Amended Statement of Ownership (sc 13g/a)
March 16 2021 - 2:46PM
Edgar (US Regulatory)
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G/A
Under the Securities Exchange Act of
1934
(Amendment No. 1)*
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MICT Inc.
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(Name of Issuer)
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Common Stock, $0.001 par value
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(Title of Class of Securities)
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55328R109
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(CUSIP Number)
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March 12, 2021
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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:
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☐
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Rule 13d-1(b)
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☒
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Rule 13d-1(c)
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☐
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Rule 13d-1(d)
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* 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 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).
1
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NAME OF REPORTING PERSONS
Altium Capital Management, LP
I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS
(ENTITIES ONLY) EIN: 82-2066653
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2
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
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(a) ☐
(b) ☒
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3
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SEC USE ONLY
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4
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CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware, United States of America
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NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON
WITH:
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5
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SOLE VOTING
0
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6
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SHARED VOTING POWER
1,567,476 shares of Common Stock
4,355,102 shares of Common Stock issuable upon exercise of Warrants
(1)
3,210,272 shares of Common Stock issuable upon exercise of Series
A Warrants(1)
1,605,136 shares of Common Stock issuable upon exercise of Series
B Warrants(1)
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7
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SOLE DISPOSITIVE POWER
0
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8
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SHARED DISPOSITIVE POWER
1,567,476 shares of Common Stock
4,355,102 shares of Common Stock issuable upon exercise of Warrants
(1)
3,210,272 shares of Common Stock issuable upon exercise of Series
A Warrants(1)
1,605,136 shares of Common Stock issuable upon exercise of Series
B Warrants(1)
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9
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
1,567,476 shares of Common Stock
4,355,102 shares of Common Stock issuable upon exercise of Warrants
(1)
3,210,272 shares of Common Stock issuable upon exercise of Series
A Warrants(1)
1,605,136 shares of Common Stock issuable upon exercise of Series
B Warrants(1)
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10
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES
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☐
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11
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
4.9% (2)
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12
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TYPE OF REPORTING PERSON
IA, PN
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(1) As
more fully described in Item 4, the Warrants, Series A Warrants and Series B Warrants are each subject to a 4.99% blocker. However,
as more fully described in Item 4, the securities reported in rows (6), (8) and (9) show the number of shares of Common Stock that
would be issuable upon full conversion and exercise of such reported securities and do not give effect to such blockers. Therefore,
the actual number of shares of Common Stock beneficially owned by each such Reporting Person, after giving effect to such blockers,
is less than the number of securities reported in rows (6), (8) and (9).
(2) Based
on 114,117,950 shares of Common Stock outstanding as of March 02, 2021 as set forth in the Issuer’s Form 424(b)(5) filed
with the Securities and Exchange Commission on March 04, 2021.
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1
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NAME OF REPORTING PERSONS
Altium Growth Fund, LP
I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS
(ENTITIES ONLY) EIN: 82-2105101
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2
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
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(a) ☐
(b) ☒
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3
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SEC USE ONLY
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4
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CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware, United States of America
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NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON
WITH:
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5
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SOLE VOTING
0
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6
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SHARED VOTING POWER
1,567,476 shares of Common Stock
4,355,102 shares of Common Stock issuable upon exercise of Warrants
(1)
3,210,272 shares of Common Stock issuable upon exercise of Series
A Warrants(1)
1,605,136 shares of Common Stock issuable upon exercise of Series
B Warrants(1)
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7
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SOLE DISPOSITIVE POWER
0
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8
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SHARED DISPOSITIVE POWER
1,567,476 shares of Common Stock
4,355,102 shares of Common Stock issuable upon exercise of Warrants
(1)
3,210,272 shares of Common Stock issuable upon exercise of Series
A Warrants(1)
1,605,136 shares of Common Stock issuable upon exercise of Series
B Warrants(1)
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9
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
1,567,476 shares of Common Stock
4,355,102 shares of Common Stock issuable upon exercise of Warrants
(1)
3,210,272 shares of Common Stock issuable upon exercise of Series
A Warrants(1)
1,605,136 shares of Common Stock issuable upon exercise of Series
B Warrants(1)
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10
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES
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☐
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11
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
4.9% (2)
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12
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TYPE OF REPORTING PERSON
PN
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(1)
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As more fully described in Item 4, the Warrants, Series A Warrants and Series B Warrants are each
subject to a 4.99% blocker. However, as more fully described in Item 4, the securities reported in rows (6), (8) and (9) show the
number of shares of Common Stock that would be issuable upon full conversion and exercise of such reported securities and do not
give effect to such blockers. Therefore, the actual number of shares of Common Stock beneficially owned by each such Reporting
Person, after giving effect to such blockers, is less than the number of securities reported in rows (6), (8) and (9).
