0001104659-11-038385.txt : 20110708
0001104659-11-038385.hdr.sgml : 20110708
20110708143526
ACCESSION NUMBER: 0001104659-11-038385
CONFORMED SUBMISSION TYPE: D
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: Rule 506
FILED AS OF DATE: 20110708
DATE AS OF CHANGE: 20110708
EFFECTIVENESS DATE: 20110708
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: 021-162517
FILM NUMBER: 11958993
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
X0704
D
LIVE
0001325768
Avantis Medical Systems Inc
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
408-733-1847
CALIFORNIA
None
None
Corporation
true
Richard
Randall
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Executive Officer
Director
John
Reed
263 Santa Ana Court
Sunnvale
CA
CALIFORNIA
94085
Executive Officer
Thomas
J.
Fogarty
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Director
Matthew
Jenusaitis
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Executive Officer
Director
Camran
Nezhat
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Director
Howard
Palefsky
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Director
John
Savarese
263 Santa Ana Court
Sunnyvale
CA
CALIFORNIA
94085
Director
Other Health Care
Decline to Disclose
- 06
false
2011-06-24
false
true
true
true
false
0
35000000
17876583
17123417
false
40
0
0
0
Funds to be used for working capital.
false
Avantis Medical Systems Inc
/s/ John Reed
John Reed
COO
2011-07-08