0001213900-22-050821.txt : 20220824
0001213900-22-050821.hdr.sgml : 20220824
20220824170308
ACCESSION NUMBER: 0001213900-22-050821
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220811
FILED AS OF DATE: 20220824
DATE AS OF CHANGE: 20220824
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kim Jay
CENTRAL INDEX KEY: 0001935590
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41479
FILM NUMBER: 221192195
MAIL ADDRESS:
STREET 1: 6940 BEACH BLVD SUITE D-705
CITY: BUENA PARK
STATE: CA
ZIP: 90621
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Reborn Coffee, Inc.
CENTRAL INDEX KEY: 0001707910
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812]
IRS NUMBER: 474752305
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 17809 GILLETTE AVE
CITY: IRVINE
STATE: CA
ZIP: 92614
BUSINESS PHONE: 949-880-2868
MAIL ADDRESS:
STREET 1: 17809 GILLETTE AVE
CITY: IRVINE
STATE: CA
ZIP: 92614
FORMER COMPANY:
FORMER CONFORMED NAME: CAPAX INC.
DATE OF NAME CHANGE: 20170530
3
1
ownership.xml
X0206
3
2022-08-11
0
0001707910
Reborn Coffee, Inc.
REBN
0001935590
Kim Jay
580 N. BERRY STREET
BREA
CA
92821
1
1
1
0
CEO
Common Stock
2530333
D
/s/ Jay Kim
2022-08-24