0001365686-15-000001.txt : 20151230 0001365686-15-000001.hdr.sgml : 20151230 20151230130437 ACCESSION NUMBER: 0001365686-15-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b ITEM INFORMATION: 4a5 FILED AS OF DATE: 20151230 DATE AS OF CHANGE: 20151230 EFFECTIVENESS DATE: 20151230 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Adapta Medical, Inc. CENTRAL INDEX KEY: 0001365686 IRS NUMBER: 000000000 STATE OF INCORPORATION: CO FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-254153 FILM NUMBER: 151312972 BUSINESS ADDRESS: STREET 1: 103 E Cheyenne Rd CITY: Colorado Springs STATE: CO ZIP: 80906 BUSINESS PHONE: 719-635-1627 MAIL ADDRESS: STREET 1: 103 E Cheyenne Rd CITY: Colorado Springs STATE: CO ZIP: 80906 FORMER COMPANY: FORMER CONFORMED NAME: Colorado Catheter Company, Inc. DATE OF NAME CHANGE: 20090528 FORMER COMPANY: FORMER CONFORMED NAME: Colorado Catheter Inc DATE OF NAME CHANGE: 20060609 D 1 primary_doc.xml X0707 D LIVE 0001365686 Adapta Medical, Inc. 142 Talamine Court Colorado Springs CO COLORADO 80907 855-329-8355 COLORADO Colorado Catheter Company, Inc. Colorado Catheter Inc Corporation true Glen House 142 Talamine Ct. Colorado Springs CO COLORADO 80907 Executive Officer Director Ronald Bracken 142 Talamine Ct. Colorado Springs CO COLORADO 80907 Director Victor Lazzaro 142 Talamine Ct. Colorado Springs CO COLORADO 80907 Director David Petso 142 Talamine Ct. Colorado Springs CO COLORADO 80907 Director Debbie Origer 142 Talamine Ct. Colorado Springs CO COLORADO 80907 Director Biotechnology Decline to Disclose 06b 4a5 false 2015-12-14 false true true true false 25000 1500000 425000 1075000 false 6 0 0 0 false Adapta Medical, Inc. /s/ Glen House Dr. Glen House Chief Executive Officer 2015-12-29