SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Belenger Olivier

(Last) (First) (Middle)
ALLE DE LA RECHERECHE 12

(Street)
ANDERLECTHT C9 1070

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/21/2017
3. Issuer Name and Ticker or Trading Symbol
Orgenesis Inc. [ ORGS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 10,904,716(1) I(1) I(1)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Option To Purchase(2) 03/02/2015 11/05/2017 Common Stock 4,905,502(2) (3) I(2) I(2)
Explanation of Responses:
1. Determined in accordance with Rule 13d-3(d)(1), as a result of their cooperation and acting in concert for the sole purpose of facilitating the orderly disposition of all of their beneficial ownership in the Common Stock of the Issuer, Theodorus SCA and Theodorus II SA may be deemed to beneficially own as a group 10,904,716 shares of the Issuer's common stock. Monsieur Belenger is the investment manager for Theodorus SCA and Theodorus II SA and has sole voting and dispositive power of the shares beneficially owned by Theodorus SCA and Theodorus II SA. Monsieur Belenger expressly disclaims beneficial ownership in the shares beneficially owned by Theodorus SCA and Theodorus II SA.
2. Includes 2,452,751 shares of common stock covered by an option to purchase shares of common between Theodorus II SA and the L'Universite Libre De Bruxelles, and 2,452,751 shares of common stock covered by an option to purchase between Theodorus SCA and the L'Universite Libre De Bruxelles, all of which are exercisable within 60 days. Monsieur Belenger is the investment manager for Theodorus SCA and Theodorus II SA and has sole voting and dispositive power of the shares beneficially owned by Theodorus SCA and Theodorus II SA. Monsieur Belenger expressly disclaims beneficial ownership in the option shares beneficially owned by Theodorus SCA and Theodorus II SA.
3. The price per share shall be calculated on the basis of the total price for all shares taking into account the following formula: Total price for all shares = 750,000 EUR * (1 + 12.5%) N whereby N = the number of years after October 14, 2011, it being understood that in case the option is exercised before November 5, 2015 this number of years is increased by one (1).
/s/ Olivier Belenger 09/20/2017
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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