0001347123-19-000001.txt : 20191007 0001347123-19-000001.hdr.sgml : 20191007 20191007142347 ACCESSION NUMBER: 0001347123-19-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06c FILED AS OF DATE: 20191007 DATE AS OF CHANGE: 20191007 EFFECTIVENESS DATE: 20191007 FILER: COMPANY DATA: COMPANY CONFORMED NAME: EBR Systems, Inc. CENTRAL INDEX KEY: 0001347123 IRS NUMBER: 571164669 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-350490 FILM NUMBER: 191140630 BUSINESS ADDRESS: STREET 1: 480 OAKMEAD PARKWAY CITY: SUNNYVALE STATE: CA ZIP: 94085 BUSINESS PHONE: 408 720-1906 MAIL ADDRESS: STREET 1: 480 OAKMEAD PARKWAY CITY: SUNNYVALE STATE: CA ZIP: 94085 FORMER COMPANY: FORMER CONFORMED NAME: EBR Systems Inc DATE OF NAME CHANGE: 20051216 D 1 primary_doc.xml X0708 D LIVE 0001347123 EBR Systems, Inc. 480 OAKMEAD PARKWAY SUNNYVALE CA CALIFORNIA 94085 408 720-1906 DELAWARE EBR Systems Inc Corporation true ALLAN WILL 480 OAKMEAD PARKWAY SUNNYVALE CA CALIFORNIA 94085 Executive Officer Director JOHN MCCUTCHEON 480 OAKMEAD PARKWAY SUNNYVALE CA CALIFORNIA 94085 Executive Officer Director SUZANNE PILKINGTON 480 OAKMEAD PARKWAY SUNNYVALE CA CALIFORNIA 94085 Executive Officer LEIGHTON READ 480 OAKMEAD PARKWAY SUNNYVALE CA CALIFORNIA 94085 Director DAVID STASSEN 480 OAKMEAD PARKWAY SUNNYVALE CA CALIFORNIA 94085 Director TREVOR MOODY 480 OAKMEAD PARKWAY SUNNYVALE CA CALIFORNIA 94085 Director CHRIS NAVE 480 OAKMEAD PARKWAY SUNNYVALE CA CALIFORNIA 94085 Director Other Health Care Decline to Disclose 06c false 2019-08-26 false true true true false 0 38746969 16159417 22587552 false 35 0 0 0 false EBR Systems, Inc. /s/ Suzanne Pilkington Suzanne Pilkington CFO 2019-10-04