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