0001567619-23-007788.txt : 20231129 0001567619-23-007788.hdr.sgml : 20231129 20231129142051 ACCESSION NUMBER: 0001567619-23-007788 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20231129 DATE AS OF CHANGE: 20231129 EFFECTIVENESS DATE: 20231129 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: 021-498351 FILM NUMBER: 231451071 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 Sandra Morgan Momentis Surgical Ltd. 3 Yahudut Canada Street Or Yehuda L3 ISRAEL 6037503 Director Michael Stansky Momentis Surgical Ltd. 3 Yahudut Canada Street Or Yehuda L3 ISRAEL 6037503 Director Frederic Moll, M.D. Momentis Surgical Ltd. 3 Yahudut Canada Street Or Yehuda L3 ISRAEL 6037503 Director Morry Blumenfeld Momentis Surgical Ltd. 3 Yahudut Canada Street Or Yehuda L3 ISRAEL 6037503 Director Other Health Care Decline to Disclose 06b false 2023-11-16 false true true true true Simple Agreements for Future Equity ("SAFE"), including the automatic conversion into Investor Shares (or Prfd Shares); and warrants to purchase additional shares equal to 10% of type of shares issued to each investor under the SAFE ("Investor Warrants"). false 0 Ceros Financial Services, Inc. 37869 None None 1445 Research Blvd. Rockville MD MARYLAND 20850 All States false Aegis Capital Corp. 15007 None None 1345 AVENUE OF THE AMERICAS 27TH FLOOR NEW YORK NY NEW YORK 10105 All States false 10000000 627878 9372122 false 5 62788 true 0 Payment of cash commission (rounded amt reflected), and 5-year warrants to purchase Investor Shares at a discount price, the price of which is not known at this time. 0 false Momentis Surgical Ltd. /s/ Dvir Cohen Dvir Cohen Chief Executive Officer 2023-11-29