0001567619-21-017322.txt : 20210920 0001567619-21-017322.hdr.sgml : 20210920 20210920105644 ACCESSION NUMBER: 0001567619-21-017322 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b ITEM INFORMATION: Section 3(c)(1) FILED AS OF DATE: 20210920 DATE AS OF CHANGE: 20210920 EFFECTIVENESS DATE: 20210920 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Stage One IV Annex Fund, L.P. CENTRAL INDEX KEY: 0001883446 IRS NUMBER: 000000000 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-413866 FILM NUMBER: 211262394 BUSINESS ADDRESS: STREET 1: 12 ABA EVEN AVENUE, ECKERSTEIN TOWERS STREET 2: BLDG. D, 3RD FLOOR CITY: HERZLIYA PITUACH STATE: L3 ZIP: 4672530 BUSINESS PHONE: 972-9-779-2250 MAIL ADDRESS: STREET 1: 12 ABA EVEN AVENUE, ECKERSTEIN TOWERS STREET 2: BLDG. D, 3RD FLOOR CITY: HERZLIYA PITUACH STATE: L3 ZIP: 4672530 FORMER COMPANY: FORMER CONFORMED NAME: Stage One I Annex Fund, L.P. DATE OF NAME CHANGE: 20210916 D 1 primary_doc.xml X0708 D LIVE 0001883446 Stage One IV Annex Fund, L.P. 12 Aba Even Avenue, Eckerstein Towers Bldg. D, 3rd Floor Herzliya Pituach L3 ISRAEL 4672530 972-9-779-2250 CAYMAN ISLANDS None Stage One I Annex Fund, L.P. Limited Partnership true 2021 - Stage One Capital (G.P.) IV, L.P. 12 Aba Even Avenue, Eckerstein Towers Bldg. D, 3rd Floor Herzliya Pituach L3 ISRAEL 4672530 Executive Officer General Partner of the Issuer - Stage One 4 Holdings Ltd. 12 Aba Even Avenue, Eckerstein Towers Bldg. D, 3rd Floor Herzliya Pituach L3 ISRAEL 4672530 Executive Officer General Partner of the General Partner of the Issuer Yuval Cohen 12 Aba Even Avenue, Eckerstein Towers Bldg. D, 3rd Floor Herzliya Pituach L3 ISRAEL 4672530 Executive Officer Director Promoter Director of the General Partner of the General Partner, and Principal, of the Issuer Tal Slobodkin 12 Aba Even Avenue, Eckerstein Towers Bldg. D, 3rd Floor Herzliya Pituach L3 ISRAEL 4672530 Executive Officer Director Promoter Director of the General Partner of the General Partner, and Principal, of the Issuer Tal Jacobi 12 Aba Even Avenue, Eckerstein Towers Bldg. D, 3rd Floor Herzliya Pituach L3 ISRAEL 4672530 Executive Officer Chief Financial Officer of the General Partner of the Issuer Pooled Investment Fund Venture Capital Fund false Decline to Disclose 06b 3C.1 false true false true false 0 Indefinite 0 Indefinite false 0 0 0 0 false Stage One IV Annex Fund, L.P. /s/ Yuval Cohen Yuval Cohen Director of the GP of GP of Issuer 2021-09-20