of 226 options per month until December 31, 2022, at which point the Option grant shall be fully vested, subject to Mr. Aharon remaining continuously employed through the final vesting date.</footnote>
        <footnote id="F6">This Option grant is approximately 27% vested as of May 12, 2022, with the remaining 73% of the Option grant vesting at a rate of 91 options per month until March 31, 2025, at which point the Option grant shall be fully vested, subject to Mr. Aharon remaining continuously employed through the final vesting date.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Eyal Aharon</signatureName>
        <signatureDate>2022-05-17</signatureDate>
    </ownerSignature>
</ownershipDocument>
</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
