0001213900-11-006462.txt : 20111201
0001213900-11-006462.hdr.sgml : 20111201
20111201213050
ACCESSION NUMBER: 0001213900-11-006462
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111129
FILED AS OF DATE: 20111201
DATE AS OF CHANGE: 20111201
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hariri Robert J
CENTRAL INDEX KEY: 0001398815
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-53298
FILM NUMBER: 111238577
MAIL ADDRESS:
STREET 1: 341 MENDHAM ROAD
CITY: BERNARDSVILLE
STATE: NJ
ZIP: 07924
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Atlas Therapeutics Corp
CENTRAL INDEX KEY: 0001402479
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-MISCELLANEOUS RETAIL [5900]
IRS NUMBER: 208758875
STATE OF INCORPORATION: NV
BUSINESS ADDRESS:
STREET 1: 4640 ADMIRALTY WAY, SUITE 500
CITY: MARINA DEL REY
STATE: CA
ZIP: 90292
BUSINESS PHONE: 310-496-5727
MAIL ADDRESS:
STREET 1: 4640 ADMIRALTY WAY, SUITE 500
CITY: MARINA DEL REY
STATE: CA
ZIP: 90292
FORMER COMPANY:
FORMER CONFORMED NAME: Rough Tide Marine Operations, Inc.
DATE OF NAME CHANGE: 20100528
FORMER COMPANY:
FORMER CONFORMED NAME: Marvin's Place, Inc.
DATE OF NAME CHANGE: 20070608
4
1
f4hariri_atlas.xml
OWNERSHIP DOCUMENT
X0304
4
2011-11-29
0
0001402479
Atlas Therapeutics Corp
ATTH
0001398815
Hariri Robert J
C/O ATLAS THERAPEUTICS CORPORATION
4640 ADMIRALTY WAY, SUITE 500
MARINA DEL REY
CA
90292
1
0
1
0
Common Stock
2011-11-29
4
A
0
150000
0
A
8550000
D
18% Convertible Promissory Note
2011-11-29
4
A
0
150000
150000
A
2011-11-29
Common Stock
750000
750000
D
The shares were granted to the reporting person as additional consideration in connection with the issuance of the 18% Convertible Promissory Note in the principal amount of $150,000 (the "Note").
The Note is convertible, at the option of the reporting person, into shares of the Company's common stock at a conversion price equal to the lower of: (i) $0.20 or (ii) the conversion rate or offering price, as applicable, for the securities sold in a subsequent financing.
Reflects a conversion price of $0.20.
/s/ Robert Hariri
2011-11-30