0001428275-17-000001.txt : 20171205 0001428275-17-000001.hdr.sgml : 20171205 20171205140709 ACCESSION NUMBER: 0001428275-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171205 DATE AS OF CHANGE: 20171205 EFFECTIVENESS DATE: 20171205 FILER: COMPANY DATA: COMPANY CONFORMED NAME: REPAIRPAL INC CENTRAL INDEX KEY: 0001428275 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-300083 FILM NUMBER: 171239326 BUSINESS ADDRESS: STREET 1: 6005 SHELLMOUND STREET STREET 2: SUITE 200 CITY: EMERYVILLE STATE: CA ZIP: 94608 BUSINESS PHONE: 800-969-9204 MAIL ADDRESS: STREET 1: 6005 SHELLMOUND STREET STREET 2: SUITE 200 CITY: EMERYVILLE STATE: CA ZIP: 94608 D 1 primary_doc.xml X0708 D LIVE 0001428275 REPAIRPAL INC 363 Clementina St., 2nd Floor San Francisco CA CALIFORNIA 94103 800-969-9204 DELAWARE None None Corporation true Art Shaw c/o RepairPal, Inc. 363 Clementina St., 2nd Floor San Francisco CA CALIFORNIA 94103 Executive Officer Director David Whorton c/o RepairPal, Inc. 363 Clementina St., 2nd Floor San Francisco CA CALIFORNIA 94103 Director Harold Logan c/o RepairPal, Inc. 363 Clementina St., 2nd Floor San Francisco CA CALIFORNIA 94103 Director Andrew Seligson c/o RepairPal, Inc. 363 Clementina St., 2nd Floor San Francisco CA CALIFORNIA 94103 Director Greg McGivney c/o RepairPal, Inc. 363 Clementina St., 2nd Floor San Francisco CA CALIFORNIA 94103 Director Terrence Rasmussen c/o RepairPal, Inc. 363 Clementina St., 2nd Floor San Francisco CA CALIFORNIA 94103 Director Alex Vetter c/o RepairPal, Inc. 363 Clementina St., 2nd Floor San Francisco CA CALIFORNIA 94103 Director Michael Smith c/o RepairPal, Inc. 363 Clementina St., 2nd Floor San Francisco CA CALIFORNIA 94103 Director Other Technology Decline to Disclose 06b false 2017-11-21 false true true true false 0 16642325 14594150 2048175 (i)$7,999,999.83 in sale of Series C Preferred Stock ("SCPS");(ii)conversion of $5,124,746.72 CPNs into SCPS; (iii)conversion of $1,455,963.40 CPNs into SCPS and Series CX Preferred Stock; (iv) warrant for up to $13,439.76 to purchase SCPS upon exercise false 4 0 0 0 false REPAIRPAL INC Art Shaw Art Shaw Chief Executive Officer 2017-12-05