0001545714-12-000002.txt : 20120815 0001545714-12-000002.hdr.sgml : 20120815 20120815165133 ACCESSION NUMBER: 0001545714-12-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20120815 DATE AS OF CHANGE: 20120815 EFFECTIVENESS DATE: 20120815 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Mirabilis Medica Inc CENTRAL INDEX KEY: 0001372781 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-182798 FILM NUMBER: 121037574 BUSINESS ADDRESS: STREET 1: 18706 NORTH CREEK PARKWAY SUITE 110 CITY: BOTHELL STATE: WA ZIP: 98011 BUSINESS PHONE: 425-486-8230 MAIL ADDRESS: STREET 1: 18706 NORTH CREEK PARKWAY SUITE 110 CITY: BOTHELL STATE: WA ZIP: 98011 D 1 primary_doc.xml X0706 D LIVE 0001372781 Mirabilis Medica Inc 18706 NORTH CREEK PARKWAY SUITE 110 BOTHELL WA WASHINGTON 98011 425-486-8230 DELAWARE None None Corporation true Roger Stern c/o 18706 North Creek Parkway Suite 110 Bothell WA WASHINGTON 98011 Director Gino Di Sciullo c/o 18706 North Creek Parkway Suite 110 Bothell WA WASHINGTON 98011 Director Michael Lau c/o 18706 North Creek Parkway Suite 110 Bothell WA WASHINGTON 98011 Executive Officer Director Dinesh Patel c/o 18706 North Creek Parkway Suite 110 Bothell WA WASHINGTON 98011 Director Nelson Teng c/o 18706 North Creek Parkway Suite 110 Bothell WA WASHINGTON 98011 Director Greg Darlington c/o 18706 North Creek Parkway Suite 110 Bothell WA WASHINGTON 98011 Executive Officer Alexander Lebedev c/o 18706 North Creek Parkway Suite 110 Bothell WA WASHINGTON 98011 Executive Officer Jens Quistgaard c/o 18706 North Creek Parkway Suite 110 Bothell WA WASHINGTON 98011 Director Other Health Care Decline to Disclose 06 false 2012-08-01 false true true false 0 600000 300000 300000 In addition, warrants to purchase shares of common stock were issued in connection with the issuance of convertible promissory notes. false 2 0 0 0 true false Mirabilis Medica Inc /s/ Alexander Lebedev Alexander Lebedev VP, Finance 2012-08-15