0001526543-12-000001.txt : 20120131 0001526543-12-000001.hdr.sgml : 20120131 20120131142533 ACCESSION NUMBER: 0001526543-12-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20120131 DATE AS OF CHANGE: 20120131 EFFECTIVENESS DATE: 20120131 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Green Ballast, Inc. CENTRAL INDEX KEY: 0001526543 STANDARD INDUSTRIAL CLASSIFICATION: ELECTRIC LIGHTING & WIRING EQUIPMENT [3640] IRS NUMBER: 451629984 STATE OF INCORPORATION: DE FISCAL YEAR END: 1211 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-172695 FILM NUMBER: 12558668 BUSINESS ADDRESS: STREET 1: 2620 THOUSAND OAKS STREET 2: SUITE 4000 CITY: MEMPHIS STATE: TN ZIP: 38118 BUSINESS PHONE: 901-260-4400 MAIL ADDRESS: STREET 1: 2620 THOUSAND OAKS STREET 2: SUITE 4000 CITY: MEMPHIS STATE: TN ZIP: 38118 D 1 primary_doc.xml X0704 D LIVE 0001526543 Green Ballast, Inc. 2620 THOUSAND OAKS SUITE 4000 MEMPHIS TN TENNESSEE 38118 901-260-4400 DELAWARE None None Corporation true 2011 J. Kevin Adams 2620 Thousand Oaks Suite 4000 Memphis TN TENNESSEE 38118 Executive Officer Director Promoter Daniel L. Brown 2620 Thousand Oaks Suite 4000 Memphis TN TENNESSEE 38118 Executive Officer Director Promoter William Bethell 2620 Thousand Oaks Suite 4000 Memphis TN TENNESSEE 38118 Executive Officer Director Promoter Kevin Clarkson 2620 Thousand Oaks Suite 4000 Memphis TN TENNESSEE 38118 Executive Officer Director Promoter Mary F. Sharp 2620 Thousand Oaks Suite 4000 Memphis TN TENNESSEE 38118 Director John H. Lamberson, Jr. 2620 Thousand Oaks Suite 4000 Memphis TN TENNESSEE 38118 Director Peter J. Weisman 2620 Thousand Oaks Suite 4000 Memphis TN TENNESSEE 38118 Director Other Decline to Disclose 06 false 2012-01-19 false true false 0 5000000 100000 4900000 false 1 0 0 0 false Green Ballast, Inc. /s/ J. Kevin Adams J. Kevin Adams Chief Executive Officer 2012-01-31