0001567619-22-017416.txt : 20220914 0001567619-22-017416.hdr.sgml : 20220914 20220914162542 ACCESSION NUMBER: 0001567619-22-017416 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20220914 DATE AS OF CHANGE: 20220914 EFFECTIVENESS DATE: 20220914 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Momentis Surgical Ltd. CENTRAL INDEX KEY: 0001834887 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 514809664 STATE OF INCORPORATION: L3 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-458906 FILM NUMBER: 221243257 BUSINESS ADDRESS: STREET 1: 3 YAHADUT CANADA STREET CITY: OR YEHUDA STATE: L3 ZIP: 6037503 BUSINESS PHONE: 972 3 6996703 MAIL ADDRESS: STREET 1: 3 YAHADUT CANADA STREET CITY: OR YEHUDA STATE: L3 ZIP: 6037503 FORMER COMPANY: FORMER CONFORMED NAME: Memic Innovative Surgery Ltd. DATE OF NAME CHANGE: 20201203 D 1 primary_doc.xml X0708 D LIVE 0001834887 Momentis Surgical Ltd. 3 YAHADUT CANADA STREET OR YEHUDA L3 ISRAEL 6037503 972 3 6996703 ISRAEL None Memic Innovative Surgery Ltd. Other Private company organized under laws of State of Israel. true Maurice Ferre Momentis Surgical Ltd. 3 Yahudut Canada Street Or Yehuda L3 ISRAEL 6037503 Director Chairman Dvir Cohen Momentis Surgical Ltd. 3 Yahudut Canada Street Or Yehuda L3 ISRAEL 6037503 Executive Officer Chief Executive Officer Noam Atar Momentis Surgical Ltd. 3 Yahudut Canada Street Or Yehuda L3 ISRAEL 6037503 Executive Officer Chief Financial Officer Eyal Lifschitz Momentis Surgical Ltd. 3 Yahudut Canada Street Or Yehuda L3 ISRAEL 6037503 Director Lior Shahory Momentis Surgical Ltd. 3 Yahudut Canada Street Or Yehuda L3 ISRAEL 6037503 Director Irit Yaniv Momentis Surgical Ltd. 3 Yahudut Canada Street Or Yehuda L3 ISRAEL 6037503 Director Other Health Care Decline to Disclose 06b false 2022-08-30 false true true true true Series E Preferred Shares, par value of NIS 0.01 (each, a "Series E Share"), convertible into Ordinary Shares. Also 5-year warrants to purchase Series E Shares (exercise price $2.523/Share) to Placement Agent as part of compensation (see Item 15 Form D). false 0 Ceros Financial Services, Inc. 37869 None None 1445 Research Blvd. Rockville MD MARYLAND 20850 All States false 40000000 4384235 35615765 Represents aggregate maximum amount that can be offered. Sales amount rounded. false 2 238424 true 0 Amount reflects cash commission. Amount does not include the value of 5-year warrants to placement agent, since it is difficult to determine value at this time. 0 false Momentis Surgical Ltd. /s/ Dvir Cohen Dvir Cohen Chief Executive Officer 2022-09-13