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Purple Biotech Ltd.

Regulatory Filings Mar 26, 2018

7004_rns_2018-03-26_118df859-c08d-42c2-be45-f4b2bd81c460.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

Notice of Exempt Offering of Securities Estimated average
burden hours per
response
4.00
1. Issuer's Identity
CIK (Filer ID Number) Previous Names None Entity Type
0001614744
Kitov Corporation
Pharmaceuticals
Holdings Ltd.
Limited Partnership
Name of Issuer Limited Liability Company
Kitov Pharma Ltd. Mainrom Line
Logistics Ltd.
General Partnership
Business Trust
Jurisdiction of Incorporation/Organization X Other (Specify)
Limited company
ISRAEL
Year of Incorporation/Organization
X Over Five Years Ago
Within Last Five Years (Specify Year)
Yet to Be Formed
2. Principal Place of Business and Contact Information
Name of Issuer
Kitov Pharma Ltd.
Street Address 1 Street Address 2
ONE AZRIELI CENTER ROUND BUILDING, 19TH FLOOR
City State/Province/Country ZIP/PostalCode Phone Number of Issuer
TEL AVIV ISRAEL 6701101 972-3-9333121
3. Related Persons
Last Name First Name Middle Name
Israel Isaac
Street Address 1 Street Address 2
One Azrieli Center
City
Round Building, 19th Floor
State/Province/Country
ZIP/PostalCode
Tel Aviv ISRAEL 6701101
Relationship: X
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Chief Executive Officer and Director of the Issuer
Last Name First Name Middle Name
Waymack
Street Address 1
John Paul Street Address 2
One Azrieli Center Round Building, 19th Floor
City State/Province/Country ZIP/PostalCode
Tel Aviv ISRAEL 6701101
Relationship: X
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Chief Medical Officer and Chairman of the Board of Directors
Last Name First Name Middle Name
Rock Simcha
Street Address 1 Street Address 2
One Azrieli Center
City
Round Building, 19th Floor
State/Province/Country
ZIP/PostalCode
Tel Aviv ISRAEL 6701101
Relationship: X
Executive Officer
X
Director
Promoter

Clarification of Response (if Necessary):

Last Name
Steinberg
First Name
Steven
Middle Name
Street Address 1 Street Address 2
One Azrieli Center Round Building, 19th Floor
City State/Province/Country ZIP/PostalCode
Tel Aviv ISRAEL 6701101
Relationship:
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Director
Last Name
Agmon
First Name
Ido
Middle Name
Street Address 1 Street Address 2
One Azrieli Center Round Building, 19th Floor
City State/Province/Country ZIP/PostalCode
Tel Aviv ISRAEL 6701101
Relationship:
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Director
Last Name First Name Middle Name
Weber Arye
Street Address 1 Street Address 2
One Azrieli Center Round Building, 19th Floor
City State/Province/Country ZIP/PostalCode
Tel Aviv ISRAEL 6701101
Relationship:
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Director
Last Name
Tzror
First Name
Ran
Middle Name
Street Address 1 Street Address 2
One Azrieli Center Round Building, 19th Floor
City State/Province/Country ZIP/PostalCode
Tel Aviv ISRAEL 6701101
Relationship:
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Director
Last Name First Name Middle Name
Stern-Raff Revital
Street Address 1 Street Address 2
One Azrieli Center Round Building, 19th Floor
City State/Province/Country ZIP/PostalCode
Tel Aviv ISRAEL 6701101
Relationship:
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Director
Last Name First Name Middle Name
Ben-Menachem Gil
Street Address 1 Street Address 2
One Azrieli Center Round Building, 19th Floor
City State/Province/Country ZIP/PostalCode
Tel Aviv ISRAEL 6701101
Relationship:
X
Executive Officer
X
Director
Promoter
Clarification of Response (if Necessary):
Vice President of Business Development and Director
Last Name First Name Middle Name
Reuveni Hadas
Street Address 1
One Azrieli Center
City
Tel Aviv
Street Address 2
Round Building, 19th Floor
State/Province/Country
ZIP/PostalCode
ISRAEL
6701101
Relationship:
X
Executive Officer
Director
Promoter
Clarification of Response (if Necessary):
Founder and Chief Technology Officer of TyrNovo Ltd., a subsidiary of the Filer
4. Industry Group
Agriculture
Banking & Financial Services
Commercial Banking
Health Care
Retailing
Restaurants
Biotechnology
Technology
Health Insurance
Insurance
Investing
Investment Banking
Computers
Hospitals & Physicians
Telecommunications
X Pharmaceuticals
Other Technology
Other Health Care
Pooled Investment Fund
Is the issuer registered as
an investment company under
the Investment Company
Act of 1940?
Yes
No
Other Banking & Financial Services
Travel
Manufacturing
Airlines & Airports
Real Estate
Lodging & Conventions
Commercial
Tourism & Travel
Construction
Services
REITS & Finance
Other Travel
Residential
Business Services
Energy
Coal Mining
Electric Utilities
Energy Conservation
Environmental Services
Oil & Gas
Other Energy
Other
Other Real Estate
5. Issuer Size
Revenue Range
No Revenues
\$1 - \$1,000,000
\$1,000,001 - \$5,000,000
\$5,000,001 - \$25,000,000
\$25,000,001 -
\$100,000,000
Over \$100,000,000
X Decline to Disclose
OR
Aggregate Net Asset Value Range
No Aggregate Net Asset Value
\$1 - \$5,000,000
\$5,000,001 - \$25,000,000
\$25,000,001 - \$50,000,000
\$50,000,001 - \$100,000,000
Over \$100,000,000
Decline to Disclose
Not Applicable Not Applicable
Rule 504(b)(1) (not (i), (ii) or (iii))
Rule 504 (b)(1)(i)
Rule 504 (b)(1)(ii)
Rule 504 (b)(1)(iii)
6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
Rule 505
X Rule 506(b)
Rule 506(c)
Securities Act Section 4(a)(5)
Investment Company Act Section 3(c)

Section 3(c)(4)
Section 3(c)(5)
Section 3(c)(6)
Section 3(c)(7)
Section 3(c)(12)
Section 3(c)(13)
Section 3(c)(14)
7. Type of Filing
X New Notice
Date of First Sale 2018-03-15
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)
X Equity
Debt
Option, Warrant or Other Right to Acquire Another Security
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?
X Yes
No
Clarification of Response (if Necessary):
An aggregate 1,462,936 of Filer's ordinary shares were issued to 2 U.S. persons as part of an exchange offer to certain
shareholders of the Filer's subsidiary TyrNovo, as disclosed by the Filer on Form 6-K furnished to the Commission on March
15, 2018.
11. Minimum Investment
Minimum investment accepted from any outside investor \$ 0 USD
12. Sales Compensation
Recipient
None
Recipient CRD Number
X None
(Associated) Broker or Dealer
X None
(Associated) Broker or Dealer CRD Number
X None
Street Address 1
NONE
NONE
City
State/Province/Country
NONE
UNKNOWN
Street Address 2
ZIP/Postal Code
0000000
State(s) of Solicitation
All States
Non-US/Foreign
AL
AK
AZ
AR
X CA
CO
CT
IL
IN
IA
KS
KY
LA
ME
MT
NE
NV
NH
NJ
NM
NY
RI
SC
SD
TN
X TX
UT
VT
DE
DC
FL
GA
HI
ID
MD
MA
MI
MN
MS
MO
NC
ND
OH
OK
OR
PA
VA
WA
WV
WI
WY
PR
13. Offering and Sales Amounts
Total Offering Amount
\$ 0
USD
or
Total Amount Sold
\$ 0
USD
Total Remaining to be Sold
\$ 0
USD
or
Indefinite
Indefinite

Clarification of Response (if Necessary):

14. Investors
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
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
2
2
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
\$ 0 USD
Estimate
Finders' Fees
\$ 0 USD
Estimate
Clarification of Response (if Necessary):
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.
Signature and Submission
Clarification of Response (if Necessary):
\$ 0 USD
Estimate
above. If the amount is unknown, provide an estimate and check the box next to the amount.

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 Regulation D for one of the reasons stated in Rule 505(b)(2)(iii) 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
Kitov Pharma Ltd. /s/ Simcha Rock Simcha Rock Chief Financial Officer and Director 2018-03-26

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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