x NoneEntity Type
0001611842
 
x Corporation
o Limited Partnership
o Limited Liability Company
o General Partnership
o Business Trust
o Other
Name of Issuer
 PolyPid Ltd.
Jurisdiction of Incorporation/OrganizationISRAEL 
Year of Incorporation/Organization
  x Over Five Years Ago
  o Within Last Five Years (Specify Year)  
  o Yet to Be Formed 



2. Principal Place of Business and Contact Information
Name of Issuer 
 PolyPid Ltd. 
Street Address 1Street Address 2
 18 HASIVIM STREET 
CityState/Province/CountryZIP/Postal CodePhone No. of Issuer
 PETACH TIKVA ISRAEL 4959376 +972-74-7195700 



3. Related Persons
Last NameFirst NameMiddle Name
WeisbergAmir
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
AkselbradDiklaCzaczkes
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
EmanuelNoam
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
MukhtarShaul
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
 

 
Last NameFirst NameMiddle Name
HazanDalit
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
HarelJacob
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
BarenholzYechezkel
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
FrydmanEli
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

 
Last NameFirst NameMiddle Name
HurvitzChaim
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
SegalAnatTsour
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
KrinskyItzhak
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
RubensGerry
Street Address 1Street Address 2
c/o PolyPid Ltd.18 Hasivim Street
CityState/Province/CountryZIP/Postal Code
Petach TikvaISRAEL4959376
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

 


4. Industry Group
o Agriculture Health Care o Retailing
 Banking & Financial Services   x Biotechnology o Restaurants
  o Commercial Banking   o Health Insurance Technology
  o Insurance  o Hospitals & Physicians  o Computers
  o Investing  o Pharmaceuticals  o Telecommunications
  o Investment Banking  o Other Health Care  o Other Technology
  o Pooled Investment Fund

    Travel
  o Other Banking & Financial Services o Manufacturing  o Airlines & Airports
 Real Estate  o Lodging & Conventions
  o Commercial  o Tourism & Travel Services
  o Construction  o Other Travel
  o REITS & Finance o Other
  o Residential 
  o Other Real Estate 
o Business Services 
 Energy 
  o Coal Mining 
  o Electric Utilities 
  o Energy Conservation 
  o Environmental Services 
  o Oil & Gas 
  o Other Energy 


5. Issuer Size
Revenue RangeAggregate Net Asset Value Range
o No Revenues o No Aggregate Net Asset Value
o $1 - $1,000,000 o $1 - $5,000,000
o $1,000,001 - $5,000,000 o $5,000,001 - $25,000,000
o $5,000,001 - $25,000,000 o $25,000,001 - $50,000,000
o $25,000,001 - $100,000,000 o $50,000,001 - $100,000,000
o Over $100,000,000 o Over $100,000,000
x Decline to Disclose o Decline to Disclose
o Not Applicable o Not Applicable


6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
o Rule 504(b)(1) (not (i), (ii) or (iii)) o Rule 505
o Rule 504 (b)(1)(i) x Rule 506(b)
o Rule 504 (b)(1)(ii) o Rule 506(c)
o Rule 504 (b)(1)(iii) o Securities Act Section 4(a)(5)
  o Investment Company Act Section 3(c)

7. Type of Filing
x New Notice Date of First Sale 2019-06-28 o First Sale Yet to Occur
o Amendment

8. Duration of Offering
Does the Issuer intend this offering to last more than one year? o Yes x No

9. Type(s) of Securities Offered (select all that apply)
o Pooled Investment Fund Interests x Equity
o Tenant-in-Common Securities o Debt
o Mineral Property Securities x Option, Warrant or Other Right to Acquire Another Security
o Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security o Other (describe)
  


10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? o Yes x No
 
Clarification of Response (if Necessary) 
  

11. Minimum Investment
Minimum investment accepted from any outside investor$ 50000 USD

12. Sales Compensation
RecipientRecipient CRD Number o None
 National Securities Corporation 7569
(Associated) Broker or Dealer o None(Associated) Broker or Dealer CRD Number o None
 National Securities Corporation 7569
Street Address 1Street Address 2
 200 VESEY STREET, 25TH FLOOR  
City State/Province/CountryZIP/Postal Code
 NEW YORK NEW YORK 10281
State(s) of Solicitation x All States o Foreign/Non-US
 

 



13. Offering and Sales Amounts
Total Offering Amount $ 50000000 USD o Indefinite
Total Amount Sold $ 26859292 USD 
Total Remaining to be Sold $ 23140708 USD o Indefinite
 
Clarification of Response (if Necessary)
  


14. Investors
o Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering
 
  Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: 361


15. Sales Commissions & Finders' Fees Expenses
Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
Sales Commissions$ 2743168 USD o Estimate
Finders' Fees$ 0 USD o Estimate
 
Clarification of Response (if Necessary)
 In addition to the cash commission above, issuer also issued warrants to purchase a number of shares of issuer's Series E-1 Preferred Shares equal to 10% of the aggregate amount of Series E-1 Preferred Shares sold in the offering.


16. Use of Proceeds
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
 $ 687186 USD o
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