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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 10/16/2023 |
3. Issuer Name and Ticker or Trading Symbol
Notable Labs, Ltd. [ NTBL ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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) |
Ordinary Shares | 968,113 | D(1) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 | ||||
Warrants (right to buy) | (2) | 06/30/2032 | Common Stock | 34,141 | 113.39 | D(1) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. The securities are held directly by B Capital Fund II, L.P. ("B Capital II"). B Capital Group Partners II, L.P. ("B Capital II GP") is the sole general partner of B Capital II. B Capital Group Investors II, Ltd. ("B Capital II Parent GP") is the sole general partner of B Capital II GP. B Capital Group Management, L.P. ("B Capital Management") serves as investment manager to B Capital II. Each of B Capital II GP, B Capital II Parent GP and B Capital Management disclaims beneficial ownership of the securities reported herein for purposes of Section 16 of the Exchange Act, except to the extent of its or his pecuniary interest therein, if any. This report shall not be deemed an admission that any of the Reporting Persons is a beneficial owner of such securities for the purpose of Section 16 of the Exchange Act, or for any other purpose. |
2. Immediately exercisable. |
B CAPITAL FUND II, L.P., By: B Capital Group Partners II, L.P., By: B Capital Group Investors II, Ltd., By: /s/ Rajarshi Ganguly, Director | 10/26/2023 | |
B CAPITAL GROUP PARTNERS II, L.P., By: B Capital Group Investors II, Ltd., By: /s/ Rajarshi Ganguly, Director | 10/26/2023 | |
B CAPITAL GROUP INVESTORS II, LTD., By: /s/ Rajarshi Ganguly, Director | 10/26/2023 | |
B CAPITAL GROUP MANAGEMENT, L.P., By: B Capital Group Ltd., By: /s/ Rajarshi Ganguly, Director | 10/26/2023 | |
** 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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |