0001582843-19-000004.txt : 20191202
0001582843-19-000004.hdr.sgml : 20191202
20191202160413
ACCESSION NUMBER: 0001582843-19-000004
CONFORMED SUBMISSION TYPE: D/A
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: 06c
FILED AS OF DATE: 20191202
DATE AS OF CHANGE: 20191202
EFFECTIVENESS DATE: 20191202
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: Certa Dose, Inc.
CENTRAL INDEX KEY: 0001582843
IRS NUMBER: 463291747
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: D/A
SEC ACT: 1933 Act
SEC FILE NUMBER: 021-354564
FILM NUMBER: 191263298
BUSINESS ADDRESS:
STREET 1: 7351 EAST LOWRY BOULEVARD, #400
CITY: DENVER
STATE: CO
ZIP: 80230
BUSINESS PHONE: (408) 835-3896
MAIL ADDRESS:
STREET 1: 7351 EAST LOWRY BOULEVARD, #400
CITY: DENVER
STATE: CO
ZIP: 80230
D/A
1
primary_doc.xml
X0708
D/A
LIVE
0001582843
Certa Dose, Inc.
7351 EAST LOWRY BOULEVARD, #400
DENVER
CO
COLORADO
80230
(408) 835-3896
DELAWARE
None
None
Corporation
true
JOHN
BLOOD
3449 Wyandot Street
Denver
CO
COLORADO
80211
Executive Officer
Former Officer who had stock in the Company. (Listed in Prior Form D Filings.)
STEPHEN
R
HOFFENBERG
48 Brookhaven Drive
Littleton
CO
COLORADO
80123
Director
Former Director who had notes and stock in the Company. (Listed in prior Form D Filings.)
STEVE
RUBIN
7351 East Lowry Boulevard, Suite 400
Denver
CO
COLORADO
80230
Director
Former Director of the Company. (Listed in prior Form D. Filings.)
Caleb
S.
Hernandez
7351 East Lowry Boulevard, Suite 400
Denver
CO
COLORADO
80230
Executive Officer
Director
Daniel
Hoffman
7351 EAST LOWRY BOULEVARD, #400
DENVER
CO
COLORADO
80230
Executive Officer
Director
Other Health Care
Decline to Disclose
- 06c
true
0001582843-19-000003
2019-11-15
false
true
This was an automatic conversion of the promissory notes that had been identified in prior Form D Filings. They converted on 11/15/19, and 15 days later was a Saturday 11/30/19. This filing is on the first business day since.
false
25000
None (Not Applicable)
None
None
None
None (Not Applicable)
Denver
CO
COLORADO
80230
CO
COLORADO
FL
FLORIDA
IL
ILLINOIS
NY
NEW YORK
TX
TEXAS
false
8100025
8100025
0
The transaction was the conversion of the notes previously sold, as referenced in the prior Form D filings concerning the notes, into preferred stock. The price paid for all of the notes had been 8,100,000. The conversion investment was $25,000.
true
0
38
0
0
There were no sales commissions or finders' fees involved. The transaction was merely a conversion of the notes that had previously been sold.
0
true
Based on prior submissions of Form D Filings, and given the fact that none of this conversion is expected to be used for payments to those mentioned in Item 3, $0 is the correct estimate.
false
Certa Dose, Inc.
Josue D. Hernandez
Josue D. Hernandez
Attorney
2019-12-02