0001339005-16-000003.txt : 20161227 0001339005-16-000003.hdr.sgml : 20161226 20161227122420 ACCESSION NUMBER: 0001339005-16-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161227 DATE AS OF CHANGE: 20161227 EFFECTIVENESS DATE: 20161227 FILER: COMPANY DATA: COMPANY CONFORMED NAME: FEMASYS INC CENTRAL INDEX KEY: 0001339005 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-277050 FILM NUMBER: 162070127 BUSINESS ADDRESS: STREET 1: 3950 JOHNS CREEK COURT STREET 2: SUITE 100 CITY: SUWANEE STATE: GA ZIP: 30024 BUSINESS PHONE: 770-500-3910 MAIL ADDRESS: STREET 1: 3950 JOHNS CREEK COURT STREET 2: SUITE 100 CITY: SUWANEE STATE: GA ZIP: 30024 D 1 primary_doc.xml X0707 D LIVE 0001339005 FEMASYS INC 3950 JOHNS CREEK COURT SUITE 100 SUWANEE GA GEORGIA 30024 770-500-3910 DELAWARE None None Corporation true Kathy Lee-Sepsick c/o Femasys Inc. 3950 Johns Creek Court, Suite 100 Suwanee GA GEORGIA 30024 Executive Officer Director Edward Uzialko c/o Femasys Inc. 3950 Johns Creek Court, Suite 100 Suwanee GA GEORGIA 30024 Director John Adams c/o Femasys Inc. 3950 Johns Creek Court, Suite 100 Suwanee GA GEORGIA 30024 Director Fred Aslan c/o Femasys Inc. 3950 Johns Creek Court, Suite 100 Suwanee GA GEORGIA 30024 Director Charles Larsen c/o Femasys Inc. 3950 Johns Creek Court, Suite 100 Suwanee GA GEORGIA 30024 Director John Dyett c/o Femasys Inc. 3950 Johns Creek Court, Suite 100 Suwanee GA GEORGIA 30024 Director William Witte c/o Femasys Inc. 3950 Johns Creek Court, Suite 100 Suwanee GA GEORGIA 30024 Director Biotechnology Decline to Disclose 06b false 2016-12-14 false true false 0 Salem Partners LLC None None None 11111 Santa Monica Boulevard, Suite 2250 Los Angeles CA CALIFORNIA 90025 All States true 36628704 36628704 0 In addition, the Issuer authorized the issuance of 3,779,045 shares upon the conversion of $3,296,700 aggregate principal amount of the Issuer's outstanding convertible notes. false 18 2000000 true 0 In addition, Recipient received warrants to purchase equity in the Issuer with an initial value equal to 3.0% of the aggregate number of securities issued. 0 false FEMASYS INC /s/ Kathy Lee-Sepsick Kathy Lee-Sepsick President and Chief Executive Officer 2016-12-27