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(2)
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Based on 114,117,950 shares of Common Stock outstanding as of March 02, 2021 as set forth in the
Issuer’s Form 424(b)(5) filed with the Securities and Exchange Commission on March 04, 2021.
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1
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NAME OF REPORTING PERSONS
Altium Growth GP, LLC
I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS
(ENTITIES ONLY) EIN: 82-2086430
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2
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
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(a) ☐
(b) ☒
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3
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SEC USE ONLY
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4
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CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware, United States of America
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NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON
WITH:
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5
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SOLE VOTING
0
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6
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SHARED VOTING POWER
1,567,476 shares of Common Stock
4,355,102 shares of Common Stock issuable upon exercise of Warrants
(1)
3,210,272 shares of Common Stock issuable upon exercise of Series
A Warrants(1)
1,605,136 shares of Common Stock issuable upon exercise of Series
B Warrants(1)
|
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7
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SOLE DISPOSITIVE POWER
0
|
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8
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SHARED DISPOSITIVE POWER
1,567,476 shares of Common Stock
4,355,102 shares of Common Stock issuable upon exercise of Warrants
(1)
3,210,272 shares of Common Stock issuable upon exercise of Series
A Warrants(1)
1,605,136 shares of Common Stock issuable upon exercise of Series
B Warrants(1)
|
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9
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
1,567,476 shares of Common Stock
4,355,102 shares of Common Stock issuable upon exercise of Warrants
(1)
3,210,272 shares of Common Stock issuable upon exercise of Series
A Warrants(1)
1,605,136 shares of Common Stock issuable upon exercise of Series
B Warrants(1)
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10
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES
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☐
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11
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
4.9% (2)
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12
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TYPE OF REPORTING PERSON
OO
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(1)
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As more fully described in Item 4, the Warrants, Series A Warrants and Series B Warrants are each
subject to a 4.9% blocker. However, as more fully described in Item 4, the securities reported in rows (6), (8) and (9) show the
number of shares of Common Stock that would be issuable upon full conversion and exercise of such reported securities and do not
give effect to such blockers. Therefore, the actual number of shares of Common Stock beneficially owned by each such Reporting
Person, after giving effect to such blockers, is less than the number of securities reported in rows (6), (8) and (9).
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(2)
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Based on 114,117,950 shares of Common Stock outstanding as of March 02, 2021 as set forth in the
Issuer’s Form 424(b)(5) filed with the Securities and Exchange Commission on March 04, 2021.
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Item 1(a).
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Name of Issuer:
MICT Inc. (the “Issuer”)
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Item 1(b).
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Address of Issuer’s Principal Executive Offices:
28
West Grand Avenue, Suite 3
Montvale, New Jersey 07645
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Item 2(a).
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Name of Person Filing:
This statement is jointly filed by and on behalf
of each of Altium Growth Fund, LP (the “Fund”), Altium Capital Management, LLC, and Altium Growth GP, LLC. The Fund
is the record and direct beneficial owner of the securities covered by this statement. Altium Capital Management, LP is the investment
adviser of, and may be deemed to beneficially own securities, owned by, the Fund. Altium Growth GP, LLC is the general partner
of, and may be deemed to beneficially own securities owned by, the Fund.
Each reporting person declares that neither the filing of this statement
nor anything herein shall be construed as an admission that such person is, for the purposes of Section 13(d) or 13(g) of the Act
or any other purpose, the beneficial owner of any securities covered by this statement.
Each of the reporting persons may be deemed
to be a member of a group with respect to the Issuer or securities of the Issuer for the purposes of Section 13(d) or 13(g) of
the Act. Each of the reporting persons declares that neither the filing of this statement nor anything herein shall be construed
as an admission that such person is, for the purposes of Section 13(d) or 13(g) of the Act or any other purpose, (i) acting (or
has agreed or is agreeing to act together with any other person) as a partnership, limited partnership, syndicate, or other group
for the purpose of acquiring, holding, or disposing of securities of the Issuer or otherwise with respect to the Issuer or any
securities of the Issuer or (ii) a member of any group with respect to the Issuer or any securities of the Issuer.
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Item 2(b).
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Address of Principal Business Office or, if None, Residence:
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The address of the principal business office of each of the reporting persons is
152 West 57th Street, FL 20, New York, NY 10019
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Item 2(c).
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Citizenship:
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See Item 4 on the cover page(s) hereto.
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Item 2(d).
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Title of Class of Securities:
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Common Stock, $0.001 par value (“Common Stock”)
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Item 2(e).
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CUSIP Number: 55328R109
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Item 3.
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If This Statement is Filed Pursuant to §§240.13d-1(b), or 240.13d-2(b) or (c), Check Whether the Person Filing is a:
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(a)
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☐
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Broker or dealer registered under Section 15 of the Act (15 U.S.C. 78o).
