UNITED STATES SECURITIES AND EXCHANGE COMMISSION | OMB APPROVAL | |
Washington, D.C. 20549 | OMB Number: | 3235-0076 |
FORM D | ||
Estimated average burden | 4.00 | |
hours per response | ||
Notice of Exempt Offering of Securities
1. Issuer's Identity
CIK (Filer ID Number)
0001614744
Name of Issuer
PURPLE BIOTECH LTD.
Jurisdiction of Incorporation/Organization
ISRAEL
Year of Incorporation/Organization
- Over Five Years Ago
Within Last Five Years (Specify Year) Yet to Be Formed
Previous Names
Kitov Pharma Ltd.
None | Entity Type |
- Corporation
Limited Partnership
Limited Liability Company
General Partnership
Business Trust
Other (Specify)
2. Principal Place of Business and Contact Information | |||
Name of Issuer | |||
PURPLE BIOTECH LTD. | |||
Street Address 1 | Street Address 2 | ||
4 OPPENHEIMER STREET | SCIENCE PARK | ||
City | State/Province/Country | ZIP/PostalCode | Phone Number of Issuer |
REHOVOT | ISRAEL | 7670104 | +972-3-933-3121 |
3. Related Persons | |||
Last Name | First Name | Middle Name | |
Efron | Gil | ||
Street Address 1 | Street Address 2 | ||
4 Oppenheimer Street | Science Park | ||
City | State/Province/Country | ZIP/PostalCode | |
Rehovot | ISRAEL | 7670104 | |
Relationship: | X Executive Officer | Director | Promoter |
Clarification of Response (if Necessary): | |||
Chief Executive Officer | |||
Last Name | First Name | Middle Name | |
Fhima | Lior | ||
Street Address 1 | Street Address 2 | ||
4 Oppenheimer Street | Science Park | ||
City | State/Province/Country | ZIP/PostalCode | |
Rehovot | ISRAEL | 7670104 | |
Relationship: | X Executive Officer | Director | Promoter |
Clarification of Response (if Necessary): | |||
Chief Financial Officer | |||
Last Name | First Name | Middle Name | |
Rowinsky | Eric | ||
Street Address 1 | Street Address 2 | ||
4 Oppenheimer Street | Science Park | ||
City | State/Province/Country | ZIP/PostalCode | |
Rehovot | ISRAEL | X Director | 7670104 |
Relationship: | Executive Officer | Promoter | |
Clarification of Response (if Necessary): | |||
Chairman of the Board of Directors | |||
Last Name | First Name | Middle Name | |
Israel | Isaac | ||
Street Address 1 | Street Address 2 | ||
4 Oppenheimer Street | Science Park | ||
City | State/Province/Country | ZIP/PostalCode | |
Rehovot | ISRAEL | X Director | 7670104 |
Relationship: | Executive Officer | Promoter |
Clarification of Response (if Necessary):
Last Name | First Name | |
Rock | Simcha | |
Street Address 1 | Street Address 2 | |
4 Oppenheimer Street | Science Park | |
City | State/Province/Country | |
Rehovot | ISRAEL | X Director |
Relationship: | Executive Officer |
Clarification of Response (if Necessary):
Middle Name
ZIP/PostalCode
7670104
Promoter
Last Name | First Name | |
Agmon | Ido | |
Street Address 1 | Street Address 2 | |
4 Oppenheimer Street | Science Park | |
City | State/Province/Country | |
Rehovot | ISRAEL | X Director |
Relationship: | Executive Officer |
Clarification of Response (if Necessary):
Middle Name
ZIP/PostalCode
7670104
Promoter
Last Name | First Name | |
Gagnon | Robert | |
Street Address 1 | Street Address 2 | |
4 Oppenheimer Street | Science Park | |
City | State/Province/Country | |
Rehovot | ISRAEL | X Director |
Relationship: | Executive Officer |
Clarification of Response (if Necessary):
Middle Name
ZIP/PostalCode
7670104
Promoter
Last Name | First Name | |
Nahum-Zilberberg | Suzana | |
Street Address 1 | Street Address 2 | |
4 Oppenheimer Street | Science Park | |
City | State/Province/Country | |
Rehovot | ISRAEL | X Director |
Relationship: | Executive Officer |
Clarification of Response (if Necessary):
Middle Name
ZIP/PostalCode
7670104
Promoter
Last Name | First Name | |
Hershkovitz | Ori | |
Street Address 1 | Street Address 2 | |
4 Oppenheimer Street | Science Park | |
City | State/Province/Country | |
Rehovot | ISRAEL | X Director |
Relationship: | Executive Officer |
