Amended Statement of Ownership (sc 13g/a)
November 28 2016 - 10:07AM
Edgar (US Regulatory)
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE
13G
Under the Securities Exchange Act of 1934
(Amendment No. 1)*
Medigus Ltd.
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(Name of Issuer)
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Ordinary Shares
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(Title of Class of Securities)
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58471G102
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(CUSIP Number)
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November 23, 2016
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(Date of Event which Requires Filing of this Statement)
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Check the appropriate box to designate the rule pursuant to
which this Schedule is filed:
¨
Rule 13d-1(b)
¨
Rule 13d-1(c)
x
Rule 13d-1(d)
* The remainder of this cover page
shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities,
and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
The information required in the remainder
of this cover page shall not be deemed to be “filed” for the purpose of this Section 18 of the Securities Exchange
Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all
other provisions of the Act (however, see the Notes).
CUSIP No. 58471G102
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Page
2
of 6
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1.
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NAME OF REPORTING PERSONS
I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY)
Dexxon Technologies 2005 Ltd.
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2.
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(SEE INSTRUCTIONS)
(a)
¨
(b)
¨
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3.
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SEC USE ONLY
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4.
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CITICITIZENSHIP OR PLACE OF ORGANIZATION
Israel
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NUMBER OF
SHARES
BENEFICIALLY
OWNED BY EACH
REPORTING
PERSON WITH
|
5.
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SOLE VOTING POWER
0
|
6.
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SHARED VOTING POWER
0
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7.
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SOLE DISPOSITIVE POWER
0
|
8.
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SHARED DISPOSITIVE POWER
0
|
9.
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
0
|
10.
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CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
¨
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11.
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PER PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
0
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12.
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TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
CO
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CUSIP No. 58471G102
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Page
3
of 6
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1.
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NAME OF REPORTING PERSONS
I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY)
Dan Oren
|
2.
|
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(SEE INSTRUCTIONS)
(a)
¨
(b)
¨
|
3.
|
SEC USE ONLY
|
4.
|
CITICITIZENSHIP OR PLACE OF ORGANIZATION
Israel
|
NUMBER OF
SHARES
BENEFICIALLY
OWNED BY EACH
REPORTING
PERSON WITH
|
5.
|
SOLE VOTING POWER
0
|
6.
|
SHARED VOTING POWER
0
|
7.
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SOLE DISPOSITIVE POWER
0
|
8.
|
SHARED DISPOSITIVE POWER
0
|
9.
|
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
0
|
10.
|
CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
¨
|
11.
|
PER PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
0
|
12.
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TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
IN
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CUSIP No. 58471G102
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Page
4
of 6
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Item 1.
(a) Name of Issuer
Medigus Ltd., a company incorporated in Israel (the “
Issuer
”).
(b) Address of Issuer’s Principal Executive Offices:
Omer Industrial Park, No. 7A
P.O. Box 3030
Omer 8496500
Israel
Item 2.
(a) Name of Person Filing
Dexxon Technologies 2005 Ltd. (“
Dexxon
”)
Dan Oren (each a “
Reporting Person
” and together, the “
Reporting Persons
”).
(b) Address of Principal Business Office
or, if none, Residence
The business address of each of the Reporting
Persons is 1 Dexcel Street, Or Akiva, 30600000, Israel.
(c) Citizenship
Dexxon is incorporated under the laws of
Israel. Dan Oren is an Israeli citizen.
(d) Title of Class of Securities
Ordinary Shares, par value NIS 0.01 per
share (“
Ordinary Shares
”).
(e) CUSIP Number
The Ordinary Shares have no CUSIP number. The ISIN
for the Ordinary Shares is 1L0010961717. The CUSIP number for the American Depository Shares traded on the NASDAQ Stock Market
is 58471G102.
Item 3.
If this
Statement is Filed Pursuant to Rule 13d-1(b), or 13d-2(b) or (c), Check
Whether the Person Filing is a:
Not applicable.
Item 4.
Ownership.
The information required by Items 4(a)-(c)
is set forth in Rows (5)-(11) of the cover page for each Reporting Person. Voting and dispositive decisions for Dexxon are made
by Dan Oren, in his capacity as sole director. Dan Oren is the sole shareholder of Dexxon.
CUSIP No. 58471G102
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Page
5
of 6
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Item 5.
Ownership of Five Percent or Less of
a Class.
If this statement is being filed to report
the fact that as of the date hereof, the Reporting Persons have ceased to be the beneficial owner of more than five percent of
the class of securities, check the following
x
.
Item 6.
Ownership of More than Five Percent
on Behalf of Another Person.
Not applicable.
Item 7.
Identification and Classification of the Subsidiary Which
Acquired the Security Being Reported on by the Parent Holding Company or Control Person
Not applicable.
Item 8.
Identification and Classification of
Members of the Group.
Not applicable.
Item 9.
Notice of Dissolution of Group.
Not applicable.
Item 10.
Certification.
Not applicable.
CUSIP No. 58471G102
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Page
6
of 6
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SIGNATURE
After reasonable inquiry and to the best
of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
Date: November 28, 2016
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DEXXON TECHNOLOGIES 2005 LTD.
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By:
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/s/ Dan Oren
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Name: Dan Oren
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Title: Director
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