0001475620-15-000001.txt : 20150828 0001475620-15-000001.hdr.sgml : 20150828 20150828114522 ACCESSION NUMBER: 0001475620-15-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150828 DATE AS OF CHANGE: 20150828 EFFECTIVENESS DATE: 20150828 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: 021-246631 FILM NUMBER: 151080844 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 X0707 D LIVE 0001475620 Ativa Medical Corp 1000 WESTGATE DRIVE SUITE 100 SAINT PAUL MN MINNESOTA 55114 651-503-9200 DELAWARE None None Corporation true James M McNally 1000 Westgate Drive Suite 100 St. Paul MN MINNESOTA 55114 Executive Officer Director Barbara E Roth 1000 Westgate Drive Suite 100 St. Paul MN MINNESOTA 55114 Executive Officer Mark Bagnall 1000 Westgate Drive Suite 100 St. Paul MN MINNESOTA 55114 Director David W Deetz 1000 Westgate Drive Suite 100 St. Paul MN MINNESOTA 55114 Director James B Stake 1000 Westgate Drive Suite 100 St. Paul MN MINNESOTA 55114 Director Dale A Wahlstrom 1000 Westgate Drive St. Paul MN MINNESOTA 55114 Director Other Technology Decline to Disclose 06b false 2015-08-14 false true false 0 23172820 23172820 0 Debt in the amount of $8,172,820 was converted into Series B-1 Preferred Stock, concurrently with new investments in the amount of $15,000,000 for the purchase of Series B-2 Preferred Stock. false 65 0 0 0 false Ativa Medical Corp /s/ David W. Deetz David W. Deetz Director 2015-08-27