UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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SCHEDULE 13D
Under the Securities Exchange Act of 1934
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MICROBOT MEDICAL INC.
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(Name of Issuer)
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Common Stock, par value $0.01 per Share
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(Title of Class of Securities)
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59503A 105
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(CUSIP Number)
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Mr. Benjamin Soffer
c/o Technion Research and Development Foundation Ltd.
Technion City, Malat Bldg., 5th Floor
Haifa, Israel 3200003
+972 829 4851
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(Name, Address and Telephone Number of Person Authorized to
Receive Notices and Communications)
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November 28, 2016
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(Date of Event which Requires Filing of this Statement)
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If the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because of §§240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box. o
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NOTE: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See Rule 13d-7 for other parties to whom copies are to be sent.
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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 disclosures provided in a prior cover page.
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CUSIP No.
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59503A 105
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1.
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Names of Reporting Person:
Technion Research and Development Foundation Ltd.
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2.
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Check the Appropriate Box if a Member of a Group (See Instructions)
(a) o
(b) o
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3.
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SEC Use Only
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4.
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Source of Funds (See Instructions):
SC
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5.
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Check if Disclosure of Legal Proceedings Is Required Pursuant to Items 2(d) or 2(e)
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o
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6.
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Citizenship or Place of Organization:
Israel
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NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON WITH
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7.
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Sole Voting Power:
3,555,339
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8.
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Shared Voting Power:
None
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9.
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Sole Dispositive Power:
3,555,339
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10.
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Shared Dispositive Power:
None
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11.
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Aggregate Amount Beneficially Owned by Each Reporting Person:
3,555,339
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12.
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Check if the Aggregate Amount in Row (11) Excludes Certain Shares (See Instructions):
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o
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13.
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Percent of Class Represented by Amount in Row (11):
9.81%
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14.
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Type of Reporting Person (See Instructions):
OO
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(a)
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As of the date of this report, Technion beneficially owns 3,555,339 shares of the Company Common Stock, which number of shares represents approximately 9.81% of the outstanding Company Common Stock based on 36,254,240 shares of outstanding Company Common Stock.
The percentage of ownership reported in this Item 5 was calculated in accordance with Rule 13d-3(d)(1)(i) promulgated under the Securities Exchange Act of 1934, as amended.
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(b)
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Technion has the power to vote or direct the vote, and to dispose or direct the disposition, of 3,555,339 shares of Company Common Stock.
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(c)
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Except as described herein, the Reporting Person has not effected any transaction in Company Common Stock in the past 60 days.
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(d) and (e)
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Not applicable
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Exhibit 1: Agreement and Plan of Merger and Reorganization (1)
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(1)
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Incorporated by reference to the Company’s Proxy Statement on Schedule 14A filed with the SEC on September 27, 2016.
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By:
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/s/ Benjamin Soffer, Manager
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Name:
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Technion Research and Development Foundation Ltd.
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