Sec Form 13G Filing - Jacobsen Per A. filing for MARIS - TECH LTD WT PUR SHS (MTEKW) - 2024-10-15

Insider filing report for Changes in Beneficial Ownership

  • Schedule 13G & 13D forms are used to report a party's ownership of stock which exceeds 5% of a company's total stock issue.
  • Schedule 13G is a shorter version of Schedule 13D with fewer reporting requirements.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. 3)

Maris Tech Ltd.
(Name of Issuer)

Common Stock, no par value per share
Warrants to Purchase Ordinary Shares
(Title of Class of Securities)

M68057104
(CUSIP Number)

October 14, 2024
(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)



*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).

CUSIP No. M68057104

(1)
Names of Reporting Persons/ I.R.S. Identification Nos. of
Above Persons (Entities Only)
Per A. Jacobsen

(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
Maryland

Number of Shares Beneficially Owned by Each Reporting Person With

(5)
Sole Voting Power
455,480

(6)
Shared Voting Power
0

(7)
Sole Dispositive Power
455,480


(8)
Shared Dispositive Power
0

(9)
Aggregate Amount Beneficially Owned by Each Reporting Person
455,480

(10)
Check if the Aggregate Amount in Row (9) Excludes Certain Shares [  ]
(See Instructions)

(11)
Percent of Class Represented by Amount in Row (9)
5.8%

(12)
Type of Reporting Person (See Instructions)
IN

Item 1.
(a) Name of Issuer
Maris Tech Ltd.

(b) Address of Issuer's Principal Executive Offices
2 Yitzhak Modai St.
Rehovot, Israel 7608804


Item 2.
(a) Name of Person Filing
Per A. Jacobsen

(b) Address of Principal Business Office or, if none, Residence
P.O. Box 444
Ashton, MD 20861-0444

(c) Citizenship
Maryland

(d) Title of Class of Securities
Common Stock, no par value per share
Warrants to Purchase Ordinary Shares

(e) CUSIP Number
M68057104


Item 3.
If this statement is filed pursuant to 240.13d-1(b)
or 240.13d-2(b) or (c), check whether the person filing
is a:
(a)[  ] Broker or dealer registered under section 15
of the Act (15 U.S.C. 78o);

(b) [  ] Bank as defined in section 3(a)(6)
of the Act (15 U.S.C. 78c);

(c) [  ] Insurance company as defined in section 3(a)(19)
of the Act (15 U.S.C. 78c);

(d) [  ] Investment company registered under section 8
of the Investment Company Act of 1940 (15 U.S.C 80a-8);

(e) [  ] An investment adviser in accordance with
240.13d-1(b)(1)(ii)(E);

(f) [  ] An employee benefit plan or endowment fund
in accordance with 240.13d-1(b)(1)(ii)(F);

(g) [  ] A parent holding company or control person
in accordance with 240.13d-1(b)(1)(ii)(G);

(h) [  ] A savings associations as defined in
Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);

(i) [  ] A church plan that is excluded from the definition
of an investment company under section 3(c)(14) of the
Investment Company Act of 1940 (15 U.S.C. 80a-3);

(j) [  ] Group, in accordance with 240.13d-1(b)(1)(ii)(J).

Item 4.
(a) Amount beneficially owned:
As of October 15, 2024, the Reporting Person held sole voting
and dispositive power over 455,480 Ordinary Shares of the Issuer
consisting of (i) 195,000 Ordinary Shares, and (ii) warrants to
purchase up to 260,480 Ordinary Shares. The warrants were
exercisable immediately upon issuance and
will expire on January 6, 2027.

(b) Percent of class:
5.8%. The percentage of shares of the Issuer's common stock
as reported in this Schedule 13G is based upon 7,878,501
shares of the Issuer's common stock outstanding as of
June 30, 2024 on a basic shares basis, as reported in the
Issuer's  Interim Financial Statements filed on or about
August 28, 2024.

(c) Number of shares as to which the person has:

(i) Sole power to vote or to direct the vote
455,480

(ii) Shared power to vote or to direct the vote
0

(iii) Sole power to dispose or to direct the disposition of
455,480

(iv) Shared power to dispose or to direct the disposition of
0


Item 5.
Ownership of Five Percent or Less of a Class
If this statement is being filed to report
the fact that as of the date hereof the
reporting person has ceased to be the beneficial
owner of more than five percent of the class of securities,
check the following [  ]


Item 6.
Ownership of More than Five Percent
on Behalf of Another Person.
N/A


Item 7.
Identification and Classification of
the Subsidiary Which Acquired the Security Being Reported
on By the Parent Holding Company.
N/A


Item 8.
Identification and Classification of Members of the Group.
N/A


Item 9.
Notice of Dissolution of Group.
N/A


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.


SIGNATURES

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: October 15, 2024
Per A. Jacobsen:

By:
/s/ Per A. Jacobsen