<SEC-DOCUMENT>0001213900-22-027953.txt : 20220518
<SEC-HEADER>0001213900-22-027953.hdr.sgml : 20220518
<ACCEPTANCE-DATETIME>20220518163115
ACCESSION NUMBER:		0001213900-22-027953
CONFORMED SUBMISSION TYPE:	3
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20220512
FILED AS OF DATE:		20220518
DATE AS OF CHANGE:		20220518

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			Hammergren Bruce
		CENTRAL INDEX KEY:			0001929790

	FILING VALUES:
		FORM TYPE:		3
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-41375
		FILM NUMBER:		22939573

	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>0001929790</rptOwnerCik>
            <rptOwnerName>Hammergren Bruce</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>EVP Sales Americas</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>23371</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>5435</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="F3"/>
            </exerciseDate>
            <expirationDate>
                <value>2026-01-21</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>4891</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>2028-05-08</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>5435</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>2029-12-30</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>5435</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">This Option grant vested in full on 06/29/2019.</footnote>
        <footnote id="F2">This Option grant vested in full on 01/20/2020.</footnote>
        <footnote id="F3">This Option grant vested in full on 01/20/2020.</footnote>
        <footnote id="F4">This Option grant vested in full on 05/07/2022.</footnote>
        <footnote id="F5">This Option grant is approximately 59% vested as of May 12, 2022, with the remaining 41% of the Option grant vesting at a rate of 113 options per month until December 4, 2023 at which point the Option grant shall be fully vested, subject to Mr. Hammergren remaining continuously employed through the final vesting date.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Bruce Hammergren</signatureName>
        <signatureDate>2022-05-18</signatureDate>
    </ownerSignature>
</ownershipDocument>
</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
