Specialized Disclosure Report (sd)
01 June 2022 - 6:06AM
Edgar (US Regulatory)
UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM
SD
SPECIALIZED
DISCLOSURE REPORT
ScoutCam
Inc.
(Exact
name of registrant as specified in its charter)
Nevada |
|
333-188920 |
|
47-4257143 |
(State
or other jurisdiction of
incorporation or organization) |
|
(Commission
file
number) |
|
(IRS
Employer
Identification No.) |
Suite
7A, Industrial Park, P.O. Box 3030
Omer,
Israel 8496500
(Address
of principal executive offices) (Zip code)
Yovav
Sameah, +972-54-2405189
(Name
and telephone number, including area code, of the person to contact in connection with this report)
Check
the appropriate box to indicate the rule pursuant to which this form is being filed, and provide the period to which the information
in this form applies:
☒
Rule 13p-1 under the Securities Exchange Act (17 CFR 240.13p-1) for the reporting period from January 1 to December 31, 2021.
SECTION
1 – CONFLICT MINERALS DISCLOSURE
Overview
Item
1.01 Conflict Minerals Disclosure and Report
References
in this report to “ScoutCam,” “our Company,” “we,” “our,” or “us” mean ScoutCam
Inc. together with its consolidated subsidiary, ScoutCam Ltd., except where the context otherwise requires.
Our
Conflict Minerals Policy
We
fully support Rule 13p-1 under the Securities Exchange Act of 1934, as amended, and Form SD (collectively, the “Conflict Minerals
Rule”) and are committed to responsible sourcing of Conflict Minerals (as defined below). ScoutCam is committed to identifying
the potential Conflict Minerals which are necessary for the functionality or production of products manufactured by ScoutCam or for ScoutCam
by a third party manufacturer and determining the country of origin of any potential Conflict Minerals.
In
furtherance of the foregoing, we have adopted and communicated to our suppliers and to the public a company policy (the “Conflict
Minerals Policy”) for the supply chain of Conflict Minerals. As used herein and in the Conflict Minerals Policy, “Conflict
Minerals” consist of columbite-tantalite (coltan), cassiterite, gold, wolframite and the derivatives tantalum, tin and tungsten,
without regard to the location of origin.
Our conflict mineral policy encourage our
suppliers to develop conflict minerals policies, due diligence frameworks and management systems that are designed to prevent conflict
minerals that are not "DRC Conflict Free" from being included in the products sold to us and our subsidiary. We work with our
suppliers to comply with the SEC reporting requirements on conflict mineral by asking them to (i) certify to the best of their knowledge
the conflict minerals status of the component supplied to us and (ii) update us of any future change in such status. It is our policy
to work to refrain from using smelters or refiners from conflict affected and high-risk areas, as reported by relevant suppliers in our
supply chain. Our Conflict Minerals Policy
indicates that suppliers who do not comply with the foregoing expectations will be reviewed and evaluated accordingly for future business
and sourcing decisions.
Applicability
of the Conflict Minerals Rule to Our Company
A
review of our products was completed in 2022 (covering the 2021 period). It was determined that Conflict Minerals could feasibly be found
within or as part of our miniature cameras and their complementary technologies such as illumination and irrigation mechanisms, as well
as their control and video processing units, for use in various medical procedures, as well
as specialized industrial applications.
We
believe that we are in most cases many levels removed from mines, smelters and refiners and have limited influence over the mines, smelters,
refiners and many of the other vendors in our supply chain. However, through the efforts described in this Form SD and the Conflict Minerals
Report included as an exhibit hereto, we seek to ensure that our sourcing practices are consistent with our Conflict Minerals Policy
and to encourage conflict-free sourcing in our supply chain.
Reasonable
Country of Origin Information
In
connection with the reasonable country of origin inquiry (“RCOI”) required by the Conflict Minerals Rule, we utilized
the same process and procedures that we established for our due diligence, including that suppliers certify to the best of their knowledge
the Conflict Minerals status of the components they supply to us and agree to update us of any future change in such status. Our due
diligence process and procedures are more fully described in the Conflict Minerals Report included as an exhibit hereto.
Despite
our RCOI and ongoing due diligence, we do not yet have sufficient information to determine the country of origin of the Conflict Minerals
used in our products or to identify the facilities used to process those Conflict Minerals.
Therefore,
we cannot exclude the possibility that some of those Conflict Minerals may have originated in the Democratic Republic of the Congo or
an adjoining country and/or are not from recycled or scrap sources.
As
such, we have determined that our products — consisting of miniaturized video cameras for use in various medical procedures
and certain specialized industrial applications — that we produced in the calendar year 2021 are “DRC Conflict Undeterminable.”
As a result we have filed a Conflict Minerals Report.
Website
Disclosure
As
required by the Conflict Minerals Rule, the foregoing information is available at our Internet website — www.scoutcam.com
. The information contained on our website is not incorporated by reference into this Form SD or our Conflict Minerals Report and should
not be considered part of this Form SD or our Conflict Minerals Report.
Item
1.02 Exhibit
The
Conflict Minerals Report required by Item 1.01 is filed as Exhibit 1.01 to this Form SD.
As
required by the Conflict Minerals Rule, a Conflict Minerals Report is provided as an exhibit to this Form SD and is available at our
Internet website — www.scoutcam.com (under “Investors”—”SEC Filings”).
SECTION
2 – EXHIBITS
Item
2.01 Exhibits
Signature
Pursuant
to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by
the duly authorized undersigned.
ScoutCam
Inc.
(Registrant)
By:
|
/s/
Yovav Sameah |
|
May
31, 2022 |
|
Yovav
Sameah |
|
Date |
|
Chief
Executive Officer |
|
|
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