Registration Form • Dec 30, 2022
Registration Form
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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 | |
| 0001158780 | PLURISTEM THERAPEUTICS INC |
X Corporation Limited Partnership Limited Liability Company |
||
| Name of Issuer | PLURISTEM LIFE SYSTEMS INC |
General Partnership Business Trust Other (Specify) |
||
| Pluri Inc. | AI SOFTWARE INC |
|||
| Jurisdiction of Incorporation/Organization NEVADA 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 Pluri Inc. Street Address 1 MATAM ADVANCED TECHNOLOGY PARK City HAIFA ISRAEL |
State/Province/Country | Street Address 2 BUILDING NO. 5 ZIP/PostalCode 3508409 |
Phone Number of Issuer 972-74-710-7171 |
|
| 3. Related Persons | ||||
| Last Name Yanay Street Address 1 Matam Advanced Technology Park City Haifa Relationship: X Executive Officer |
First Name Yaky Street Address 2 Building No. 5 State/Province/Country ISRAEL Director |
Promoter | Middle Name ZIP/PostalCode 3508409 |
|
| Clarification of Response (if Necessary): | ||||
| Chief Executive Officer and President | ||||
| Last Name Franco-Yehuda Street Address 1 Matam Advanced Technology Park City Haifa Relationship: X Executive Officer |
First Name Chen Street Address 2 Building No. 5 State/Province/Country ISRAEL Director |
Promoter | Middle Name ZIP/PostalCode 3508409 |
|
| Clarification of Response (if Necessary): | ||||
| Chief Financial Officer | ||||
| Last Name Aberman Street Address 1 Matam Advanced Technology Park City Haifa Relationship: Executive Officer |
First Name Zami Street Address 2 Building No. 5 State/Province/Country ISRAEL X Director |
Promoter | Middle Name ZIP/PostalCode 3508409 |
|
| Clarification of Response (if Necessary): | ||||
| Chairman of the Board of Directors |
| Last Name | First Name | Middle Name |
|---|---|---|
| Birger Street Address 1 |
Doron Street Address 2 |
|
| Matam Advanced Technology Park | Building No. 5 | |
| City Haifa |
State/Province/Country ISRAEL |
ZIP/PostalCode 3508409 |
| Relationship: Executive Officer |
X Director Promoter |
|
| Clarification of Response (if Necessary): | ||
| Last Name | First Name | Middle Name |
| Levi | Rami | |
| Street Address 1 Matam Advanced Technology Park |
Street Address 2 Building No. 5 |
|
| City | State/Province/Country | ZIP/PostalCode |
| Haifa Relationship: Executive Officer |
ISRAEL X Director Promoter |
3508409 |
| Clarification of Response (if Necessary): | ||
| Last Name Shalev |
First Name Varda |
Middle Name |
| Street Address 1 | Street Address 2 | |
| Matam Advanced Technology Park City |
Building No. 5 State/Province/Country |
ZIP/PostalCode |
| Haifa | ISRAEL | 3508409 |
| Relationship: Executive Officer |
X Director Promoter |
|
| Clarification of Response (if Necessary): | ||
| Last Name | First Name | Middle Name |
| Shemesh-Rasmussen | Maital | |
| Street Address 1 Matam Advanced Technology Park |
Street Address 2 Building No. 5 |
|
| City | State/Province/Country | ZIP/PostalCode |
| Haifa Relationship: Executive Officer |
ISRAEL X Director Promoter |
3508409 |
| Clarification of Response (if Necessary): | ||
| 4. Industry Group | ||
| Agriculture | Health Care | Retailing |
| Banking & Financial Services | X Biotechnology | Restaurants |
| Commercial Banking | Health Insurance | Technology |
| Insurance | Hospitals & Physicians | Computers |
| Investing | Pharmaceuticals | Telecommunications |
| Investment Banking | Other Health Care | Other Technology |
| Pooled Investment Fund | Manufacturing | Travel |
| Is the issuer registered as an investment company under |
Real Estate | Airlines & Airports |
| the Investment Company Act of 1940? |
Commercial | Lodging & Conventions Tourism & Travel |
| Yes No |
Construction REITS & Finance |
Services |
| Other Banking & Financial Services | Residential | Other Travel |
| Business Services | Other Real Estate | Other |
| Energy | ||
| Coal Mining | ||
| Electric Utilities | ||
| Energy Conservation | ||
| Environmental Services | ||
| Oil & Gas | ||
| Other Energy |
| 5. Issuer Size | ||
|---|---|---|
| Revenue Range | OR | Aggregate Net Asset Value Range |
| 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 | |
| X 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)) Rule 504 (b)(1)(i) |
X Rule 506(b) 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 Amendment |
Date of First Sale 2022-12-13 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 | 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 Right to Acquire Security |
Other (describe) | |
| 10. Business Combination Transaction | ||
| merger, acquisition or exchange offer? |
Is this offering being made in connection with a business combination transaction, such as a Yes X No |
|
| Clarification of Response (if Necessary): | ||
| 11. Minimum Investment | ||
| Minimum investment accepted from any outside investor \$ 0 USD | ||
| 12. Sales Compensation | ||
| Recipient | Recipient CRD Number X None |
|
(Associated) Broker or Dealer X None (Associated) Broker or Dealer CRD Number X None
Street Address 1 Street Address 2
| City | State/Province/Country | ZIP/Postal Code | |
|---|---|---|---|
| State(s) of Solicitation AL AK IL IN MT NE RI SC |
All States Non-US/Foreign AZ AR CA CO IA KS KY LA NV NH NJ NM SD TN TX UT |
CT DE DC FL GA ME MD MA MI MN NY NC ND OH OK VT VA WA WV WI |
HI ID MS MO OR PA WY PR |
| 13. Offering and Sales Amounts | |||
| Total Offering Amount Total Amount Sold Total Remaining to be Sold |
\$ 8,469,323 USD \$ 8,469,323 USD \$ 0 USD Clarification of Response (if Necessary): |
or Indefinite or Indefinite |
|
| 14. Investors | |||
| invested in the offering. invested in the offering: |
not qualify as accredited investors, enter the total number of investors who already have | 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 Regardless of whether securities in the offering have been or may be sold to persons who do |
14 |
| 15. Sales Commissions & Finder's Fees Expenses | |||
| Sales Commissions Finders' Fees 16. Use of Proceeds |
expenditure is not known, provide an estimate and check the box next to the amount. \$ 0 USD Estimate \$ 0 USD Estimate Clarification of Response (if Necessary): |
Provide separately the amounts of sales commissions and finders fees expenses, if any. If the amount of an | |
| Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to | |||
| above. If the amount is unknown, provide an estimate and check the box next to the amount. \$ 0 USD |
any of the persons required to be named as executive officers, directors or promoters in response to Item 3 Estimate |
||
| Clarification of Response (if Necessary): | |||
| Signature and Submission | |||
| and submitting this notice. Terms of Submission |
Please verify the information you have entered and review the Terms of Submission below before signing | ||
| In submitting this notice, each identified issuer is: | |||
| furnished to offerees.* | • 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 |
• 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 Signer |
Title | Date |
|---|---|---|---|---|
| Pluri Inc. | Chen Franco Yehuda |
Chief Financial Officer | 2022-12-30 |
* 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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