-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, T+EaTo6e5heA7k482LLg0cMi+GWPJj7jecjQG5hkVLqwxMNjX9uByKBK1M8LoWR9 X0Ij3P2KsYVfH8LNecFS6w== 0001104659-09-070434.txt : 20091217 0001104659-09-070434.hdr.sgml : 20091217 20091217161103 ACCESSION NUMBER: 0001104659-09-070434 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20091217 DATE AS OF CHANGE: 20091217 EFFECTIVENESS DATE: 20091217 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Avantis Medical Systems Inc CENTRAL INDEX KEY: 0001325768 IRS NUMBER: 000000000 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-76534 FILM NUMBER: 091247384 BUSINESS ADDRESS: STREET 1: 263 SANTA ANA COURT CITY: SUNNYVALE STATE: CA ZIP: 94085 BUSINESS PHONE: 408-733-1901 MAIL ADDRESS: STREET 1: 263 SANTA ANA COURT CITY: SUNNYVALE STATE: CA ZIP: 94085 D 1 primary_doc.xml X0603 D LIVE 0001325768 Avantis Medical Systems Inc 263 Santa Ana Court Sunnyvale CA 94085 408-733-1901 CALIFORNIA None None Corporation true 2004 Scott Dodson 263 Santa Ana Court Sunnyvale CA 94085 Executive Officer Director Thomas J. Fogarty 263 Santa Ana Court Sunnyvale CA 94083 Director Matthew Jenusaitis 263 Santa Ana Court Sunnyvale CA 94085 Executive Officer Director Camran Nazhat 263 Santa Ana Court Sunnyvale CA 94085 Director Howard Palefsky 263 Santa Ana Court Sunnyvale CA 94085 Director Fred R. Seddiqui 263 Santa Ana Court Sunnyvale CA 94085 Director Other Health Care Decline to Disclose 06 false 2009-12-10 false true true true false 0 4000000 1436411 2563589 false 2 0 0 0 Funds to be used for working capital. true Avantis Medical Systems Inc /s/ Ann Coppel Ann Coppel Sr. Legal Assistant 2009-12-17 -----END PRIVACY-ENHANCED MESSAGE-----