<SEC-DOCUMENT>0001213900-17-012642.txt : 20171127
<SEC-HEADER>0001213900-17-012642.hdr.sgml : 20171127
<ACCEPTANCE-DATETIME>20171127180441
ACCESSION NUMBER:		0001213900-17-012642
CONFORMED SUBMISSION TYPE:	3
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20171116
FILED AS OF DATE:		20171127
DATE AS OF CHANGE:		20171127

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			Raveh Abir
		CENTRAL INDEX KEY:			0001723699

	FILING VALUES:
		FORM TYPE:		3
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-52545
		FILM NUMBER:		171223771

	MAIL ADDRESS:	
		STREET 1:		32A HABARZEL ST.
		CITY:			TEL AVIV
		STATE:			L3
		ZIP:			69710

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			Rimon Gold Assets Ltd
		CENTRAL INDEX KEY:			0001721808

	FILING VALUES:
		FORM TYPE:		3
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-52545
		FILM NUMBER:		171223772

	BUSINESS ADDRESS:	
		STREET 1:		RAVEN RAVID & CO.
		STREET 2:		32A HABARZEL ST.
		CITY:			TEL AVIV
		STATE:			L3
		ZIP:			6971047
		BUSINESS PHONE:		972-3-7676999

	MAIL ADDRESS:	
		STREET 1:		RAVEN RAVID & CO.
		STREET 2:		32A HABARZEL ST.
		CITY:			TEL AVIV
		STATE:			L3
		ZIP:			6971047

ISSUER:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			Wize Pharma, Inc.
		CENTRAL INDEX KEY:			0001218683
		STANDARD INDUSTRIAL CLASSIFICATION:	PHARMACEUTICAL PREPARATIONS [2834]
		IRS NUMBER:				880445167
		FISCAL YEAR END:			1231

	BUSINESS ADDRESS:	
		STREET 1:		5B HANAGAR STREET
		CITY:			HOD HASHARON
		STATE:			L3
		ZIP:			4527708
		BUSINESS PHONE:		972 472 260 0536

	MAIL ADDRESS:	
		STREET 1:		5B HANAGAR STREET
		CITY:			HOD HASHARON
		STATE:			L3
		ZIP:			4527708

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	OphthaliX, Inc.
		DATE OF NAME CHANGE:	20120207

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	DENALI CONCRETE MANAGEMENT INC
		DATE OF NAME CHANGE:	20030213
</SEC-HEADER>
<DOCUMENT>
<TYPE>3
<SEQUENCE>1
<FILENAME>f3111617rimon_wizepharma.xml
<DESCRIPTION>OWNERSHIP DOCUMENT
<TEXT>
<XML>
<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0206</schemaVersion>

    <documentType>3</documentType>

    <periodOfReport>2017-11-16</periodOfReport>

    <noSecuritiesOwned>0</noSecuritiesOwned>

    <issuer>
        <issuerCik>0001218683</issuerCik>
        <issuerName>Wize Pharma, Inc.</issuerName>
        <issuerTradingSymbol>WIZP</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001721808</rptOwnerCik>
            <rptOwnerName>Rimon Gold Assets Ltd</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>32 HABARZEL STREET</rptOwnerStreet1>
            <rptOwnerStreet2></rptOwnerStreet2>
            <rptOwnerCity>TEL AVIV</rptOwnerCity>
            <rptOwnerState>L3</rptOwnerState>
            <rptOwnerZipCode>6971047</rptOwnerZipCode>
            <rptOwnerStateDescription>ISRAEL</rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>0</isDirector>
            <isOfficer>0</isOfficer>
            <isTenPercentOwner>1</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle></officerTitle>
            <otherText></otherText>
        </reportingOwnerRelationship>
    </reportingOwner>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001723699</rptOwnerCik>
            <rptOwnerName>Raveh Abir</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>32 HABARZEL STREET</rptOwnerStreet1>
            <rptOwnerStreet2></rptOwnerStreet2>
            <rptOwnerCity>TEL AVIV</rptOwnerCity>
            <rptOwnerState>L3</rptOwnerState>
            <rptOwnerZipCode>6971047</rptOwnerZipCode>
            <rptOwnerStateDescription>ISRAEL</rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>0</isDirector>
            <isOfficer>0</isOfficer>
            <isTenPercentOwner>1</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle></officerTitle>
            <otherText></otherText>
        </reportingOwnerRelationship>
    </reportingOwner>

    <derivativeTable>
        <derivativeHolding>
            <securityTitle>
                <value>2016 Convertible Notes</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.04</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2016-03-31</value>
            </exerciseDate>
            <expirationDate>
                <value>2017-12-31</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock, par value $0.001 per share</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>13906526</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>2016 Future Investment Rights</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.06</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2016-03-31</value>
            </exerciseDate>
            <expirationDate>
                <value>2019-06-30</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock, par value $0.001 per share</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>14627926</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>2017 Convertible Notes</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.05</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2017-04-07</value>
            </exerciseDate>
            <expirationDate>
                <value>2017-12-31</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock, par value $0.001 per share</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>6071361</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>2017 Future Investment Rights</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.06</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2017-04-07</value>
            </exerciseDate>
            <expirationDate>
                <value>2019-06-30</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock, par value $0.001 per share</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>7401034</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
    </derivativeTable>

    <remarks>Rimon Gold Assets Ltd. (Rimon Gold) is an Israeli private company wholly owned by the Goldfinger Trust (the Trust), whose trustee is Abir Raveh (the Trustee). The Trust directs the management of Rimon Gold, its investment and voting decisions and the Trustee directs the management of the Trust, its investment and voting decisions. Rimon Gold's loan in the principal amount of NIS 2,000,000 (approximately $569,000), which bears interest at an annual rate of 4% (the 2016 Convertible Notes) is convertible (including accrued interest as of November 27, 2017), into 13,906,526 shares of common stock based on a conversion price per share of NIS 0.15 (approximately $0.04). Rimon Gold has the right (the 2016 Future Investment Right), until the lapse of 18 months following the conversion of the 2016 Convertible Notes, to invest up to NIS 3 million (approximately $854,000), at an agreed price per share of NIS 0.21 (approximately $0.06), if the Issuer conducts any equity financing. Rimon Gold's loan in the principal amount of NIS 1,000,000 (approximately $285,000) , which bears interest at an annual rate of 4% (the 2017 Convertible Notes) is convertible (including accrued interest as of November 27, 2017), into 6,071,361 shares of common stock based on a loan conversion price per share of NIS 0.17 (approximately $0.05). The maturity date of the 2016 Convertible Notes and the 2017 Convertible Notes is December 31, 2017. For a period of 18 months following the conversion of the 2017 Convertible Notes, Rimon Gold has the right (the 2017 Future Investment Right) to make investments in the Issuer in an amount equal to NIS 1.50 (approximately $0.40) for each NIS 1.00 (approximately $0.30) of the 2017 Convertible Notes converted, at an agreed price per share equal to 120% of the loan conversion price. US dollar translations of NIS amounts presented herein are translated using the rate of NIS 3.513 to one US dollar, the exchange rate reported by the Bank of Israel for November 26, 2017.</remarks>

    <ownerSignature>
        <signatureName>/s/ Abir Raveh</signatureName>
        <signatureDate>2017-11-27</signatureDate>
    </ownerSignature>

    <ownerSignature>
        <signatureName>/s/ Abir Raveh</signatureName>
        <signatureDate>2017-11-27</signatureDate>
    </ownerSignature>
</ownershipDocument>
</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
