o None
Entity Type
0001614744
Mainrom Line Logistics Ltd.
Kitov Pharmaceuticals Holdings Ltd.
 
o Corporation
o Limited Partnership
o Limited Liability Company
o General Partnership
o Business Trust
x Other
Limited company
Name of Issuer
 Kitov Pharma Ltd.
Jurisdiction of Incorporation/Organization
ISRAEL
 
Year of Incorporation/Organization
  x Over Five Years Ago
  o Within Last Five Years (Specify Year)  
  o 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
City State/Province/Country ZIP/Postal Code Phone No. of Issuer
 TEL AVIV  ISRAEL  6701101  97239333121 



3. Related Persons
Last Name First Name Middle Name
Israel Isaac
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  Chief Executive Officer and Director of the Issuer

Last Name First Name Middle Name
Rowinsky Eric
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  Independent Director and Chairman of the Board of Directors of the Issuer

Last Name First Name Middle Name
Rock Simcha
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  Director of the Issuer

Last Name First Name Middle Name
Steinberg Steven
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  Independent Director of the Issuer

 
Last Name First Name Middle Name
Agmon Ido
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  Independent Director of the Issuer

Last Name First Name Middle Name
Tzror Ran
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  Independent Director of the Issuer

Last Name First Name Middle Name
Stern-Raff Revital
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  Independent Director of the Issuer

Last Name First Name Middle Name
Ben-Menachem Gil
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
  Vice President of Business Development of the Issuer

 
Last Name First Name Middle Name
Reuveni Hadas
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
  VP R&D of the Issuer

Last Name First Name Middle Name
Efron Gil
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
  Deputy CEO and Chief Financial Officer of the Issuer

Last Name First Name Middle Name
Liang Bertrand
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
  Chief Medical Officer of the Issuer

Last Name First Name Middle Name
Schickler Michael
Street Address 1 Street Address 2
One Azrieli Center Round Building
City State/Province/Country ZIP/Postal Code
Tel Aviv ISRAEL 6701101
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
  Head of Clinical Operations of the Issuer

 


4. Industry Group
o Agriculture   Health Care o Retailing
  Banking & Financial Services   o Biotechnology o Restaurants
  o Commercial Banking   o Health Insurance   Technology
  o Insurance   o Hospitals & Physicians   o Computers
  o Investing   x Pharmaceuticals   o Telecommunications
  o Investment Banking   o Other Health Care   o Other Technology
  o Pooled Investment Fund

        Travel
  o Other Banking & Financial Services o Manufacturing   o Airlines & Airports
  Real Estate   o Lodging & Conventions
  o Commercial   o Tourism & Travel Services
  o Construction   o Other Travel
  o REITS & Finance o Other
  o Residential  
  o Other Real Estate  
o Business Services  
  Energy  
  o Coal Mining  
  o Electric Utilities  
  o Energy Conservation  
  o Environmental Services  
  o Oil & Gas  
  o Other Energy  


5. Issuer Size
Revenue Range Aggregate Net Asset Value Range
o No Revenues o No Aggregate Net Asset Value
o $1 - $1,000,000 o $1 - $5,000,000
o $1,000,001 - $5,000,000 o $5,000,001 - $25,000,000
o $5,000,001 - $25,000,000 o $25,000,001 - $50,000,000
o $25,000,001 - $100,000,000 o $50,000,001 - $100,000,000
o Over $100,000,000 o Over $100,000,000
x Decline to Disclose o Decline to Disclose
o Not Applicable o Not Applicable


6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
o Rule 504(b)(1) (not (i), (ii) or (iii)) o Rule 505
o Rule 504 (b)(1)(i) x Rule 506(b)
o Rule 504 (b)(1)(ii) o Rule 506(c)
o Rule 504 (b)(1)(iii) o Securities Act Section 4(a)(5)
  o Investment Company Act Section 3(c)

7. Type of Filing
x New Notice Date of First Sale  2020-05-06 o First Sale Yet to Occur
o Amendment

8. Duration of Offering
Does the Issuer intend this offering to last more than one year? o Yes x No

9. Type(s) of Securities Offered (select all that apply)
o Pooled Investment Fund Interests o Equity
o Tenant-in-Common Securities o Debt
o Mineral Property Securities x 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 o 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? o 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 o 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  3RD FLOOR
City State/Province/Country ZIP/Postal Code
 NEW YORK  NEW YORK  10022
State(s) of Solicitation o All States o Foreign/Non-US
 CALIFORNIA
 NEW JERSEY
 NEW YORK
 

 



13. Offering and Sales Amounts
Total Offering Amount $ 10000001 USD o Indefinite
Total Amount Sold $ 10000001 USD  
Total Remaining to be Sold $ 0 USD o Indefinite
 
Clarification of Response (if Necessary)
 Represents the aggregate amount received from investors in connection with Issuer's registered offering of ADSs and concurrent private placement of warrants, respectively, which were issued jointly to investors for a single purchase price.


14. Investors
o Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
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: 3


15. Sales Commissions & Finders’ Fees Expenses
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 $ 700000 USD x Estimate
Finders' Fees $ 0 USD o Estimate
 
Clarification of Response (if Necessary)
 Represents 7% commission of gross proceeds from investors for sale of ADSs in the registered offering and concurrent private placement of warrants. We also paid or reimbursed expenses of $62,900 and issued unregistered warrants to purchase up to 1,750,000


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 o
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