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(b)
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☐
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Bank as defined in Section 3(a)(6) of the Act (15 U.S.C. 78c).
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(c)
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☐
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Insurance company
as defined in Section 3(a)(19) of the Act (15 U.S.C. 78c).
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(d)
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☐
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Investment
company registered under Section 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8).
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(e)
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☐
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An investment adviser in accordance with §240.13d-1(b)(1)(ii)(E);
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(f)
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☐
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An employee benefit plan or endowment fund in accordance with §240.13d-1(b)(1)(ii)(F);
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(g)
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☐
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A parent holding company or control person in accordance with §240.13d-1(b)(ii)(G);
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(h)
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☐
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A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);
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(i)
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☐
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A church plan that is excluded from the definition of an investment company under Section 3(c)(14) of the Investment Company Act (15 U.S.C. 80a-3);
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(j)
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☐
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Group, in accordance with §240.13d-1(b)(1)(ii)(J).
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Item 4.
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Ownership.
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Provide the following information regarding the aggregate number
and percentage of the class of securities of the issuer identified in Item 1.
The information as of the date of the event
which requires filing of this statement required by Items 4(a) – (c) is set forth in Rows 5 – 11 of the cover page
for each Reporting Person listed above and is incorporated by reference for each such Reporting Person. The percentage set forth
in Row 11 of the cover page for each Reporting Person is based on 114,117,950 shares of Common Stock outstanding as of March 02,
2021 as set forth in the Issuer’s Form 424(b)(5) filed with the Securities and Exchange Commission on March 04, 2021
Pursuant to the terms of the securities
purchase agreement entered into between the Fund and the Issuer, the Fund purchased Common Stock, Warrants, Series A Warrants,
and Series B Warrants. The Reporting Persons can neither exercise the Warrants, Series A Warrants nor the Series B Warrants to
the extent the Reporting Persons would beneficially own, after any such exercise, more than 4.9% of the outstanding shares of Common
Stock (the “Warrant Blocker”). The percentage set forth in Row 11 of the cover page for each Reporting Person
gives effect to the Warrant Blocker.
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Item 5.
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Ownership of Five Percent or Less of a Class.
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If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following ☒
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Item 6.
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Ownership of More than Five Percent on Behalf of Another Person.
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Not applicable
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Item 7.
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Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person.
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Not applicable
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Item 8.
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Identification and Classification of Members of the Group.
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Not applicable
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Item 9.
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Notice of Dissolution of Group.
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Not applicable
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Item 10.
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Certification.
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By signing below I certify that, to the best of my knowledge
and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing
or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant
in any transaction having that purpose or effect, other than activities solely in connection with a nomination under §
240.14a-11.
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.
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Dated:
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March 16, 2021
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Altium Capital Management, LP
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By:
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/s/ Jacob Gottlieb
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Name:
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Jacob Gottlieb
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Title:
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CEO
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Altium Growth Fund, LP
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By: Altium Growth GP, LLC
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Its: General Partner
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Signature:
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/s/ Jacob Gottlieb
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Name:
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Jacob Gottlieb
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Title:
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Managing Member of Altium Growth GP, LLC
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Altium Growth GP, LLC
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By:
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/s/ Jacob Gottlieb
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Name:
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Jacob Gottlieb
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Title:
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Managing Member
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EXHIBIT INDEX
EXHIBIT 1: Joint Acquisition Statement Pursuant to Section 240.13d-1(k)
Members of Group
EXHIBIT 1
JOINT ACQUISITION STATEMENT
PURSUANT TO SECTION 240.13d-1(k)
The undersigned acknowledge and agree that
the foregoing statement on Schedule 13G is filed on behalf of each of the undersigned and that all subsequent amendments to this
statement on Schedule 13G shall be filed on behalf of each of the undersigned without the necessity of filing additional joint
acquisition statements. The undersigned acknowledge that each shall be responsible for the timely filing of such amendments,
and for the completeness and accuracy of the information concerning him, her or it contained therein, but shall not be responsible
for the completeness and accuracy of the information concerning the other entities or persons, except to the extent that he, she
or it knows or has reason to believe that such information is inaccurate.
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Dated:
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March 16, 2021
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Altium Capital Management, LP
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By:
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/s/ Jacob Gottlieb
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Name:
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Jacob Gottlieb
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Title:
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CEO
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Altium Growth Fund, LP
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By: Altium Growth GP, LLC
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Its: General Partner
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Signature:
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/s/ Jacob Gottlieb
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Name:
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Jacob Gottlieb
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Title:
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Managing Member of Altium Growth GP, LLC
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Altium Growth GP, LLC
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By:
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/s/ Jacob Gottlieb
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Name:
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Jacob Gottlieb
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Title:
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Managing Member
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