0001104659-11-028522.txt : 20110512
0001104659-11-028522.hdr.sgml : 20110512
20110512141850
ACCESSION NUMBER: 0001104659-11-028522
CONFORMED SUBMISSION TYPE: D
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: Rule 506
FILED AS OF DATE: 20110512
DATE AS OF CHANGE: 20110512
EFFECTIVENESS DATE: 20110512
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: Avantis Medical Systems Inc
CENTRAL INDEX KEY: 0001325768
IRS NUMBER: 000000000
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: D
SEC ACT: 1933 Act
SEC FILE NUMBER: 021-159709
FILM NUMBER: 11835215
BUSINESS ADDRESS:
STREET 1: 263 SANTA ANA COURT
CITY: SUNNYVALE
STATE: CA
ZIP: 94085
BUSINESS PHONE: 408-733-1901
MAIL ADDRESS:
STREET 1: 263 SANTA ANA COURT
CITY: SUNNYVALE
STATE: CA
ZIP: 94085
D
1
primary_doc.xml
X0704
D
LIVE
0001325768
Avantis Medical Systems Inc
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
408-733-1847
CALIFORNIA
None
None
Corporation
true
Richard
Randall
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Executive Officer
Director
John
Reed
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Executive Officer
Thomas
J.
Fogarty
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Director
Matthew
Jenusaitis
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Executive Officer
Director
Camran
Nezhat
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Director
Howard
Palefsky
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Director
Other Health Care
Decline to Disclose
- 06
false
2011-04-30
false
true
true
true
false
0
4400000
2210665
2189335
false
9
0
0
0
Funds to be used for working capital
false
Avantis Medical Systems Inc
/s/ Michael O'Donnell
Michael O'Donnell
Secretary
2011-05-12