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Purple Biotech Ltd.

Regulatory Filings Oct 31, 2023

7004_rns_2023-10-31_c45e85fc-1a62-49e5-b7b2-cc4aa0891657.pdf

Regulatory Filings

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UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL

Washington, D.C. 20549 FORM D

OMB Number: 3235-0076 Estimated average burden hours per response 4.00

Notice of Exempt Offering of Securities

1. Issuer's Identity
CIK (Filer ID Number) Previous Names None Entity Type
0001614744
Name of Issuer
Kitov Pharma
Ltd.
X Corporation
Limited Partnership
PURPLE BIOTECH LTD. Limited Liability Company
Jurisdiction of Incorporation/Organization General Partnership
ISRAEL
Year of Incorporation/Organization
Business Trust
X Over Five Years Ago Other (Specify)
Within Last Five Years (Specify Year)
Yet to Be Formed
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
Street Address 1
Gil
Street Address 2
4 Oppenheimer Street Science Park
City State/Province/Country ZIP/PostalCode
Rehovot
Relationship:
X
Executive Officer
ISRAEL
Director
Promoter 7670104
Clarification of Response (if Necessary):
Chief Executive Officer
Last Name First Name Middle Name
Fhima Lior
Street Address 1
4 Oppenheimer Street
Street Address 2
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
Street Address 1
Eric
Street Address 2
4 Oppenheimer Street Science Park
City State/Province/Country ZIP/PostalCode
Rehovot
Relationship:
Executive Officer
ISRAEL
X
Director
Promoter 7670104
Clarification of Response (if Necessary):
Chairman of the Board of Directors
Last Name First Name Middle Name
Israel
Street Address 1
Isaac
Street Address 2
4 Oppenheimer Street Science Park
City State/Province/Country ZIP/PostalCode
Rehovot
Relationship:
Executive Officer
ISRAEL
X
Director
Promoter 7670104

Clarification of Response (if Necessary):

Last Name First Name Middle Name
Rock Simcha
Street Address 1 Street Address 2
4 Oppenheimer Street Science Park
City State/Province/Country ZIP/PostalCode
Rehovot ISRAEL 7670104
Relationship:
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Last Name First Name Middle Name
Agmon Ido
Street Address 1 Street Address 2
4 Oppenheimer Street Science Park
City State/Province/Country ZIP/PostalCode
Rehovot ISRAEL 7670104
Relationship:
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Last Name First Name Middle Name
Gagnon Robert
Street Address 1 Street Address 2
4 Oppenheimer Street Science Park
City State/Province/Country ZIP/PostalCode
Rehovot ISRAEL 7670104
Relationship:
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Last Name First Name Middle Name
Nahum-Zilberberg Suzana
Street Address 1 Street Address 2
4 Oppenheimer Street Science Park
City State/Province/Country ZIP/PostalCode
Rehovot ISRAEL 7670104
Relationship:
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Last Name First Name Middle Name
Hershkovitz Ori
Street Address 1 Street Address 2
4 Oppenheimer Street Science Park
City State/Province/Country ZIP/PostalCode
Rehovot ISRAEL 7670104
Relationship:
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Last Name First Name Middle Name
Reuveni Hadas
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 Research and Development
Last Name First Name Middle Name
Schickler Michael
Street Address 1 Street Address 2
4 Oppenheimer Street Science Park
City State/Province/Country ZIP/PostalCode
Rehovot
Relationship:
X
Executive Officer
ISRAEL
Director
Promoter
7670104
Clarification of Response (if Necessary):
Head of Regulatory and Clinical Operations
Last Name
Morpurgo
First Name
Ido
Middle Name
Street Address 1 Street Address 2
4 Oppenheimer Street Science Park
City
Rehovot
State/Province/Country
ISRAEL
ZIP/PostalCode
7670104
Relationship:
X
Executive Officer
Director
Promoter
Clarification of Response (if Necessary):
Vice President of Operations
Last Name First Name Middle Name
Sebille
Street Address 1
Fabien
Street Address 2
4 Oppenheimer Street Science Park
City
Rehovot
State/Province/Country
ISRAEL
ZIP/PostalCode
7670104
Relationship:
X
Executive Officer
Director
Promoter
Clarification of Response (if Necessary):
Chief Business Officer
4. Industry Group
Agriculture Health Care Retailing
Banking & Financial Services X Biotechnology Restaurants
Technology
Commercial Banking Health Insurance Computers
Insurance Hospitals & Physicians Telecommunications
Investing Pharmaceuticals Other Technology
Investment Banking Other Health Care
Pooled Investment Fund Manufacturing Travel
Is the issuer registered as
an investment company under
Real Estate Airlines & Airports
the Investment Company Commercial Lodging & Conventions
Act of 1940? Construction Tourism & Travel
Services
Yes
No
REITS & Finance Other Travel
Other Banking & Financial Services Residential Other
Business Services Other Real Estate
Energy
Coal Mining
Electric Utilities
Energy Conservation
Environmental Services
Oil & Gas
Other Energy
5. Issuer Size
Revenue Range OR
Aggregate Net Asset Value Range
X No Revenues No Aggregate Net Asset Value
\$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 -
\$100,000,000
\$50,000,001 - \$100,000,000
Over \$100,000,000 Over \$100,000,000
Decline to Disclose
Decline to Disclose
Not Applicable
Not Applicable
6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
Rule 504(b)(1) (not (i), (ii) or (iii))
X Rule 506(b)
Rule 504 (b)(1)(i)
Rule 506(c)
Rule 504 (b)(1)(ii)
Securities Act Section 4(a)(5)
Rule 504 (b)(1)(iii)
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)
7. Type of Filing
X New Notice
Date of First Sale 2023-10-17
First Sale Yet to Occur
Amendment
8. Duration of Offering
X No
Does the Issuer intend this offering to last more than one year?
Yes
9. Type(s) of Securities Offered (select all that apply)
Equity
Pooled Investment Fund Interests
Debt
Tenant-in-Common Securities
X Option, Warrant or Other Right to Acquire Another Security
Mineral Property Securities
X Security to be Acquired Upon Exercise of Option, Warrant or
Other (describe)
Other Right to Acquire Security
10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a
Yes
X No
merger, acquisition
or exchange offer?
Clarification of Response (if Necessary):
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
X None
Street Address 1
Street Address 2
430 PARK AVENUE
NEW YORK
City
State/Province/Country
ZIP/Postal Code
NEW YORK
NEW YORK
10022
State(s) of Solicitation
All States
Non-US/Foreign
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MT
NE
NV
NH
NJ
NM
X NY
NC
ND
OH
OK
OR
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
MO
PA
PR
13. Offering and Sales Amounts
Total Offering Amount \$ 5,434,784 USD or Indefinite
Total Amount Sold \$ 5,434,784 USD
Total Remaining to be Sold \$ 0 USD or Indefinite
Clarification of Response (if Necessary):
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
invested in the offering.
invested in the offering:
X 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
0
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
1
15. Sales Commissions & Finder's Fees Expenses
expenditure is not known, provide an estimate and check the box next to the amount. Provide separately the amounts of sales commissions and finders fees expenses, if any. If the amount of an
\$ 350,000 USD
Sales Commissions
Estimate
\$ 0
Finders' Fees
USD
Estimate
Clarification of Response (if Necessary):
\$1.4375 per ADS, each representing 10 ordinary shares, no par value per share, of the Company. The placement agent also received a 1% management fee and warrants to purchase 304,348 ADSs at an exercise price of
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 Estimate
Clarification of Response (if Necessary):
Signature and Submission
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:

• 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
Signer
Title Date
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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