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