Clarification of Response (if Necessary):
Middle Name
ZIP/PostalCode
7670104
Promoter
Last Name | First Name | |
Reuveni | Hadas | |
Street Address 1 | Street Address 2 | |
4 Oppenheimer Street | Science Park | |
City | State/Province/Country | |
Rehovot | ISRAEL | |
Relationship: | X Executive Officer | Director |
Clarification of Response (if Necessary):
Vice President of Research and Development
Middle Name
ZIP/PostalCode
7670104
Promoter
Last Name | First Name | Middle Name |
Schickler | Michael | |
Street Address 1 | Street Address 2 | |
4 Oppenheimer Street | Science Park |
City | State/Province/Country | |||
Rehovot | ISRAEL | |||
Relationship: | X | Executive Officer | Director |
Clarification of Response (if Necessary):
Head of Regulatory and Clinical Operations
ZIP/PostalCode
7670104
Promoter
Last Name | First Name | Middle Name | |
Morpurgo | Ido | ||
Street Address 1 | Street Address 2 | ||
4 Oppenheimer Street | Science Park | ||
City | State/Province/Country | ZIP/PostalCode | |
Rehovot | ISRAEL | 7670104 | |
Relationship: | X Executive Officer | Director | Promoter |
Clarification of Response (if Necessary): | |||
Vice President of Operations | |||
Last Name | First Name | Middle Name | |
Sebille | Fabien | ||
Street Address 1 | Street Address 2 | ||
4 Oppenheimer Street | Science Park | ||
City | State/Province/Country | ZIP/PostalCode | |
Rehovot | ISRAEL | 7670104 | |
Relationship: | X Executive Officer | Director | Promoter |
Clarification of Response (if Necessary):
Chief Business Officer
4. Industry Group
Agriculture
Banking & Financial Services
Commercial Banking Insurance Investing Investment Banking Pooled Investment Fund
Is the issuer registered as
an investment company under the Investment Company Act of 1940?
Yes No
Other Banking & Financial Services
Business Services
Energy
Coal Mining
Electric Utilities
Energy Conservation
Environmental Services
Oil & Gas
Other Energy
Health Care
- Biotechnology
Health Insurance
Hospitals & Physicians
Pharmaceuticals
Other Health Care
Manufacturing
Real Estate
Commercial
Construction
REITS & Finance
Residential
Other Real Estate
Retailing
Restaurants
Technology
Computers
Telecommunications
Other Technology
Travel
Airlines & Airports
Lodging & Conventions
Tourism & Travel
Services
Other Travel
Other
5. Issuer Size | ||||||
Revenue Range | OR | Aggregate Net Asset Value Range | ||||
No Aggregate Net Asset Value | ||||||
X | No Revenues | |||||
$1 - $1,000,000 | $1 - $5,000,000 | |||||
$1,000,001 - $5,000,000 | $5,000,001 - $25,000,000 | |||||
$5,000,001 - $25,000,000 | $25,000,001 - $50,000,000 | |||||
$25,000,001 - | $50,000,001 - $100,000,000 | |||||
$100,000,000 | ||||||
Over $100,000,000 | Over $100,000,000 | |||||
Decline to Disclose Not Applicable
Decline to Disclose Not Applicable
6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
Rule 504(b)(1) (not (i), (ii) or (iii)) Rule 504 (b)(1)(i)
Rule 504 (b)(1)(ii)
Rule 504 (b)(1)(iii)
7. Type of Filing
X
Rule 506(b)
Rule 506(c)
Securities Act Section 4(a)(5)
Investment Company Act Section 3(c)
Section 3(c)(1) | Section 3(c)(9) | |
Section 3(c)(2) | Section 3(c)(10) | |
Section 3(c)(3) | Section 3(c)(11) | |
Section 3(c)(4) | Section 3(c)(12) | |
Section 3(c)(5) | Section 3(c)(13) | |
Section 3(c)(6) | Section 3(c)(14) | |
Section 3(c)(7) |
X
New Notice | Date of First Sale 2023-10-17 |
Amendment |
First Sale Yet to Occur
8. Duration of Offering
Does the Issuer intend this offering to last more than one year?
Yes
X
No
9. Type(s) of Securities Offered (select all that apply)
Equity
Debt
-
Option, Warrant or Other Right to Acquire Another Security X Security to be Acquired Upon Exercise of Option, Warrant or
Other Right to Acquire Security
Pooled Investment Fund Interests
Tenant-in-Common Securities
Mineral Property Securities
Other (describe)
10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition
or exchange offer?
