0001475620-12-000003.txt : 20120124
0001475620-12-000003.hdr.sgml : 20120124
20120124113031
ACCESSION NUMBER: 0001475620-12-000003
CONFORMED SUBMISSION TYPE: D
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: Rule 506
FILED AS OF DATE: 20120124
DATE AS OF CHANGE: 20120124
EFFECTIVENESS DATE: 20120124
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: Ativa Medical Corp
CENTRAL INDEX KEY: 0001475620
IRS NUMBER: 263653862
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: D
SEC ACT: 1933 Act
SEC FILE NUMBER: 021-172349
FILM NUMBER: 12541261
BUSINESS ADDRESS:
STREET 1: 1000 WESTGATE DRIVE
STREET 2: SUITE 100
CITY: SAINT PAUL
STATE: MN
ZIP: 55114
BUSINESS PHONE: 651-503-9200
MAIL ADDRESS:
STREET 1: 1000 WESTGATE DRIVE
STREET 2: SUITE 100
CITY: SAINT PAUL
STATE: MN
ZIP: 55114
D
1
primary_doc.xml
X0704
D
LIVE
0001475620
Ativa Medical Corp
1000 WESTGATE DRIVE
SUITE 100
SAINT PAUL
MN
MINNESOTA
55114
651-503-9200
DELAWARE
None
None
Corporation
true
2008
David
W.
Deetz
1000 Westgate Drive
Suite 100
St. Paul
MN
MINNESOTA
55114
Executive Officer
Director
Robert
S.
Galen
1000 Westgate Drive
Suite 100
St. Paul
MN
MINNESOTA
55114
Executive Officer
Director
Dennis
J.
McFadden
1000 Westgate Drive
Suite 100
St. Paul
MN
MINNESOTA
55114
Executive Officer
Tiffany
P.
Olson
1000 Westgate Drive
Suite 100
St. Paul
MN
MINNESOTA
55114
Director
Barbara
E.
Roth
1000 Westgate Drive
Suite 100
St. Paul
MN
MINNESOTA
55114
Executive Officer
Randall
K.
Seeliger
1000 Westgate Drive
Suite 100
St. Paul
MN
MINNESOTA
55114
Executive Officer
James
B.
Stake
1000 Westgate Drive
Suite 100
St. Paul
MN
MINNESOTA
55114
Director
Dale
A.
Wahlstrom
1000 Westgate Drive
Suite 100
St. Paul
MN
MINNESOTA
55114
Director
Other Technology
Decline to Disclose
- 06
false
2011-12-09
false
true
false
50000
5000000
275000
4725000
false
5
0
0
0
false
Ativa Medical Corp
/s/ Dennis J. McFadden
Dennis J. McFadden
CFO, VP - Corporate Development
2012-01-23