Amended Statement of Ownership (sc 13g/a)
29 Janvier 2021 - 12:19PM
Edgar (US Regulatory)
UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE
13G
Under the Securities Exchange Act of
1934
(Amendment No.
1)*
My
Size, Inc.
(Name
of Issuer)
Common
Stock, $0.001 par value per share
(Title
of Class of Securities)
62844N208
(CUSIP
Number)
December 31, 2020
(Date
of Event Which Requires Filing of this Statement)
Check
the appropriate box to designate the rule pursuant to which this Schedule is filed:
*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 the disclosures provided in a prior
cover page.
The information required in the remainder
of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of
1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions
of the Act (however, see the Notes).
1.
|
Names
of Reporting Persons.
Mitchell
P. Kopin
|
2.
|
Check
the Appropriate Box if a Member of a Group (See Instructions)
(a) ☐
(b) ☐
|
3.
|
SEC
Use Only
|
4.
|
Citizenship
or Place of Organization
|
|
|
|
United
States of America
|
Number
of
Shares
Beneficially
Owned by
Each
Reporting
Person With:
|
5.
|
Sole
Voting Power
0
|
6.
|
Shared
Voting Power
626,145
|
7.
|
Sole
Dispositive Power
0
|
8.
|
Shared
Dispositive Power
626,145
|
9.
|
Aggregate
Amount Beneficially Owned by Each Reporting Person
626,145 (see Item 4)
|
10.
|
Check
if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) ☐
|
11.
|
Percent
of Class Represented by Amount in Row (9)
8.0%
(see Item 4)
|
12.
|
Type
of Reporting Person (See Instructions)
IN; HC
|
1.
|
Names
of Reporting Persons.
Daniel B. Asher
|
2.
|
Check
the Appropriate Box if a Member of a Group (See Instructions)
(a) ☐
(b) ☐
|
3.
|
SEC
Use Only
|
4.
|
Citizenship
or Place of Organization
|
|
|
|
United
States of America
|
Number
of
Shares
Beneficially
Owned by
Each
Reporting
Person With:
|
5.
|
Sole
Voting Power
0
|
6.
|
Shared
Voting Power
626,145
|
7.
|
Sole
Dispositive Power
0
|
8.
|
Shared
Dispositive Power
626,145
|
9.
|
Aggregate
Amount Beneficially Owned by Each Reporting Person
626,145 (see Item 4)
|
10.
|
Check
if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) ☐
|
11.
|
Percent
of Class Represented by Amount in Row (9)
8.0% (see Item 4)
|
12.
|
Type
of Reporting Person (See Instructions)
IN; HC
|
1.
|
Names
of Reporting Persons.
Intracoastal Capital LLC
|
2.
|
Check
the Appropriate Box if a Member of a Group (See Instructions)
(a) ☐
(b) ☐
|
3.
|
SEC
Use Only
|
4.
|
Citizenship
or Place of Organization
|
|
|
|
Delaware
|
Number
of
Shares
Beneficially
Owned by
Each
Reporting
Person With:
|
5.
|
Sole
Voting Power
0
|
6.
|
Shared
Voting Power
626,145
|
7.
|
Sole
Dispositive Power
0
|
8.
|
Shared
Dispositive Power
626,145
|
9.
|
Aggregate
Amount Beneficially Owned by Each Reporting Person
626,145 (see Item 4)
|
10.
|
Check
if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) ☐
|
11.
|
Percent
of Class Represented by Amount in Row (9)
8.0% (see Item 4)
|
12.
|
Type
of Reporting Person (See Instructions)
OO
|
This Amendment No. 1 is being filed jointly by the Reporting
Persons and amends the Schedule 13G initially filed by the Reporting Persons with the Securities and Exchange Commission (the
“SEC”) on January 24, 2020 (the “Schedule 13G”).
Except as set forth below, all Items of the Schedule 13G
remain unchanged. All capitalized terms not otherwise defined herein shall have the meanings ascribed to such terms in the Schedule
13G.
Item 4. Ownership.
(a) and (b):
As of the close of business on December 31, 2020, each of the
Reporting Persons may have been deemed to have beneficial ownership of 626,145 shares of Common Stock,
which consisted of (i) 171,600 shares of Common Stock issuable upon exercise of a warrant held by Intracoastal (“Intracoastal
Warrant 1”) and (ii) 454,545 shares of Common Stock issuable upon exercise of a second warrant held by Intracoastal (“Intracoastal
Warrant 2”), and all such shares of Common Stock represented beneficial
ownership of approximately 8.0% of the Common Stock, based on (1) 7,232,836 shares of Common Stock outstanding as of December 22,
2020 as reported by the Issuer, plus (2) 171,600 shares of Common Stock issuable upon exercise of Intracoastal Warrant 1 and (3)
454,545 shares of Common Stock issuable upon exercise of Intracoastal Warrant 2. The foregoing excludes (I) 4,074 shares of Common
Stock issuable upon exercise of a third warrant held by Intracoastal (“Intracoastal Warrant 3”) because Intracoastal
Warrant 3 contains a blocker provision under which the holder thereof does not have the right to exercise Intracoastal Warrant
3 to the extent (but only to the extent) that such exercise would result in beneficial ownership by the holder thereof, together
with the holder’s affiliates, and any other persons acting as a group together with the holder or any of the holder’s
affiliates, of more than 4.99% of the Common Stock and (II) 8,500 shares of Common Stock issuable upon exercise of a fourth warrant
held by Intracoastal (“Intracoastal Warrant 4”) because Intracoastal Warrant 4 contains a blocker provision
under which the holder thereof does not have the right to exercise Intracoastal Warrant 4 to the extent (but only to the extent)
that such exercise would result in beneficial ownership by the holder thereof, together with the holder’s affiliates, and
any other persons acting as a group together with the holder or any of the holder’s affiliates, of more than 4.99% of the
Common Stock. Without such blocker provisions, each of the Reporting Persons may have been deemed to have beneficial ownership
of 638,719 shares of Common Stock.
(c) Number of shares
as to which each Reporting Person has:
(i) Sole power to vote or to direct the vote: 0
.
(ii) Shared power to vote or to direct the vote:
626,145 .
(iii) Sole power to dispose or to direct the disposition
of 0 .
(iv) Shared power to dispose or to direct the disposition
of 626,145 .
Item 10. Certification
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, other than activities solely
in connection with a nomination under §240.14a-11.
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: January 29, 2021
|
/s/ Mitchell
P. Kopin
|
|
Mitchell P. Kopin
|
|
|
|
|
/s/ Daniel
B. Asher
|
|
Daniel B. Asher
|
|
|
|
Intracoastal Capital LLC
|
|
|
|
|
By:
|
/s/ Mitchell
P. Kopin
|
|
|
Mitchell P. Kopin, Manager
|
Page 6 of 6
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