0001213900-17-012626.txt : 20171127 0001213900-17-012626.hdr.sgml : 20171127 20171127165931 ACCESSION NUMBER: 0001213900-17-012626 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20171127 DATE AS OF CHANGE: 20171127 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: Wize Pharma, Inc. CENTRAL INDEX KEY: 0001218683 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 880445167 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-82946 FILM NUMBER: 171223428 BUSINESS ADDRESS: STREET 1: 5B HANAGAR STREET CITY: HOD HASHARON STATE: L3 ZIP: 4527708 BUSINESS PHONE: 972 472 260 0536 MAIL ADDRESS: STREET 1: 5B HANAGAR STREET CITY: HOD HASHARON STATE: L3 ZIP: 4527708 FORMER COMPANY: FORMER CONFORMED NAME: OphthaliX, Inc. DATE OF NAME CHANGE: 20120207 FORMER COMPANY: FORMER CONFORMED NAME: DENALI CONCRETE MANAGEMENT INC DATE OF NAME CHANGE: 20030213 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Sadan Simcha CENTRAL INDEX KEY: 0001721347 FILING VALUES: FORM TYPE: SC 13G MAIL ADDRESS: STREET 1: HASHOONIT 10 CITY: HERZLIYA STATE: L3 ZIP: 4655507 SC 13G 1 sc13g1117sadan_wizepharma.htm SCHEDULE 13G

 

 

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

SCHEDULE 13G

 

Under the Securities Exchange Act of 1934

(Amendment No. __)

(Rule 13d-102)

 

INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13d-1(b), (c) AND (d) AND
AMENDMENTS THERETO FILED PURSUANT TO RULE 13d-2(b)

 

Under the Securities Exchange Act of 1934

 

WIZE PHARMA, INC.
(Name of Issuer)
 
Common Stock, NIS 0.001 par value
(Title of Class of Securities)
 
97751M108
(CUSIP Number)
 
November 16, 2017
(Date of Event Which Requires Filing of this Statement)

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

 

  ☐ Rule 13d-1(b)
     
  ☒ Rule 13d-1(c)
     
  ☐ 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 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 .  97751M108  

 

1

Name of Reporting Persons/
I.R.S. Identification Nos. of above persons (entities only).

 

Simcha Sadan

2

Check the Appropriate Box if a Member of a Group

 

(a) ☐

(b) ☐

3

SEC Use only

 

4

Place of Organization

 

Israel

Number of
Shares

 5

Sole Voting Power

 

16,388,217

Beneficially
Owned by
Each

 6

Shared Voting Power 

 

0 

Reporting
Person With:

 7

Sole Dispositive Power 

 

16,388,217

8

Shared Dispositive Power 

 

0 

9

Aggregate Amount Beneficially Owned by Each Reporting Person

 

16,388,217

10

Check if the Aggregate Amount in Row (9) Excludes Certain Shares     ☐

 

11

Percent of Class Represented by Amount in Row (9)

 

14.8%*

12

Type of Reporting Person :

 

IN
       

* Based on 104,412,510 shares of Common Stock outstanding as of November 16, 2017 (as reported by the Issuer in its Form 8-K filed with the Securities and Exchange Commission on November 16, 2017) and 6,216,869 shares of Common Stock issuable upon the exercise of warrants held by Mr. Sadan within 60 days of the date hereof.

 

 Page 2 of 4 Pages 

 

 

Item 1.

 

(a)Name of Issuer: WIZE PHARMA, INC. (the "Issuer").
  
(b)Address of Issuer’s Principal Executive Offices:
5b Hanagar Street, Hod Hasharon, Israel 4527708

 

Item 2.

 

(a) Name of Person Filing:

 

This Statement is filed by:

 

(1) Simcha Sadan

 

The foregoing is referred to as the "Reporting Person" in this Statement.

 

(b) Address of Principal Business Offices or, if none, Residence:

 

Simcha Sadan – Hashoonit 10, Herzliya Israel 4655507

 

(c)Place of Organization:

 

Not applicable.

 

(d)Title of Class of Securities:

 

Common Stock, $0.001 par value (the “Common Stock”).

 

(e)CUSIP Number:

 

97751M108

 

Item 3.If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b) or (c), check whether the person filing is a:

 

Not applicable.

 

Item 4.Ownership

 

See items 5-11 of the cover pages hereto for beneficial ownership, percentage of class and dispositive power of the Reporting Persons.

 

Item 5.Ownership of 5 Percent or Less of a Class

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 5 percent of the class of securities, check the following [ ].

 

Item 6.Ownership of More than 5 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. Certifications

 

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.

 

 Page 3 of 4 Pages 

 

 

SIGNATURES

 

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.

 

November 27, 2017

 

  /s/ Simcha Sadan
 

Simcha Sadan

 

 

 

Page 4 of 4 Pages