Clarification of Response (if Necessary):
Yes
- No
11. Minimum Investment
Minimum investment accepted from any outside investor $ 0 USD
12. Sales Compensation
Recipient | Recipient CRD Number | None | |
H.C. Wainwright & Co., LLC | 375 | ||
(Associated) Broker or Dealer X None | (Associated) Broker or Dealer CRD Number | ||
Street Address 1 | Street Address 2 | ||
430 PARK AVENUE | NEW YORK | ||
City | State/Province/Country | ZIP/Postal Code | |
NEW YORK | NEW YORK | 10022 |
- None
State(s) of Solicitation | All States | |||
AL | AK | AZ | AR | CA |
IL | IN | IA | KS | KY |
MT | NE | NV | NH | NJ |
RI | SC | SD | TN | TX |
Non-US/Foreign
CO | CT |
LA | ME |
NM | X NY |
UT | VT |
DE MD NC VA
DC MA ND WA
FL
MI
OH WV
GA MN OK WI
HI
MS OR WY
ID
MO PA PR
13. Offering and Sales Amounts
Total Offering Amount | $ 5,434,784 | USD | or |
Total Amount Sold | $ 5,434,784 | USD | |
Total Remaining to be Sold | $ 0 | USD | or |
Clarification of Response (if Necessary):
Indefinite
Indefinite
This Form D is being filed in connection with the issuance of warrants to purchase up to 4,347,827 ADSs at an exercise price of $1.25 per ADS, with each ADS representing 10 ordinary shares, no par value per share, of the Company.
14. Investors
-
Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors, and enter the number of such non-accredited investors who already have invested in the offering.
Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering:
15. Sales Commissions & Finder's Fees Expenses
0
1
Provide separately the amounts of sales commissions and finders fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
Sales Commissions $ 350,000 USD
Finders' Fees | $ 0 | USD |
Estimate
Estimate
Clarification of Response (if Necessary):
The placement agent also received a 1% management fee and warrants to purchase 304,348 ADSs at an exercise price of $1.4375 per ADS, each representing 10 ordinary shares, no par value per share, of the Company.
16. Use of Proceeds
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
$ 0 USD
Clarification of Response (if Necessary):
Signature and Submission
Estimate
Please verify the information you have entered and review the Terms of Submission below before signing and submitting this notice.
Terms of Submission
In submitting this notice, each identified issuer is:
- Notifying the SEC and/or each State in which this notice is filed of the offering of securities described and undertaking to furnish them, upon written request, in the accordance with applicable law, the information furnished to offerees.*
- Irrevocably appointing each of the Secretary of the SEC and the Securities Administrator or other legally designated officer of the State in which the issuer maintains its principal place of business and any State in which this notice is filed, as its agents for service of process, and agreeing that these persons may accept service on its behalf, of any notice, process or pleading, and further agreeing that such service may be made by registered or certified mail, in any Federal or state action, administrative proceeding, or arbitration brought against the issuer in any place subject to the jurisdiction of the United States, if the action, proceeding or arbitration (a) arises out of any activity in connection with the offering of securities that is the subject of this notice, and (b) is founded, directly or indirectly, upon the provisions of: (i) the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture Act of 1939, the Investment Company Act of 1940, or the Investment Advisers Act of 1940, or any rule or regulation under any of these statutes; or (ii) the laws of the State in which the issuer maintains its principal place of business or any State in which this notice is filed.
-
Certifying that, if the issuer is claiming a Regulation D exemption for the offering, the issuer is not disqualified from relying on Rule 504 or Rule 506 for one of the reasons stated in Rule 504(b)(3) or Rule 506
(d).
Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person.
For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature.
Issuer | Signature | Name of | Title | Date |
Signer | ||||
PURPLE BIOTECH LTD. | /s/ Lior Fhima | Lior Fhima | Chief Financial Officer | 2023-10-31 |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
- This undertaking does not affect any limits Section 102(a) of the National Securities Markets Improvement Act of 1996 ("NSMIA") [Pub. L. No. 104-290, 110 Stat. 3416 (Oct. 11, 1996)] imposes on the ability of States to require information. As a result, if the securities that are the subject of this Form D are "covered securities" for purposes of NSMIA, whether in all instances or due to the nature of the offering that is the subject of this Form D, States cannot routinely require offering materials under this undertaking or otherwise and can require offering materials only to the extent NSMIA permits them to do so under NSMIA's preservation of their anti-fraud authority.
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Purple Biotech Ltd. published this content on 31 October 2023 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 31 October 2023 21:00:03 UTC.