Filing Details
- Accession Number:
- 0001654954-18-001455
- Form Type:
- 13G Filing
- Publication Date:
- 2018-02-13 17:11:11
- Filed By:
- Groussman Mark
- Company:
- Polarityte Inc. (NASDAQ:PTE)
- Filing Date:
- 2018-02-13
- SEC Url:
- 13G Filing
Ownership Summary
Please notice the below summary table is generated without human intervention and may contain errors. Please refer to the complete filing displayed below for exact figures.
| Name | Sole Voting Power | Shared Voting Power | Sole Dispositive Power | Shared Dispositive Power | Aggregate Amount Owned Power | Percent of Class |
|---|---|---|---|---|---|---|
| Mark Groussman | 0 | 5 | 0 | 540,391 | 540,391 | 7.73% |
| Melechdavid, Inc | 0 | 472,800 | 0 | 472,800 | 472,800 | 6.76% |
| Melechdavid, Inc. Retirement Plan | 0 | 67,591 | 0 | 67,591 | 67,591 | 0.97% |
Filing
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
Amendment No. 6
To
SCHEDULE 13G
(Rule 13d-102)
INFORMATION TO BE INCLUDED IN STATEMENTS FILED
PURSUANT
TO RULE 13d-1(b) (c), AND (d) AND AMENDMENTS THERETO FILED PURSUANT
TO
RULE 13d-2(b)
POLARITYTE,
INC.
(Name
of Issuer)
COMMON
STOCK
(Title
of Class of Securities)
731094108
(CUSIP
Number)
December 31,
2017
(Date
of Event Which Requires Filing of This Statement)
Check
the appropriate box to designate the rule pursuant to which this
Schedule is filed:
[ ] Rule
13d-1(b)
[X]
Rule 13d-1(c)
[ ] Rule
13d-1(d)
| CUSIP
No. 731094108 |
| 1 | NAME OF REPORTING
PERSONS S.S. OR I.R.S.
IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Mark
Groussman |
| 2 | CHECK THE
APPROPRIATE BOX IF A MEMBER OF A
GROUP* (a)
◻
(b) ◻ |
| 3 | SEC USE
ONLY |
| 4 | CITIZENSHIP OR
PLACE OF ORGANIZATION United
States |
| NUMBER OF
SHARES | 5 | SOLE VOTING
POWER 0 |
| BENEFICIALLY OWNED
BY | 6 | SHARED VOTING
POWER 540,391(1) |
| EACH REPORTING | 7 | SOLE DISPOSITIVE
POWER 0 |
| PERSON WITH | 8 | SHARED DISPOSITIVE
POWER 540,391(1) |
| 9 | AGGREGATE AMOUNT
BENEFICIALLY OWNED BY EACH REPORTING PERSON 540,391(1) |
| 10 | CHECK IF THE
AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE
INSTRUCTIONS) ☐ |
| 11 | PERCENT OF CLASS
REPRESENTED BY AMOUNT IN ROW 9 7.73% (Based on 6,992,044 shares outstanding as of
December 31, 2017) |
| 12 | TYPE OF REPORTING
PERSON* IN |
(1)
Includes (i)
472,800 shares of common stock held by Melechdavid, Inc.
(“Melechdavid”) and (ii) 67,591 shares of common stock
held by Melechdavid, Inc. Retirement Plan (“Retirement
Plan”). Excludes 54,545 shares of common stock underlying
Series F Convertible Preferred Stock held by Melechdavid. The
Series F Convertible Preferred Stock contains an ownership
limitation such that the holder may not convert any of such
securities to the extent that conversion would result in the
holder’s beneficial ownership being in excess of 4.99%. Mark
Groussman is the President of Melechdavid and the trustee of
Retirement Plan and in such capacities has voting and dispositive
power over the securities held by such entities.
| CUSIP
No. 731094108 |
| 1 | NAME OF REPORTING
PERSONS S.S. OR I.R.S.
IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Melechdavid,
Inc. |
| 2 | CHECK THE
APPROPRIATE BOX IF A MEMBER OF A
GROUP*
(a) ◻ (b)
◻ |
| 3 | SEC USE
ONLY |
| 4 | CITIZENSHIP OR
PLACE OF ORGANIZATION Florida |
| NUMBER OF
SHARES | 5 | SOLE VOTING
POWER 0 |
| BENEFICIALLY OWNED
BY | 6 | SHARED VOTING
POWER 472,800
(1) |
| EACH REPORTING | 7 | SOLE DISPOSITIVE
POWER 0 |
| PERSON WITH | 8 | SHARED DISPOSITIVE
POWER 472,800
(1) |
| 9 | AGGREGATE AMOUNT
BENEFICIALLY OWNED BY EACH REPORTING PERSON 472,800
(1) |
| 10 | CHECK IF THE
AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE
INSTRUCTIONS) ☐ |
| 11 | PERCENT OF CLASS
REPRESENTED BY AMOUNT IN ROW 9 6.76% (Based on 6,992,044 shares outstanding as of
December 31, 2017) |
| 12 | TYPE OF REPORTING
PERSON* CO |
(1)
Includes 472,800
shares of common stock held by Melechdavid. Excludes 54,545 shares
of common stock underlying Series F Convertible Preferred Stock
held by Melechdavid. The Series F Convertible Preferred Stock
contains an ownership limitation such that the holder may not
convert any of such securities to the extent that conversion would
result in the holder’s beneficial ownership being in excess
of 4.99%. Mark Groussman is the President of Melechdavid in such
capacity has voting and dispositive power over the securities held
by such entity.
| CUSIP
No. 731094108 |
| 1 | NAME OF REPORTING
PERSONS S.S. OR I.R.S.
IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Melechdavid, Inc.
Retirement Plan |
| 2 | CHECK THE
APPROPRIATE BOX IF A MEMBER OF A
GROUP*
(a) ◻ (b)
◻ |
| 3 | SEC USE
ONLY |
| 4 | CITIZENSHIP OR
PLACE OF ORGANIZATION |
| NUMBER OF
SHARES | 5 | SOLE VOTING
POWER 0 |
| BENEFICIALLY OWNED
BY | 6 | SHARED VOTING
POWER 67,591(1) |
| EACH REPORTING | 7 | SOLE DISPOSITIVE
POWER 0 |
| PERSON WITH | 8 | SHARED DISPOSITIVE
POWER 67,591(1) |
| 9 | AGGREGATE AMOUNT
BENEFICIALLY OWNED BY EACH REPORTING PERSON 67,591(1) |
| 10 | CHECK IF THE
AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE
INSTRUCTIONS) ☐ |
| 11 | PERCENT OF CLASS
REPRESENTED BY AMOUNT IN ROW 9 0.97% (Based on 6,992,044 shares outstanding as of
December 31, 2017) |
| 12 | TYPE OF REPORTING
PERSON* OO |
(1)
Mark Groussman
is the trustee of Retirement Plan and in such capacity has voting
and dispositive power over the securities held by such
entity.
Item
1(a).
Name of
Issuer:
PolarityTE,
Inc., a Delaware corporation (“Issuer”)
Item
1(b).
Address of Issuer's
Principal Executive Offices:
Item
2(a).
Name of Person
Filing.
The
statement is filed on behalf of Mark Groussman, Melechdavid, and
Retirement Plan (together, the “Reporting
Person”).
Item
2(b).
Address of
Principal Business Office or, if None, Residence.
5154 La Gorce Drive, Miami Beach, FL 33140
Item
2(c).
Citizenship.
United
States/Florida
Item
2(d).
Title of Class of
Securities.
Common
Stock, par value $0.001.
Item
2(e).
CUSIP
Number.
731094108
Item
3.
Type of
Person
Not
applicable.
Item
4.
Ownership.
(a)
Amount beneficially owned: 540,391 (1)
(b)
Percent
of class: 7.73% (Based on 6,992,044
shares outstanding as of December 31,
2017)
(c)
Number of shares as to which the person has:
(i)
Sole power to vote or to direct the vote: 0
(ii)
Shared power to vote or to direct the vote: 540,391 (1)
(iii)
Sole power to dispose or to direct the disposition of:
0
(iv)
Shared power to dispose or to direct the disposition of: 540,391
(1)
(1)
Includes (i)
472,800 shares of common stock held by Melechdavid and (ii) 67,591
shares of common stock held by Retirement Plan. Excludes 54,545
shares of common stock underlying Series F Convertible Preferred
Stock held by Melechdavid. The Series F Convertible Preferred Stock
contains an ownership limitation such that the holder may not
convert any of such securities to the extent that conversion would
result in the holder’s beneficial ownership being in excess
of 4.99%. Mark Groussman is the President of Melechdavid and the
trustee of Retirement Plan and in such capacities has voting and
dispositive power over the securities held by such
entities.
Item
5.
Ownership of Five
Percent or Less of a Class.
Not
applicable.
Item
6.
Ownership of More
than Five Percent on Behalf of Another Person.
Not
applicable.
Item
7.
Identification and
Classification of the Subsidiary Which Acquired the Security Being
Reported by the Parent Holding Company.
Not
applicable.
Item
8.
Identification and
Classification of Members of the Group.
Not
applicable.
Item
9.
Notice of
Dissolution of Group.
Not
applicable.
Item
10.
Certifications.
By
signing below I certify that, to the best of my knowledge and
belief, the securities referred to above were not acquired and are
not held for the purpose of or with the effect of changing or
influencing the control of the issuer of the securities and were
not acquired and are not held in connection with or as a
participant in any transaction having that purpose or
effect.
SIGNATURE
After
reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true,
complete and correct.
| | | | |
| Date: February 14,
2018 | | /s/
Mark Groussman | |
| | | Mark
Groussman | |
| | | Melechdavid,
Inc. | |
| Date: February 14,
2018 | By: | /s/
Mark Groussman | |
| | | Mark
Groussman, President | |
| | | Melechdavid,
Inc. Retirement Plan | |
| Date:
February 14, 2018 | By: | /s/
Mark Groussman | |
| | | Mark
Groussman, Trustee | |