0001479362-18-000001.txt : 20180904 0001479362-18-000001.hdr.sgml : 20180904 20180904162420 ACCESSION NUMBER: 0001479362-18-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180904 DATE AS OF CHANGE: 20180904 EFFECTIVENESS DATE: 20180904 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PROFUSA, Inc. CENTRAL INDEX KEY: 0001479362 IRS NUMBER: 264589529 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-320601 FILM NUMBER: 181052637 BUSINESS ADDRESS: STREET 1: 345 ALLERTON AVE. CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 BUSINESS PHONE: (925) 997-6925 MAIL ADDRESS: STREET 1: 345 ALLERTON AVE. CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 FORMER COMPANY: FORMER CONFORMED NAME: Profusa, Inc. DATE OF NAME CHANGE: 20091223 D 1 primary_doc.xml X0708 D LIVE 0001479362 PROFUSA, Inc. 345 ALLERTON AVE. SOUTH SAN FRANCISCO CA CALIFORNIA 94080 (925) 997-6925 CALIFORNIA Profusa, Inc. Corporation true Ben Hwang PROFUSA, Inc. 345 Allerton Ave. South San Francisco CA CALIFORNIA 94080 Executive Officer Director Natalie Wisniewski PROFUSA, Inc. 345 Allerton Ave. South San Francisco CA CALIFORNIA 94080 Executive Officer Director Bill McMillan PROFUSA, Inc. 345 Allerton Ave. South San Francisco CA CALIFORNIA 94080 Executive Officer Thomas Gutshall PROFUSA, Inc. 345 Allerton Ave. South San Francisco CA CALIFORNIA 94080 Director Qianye Karen Liu PROFUSA, Inc. 345 Allerton Ave. South San Francisco CA CALIFORNIA 94080 Director NG Siu Wai PROFUSA, Inc. 345 Allerton Ave. South San Francisco CA CALIFORNIA 94080 Director Joan Braddi PROFUSA, Inc. 345 Allerton Ave. South San Francisco CA CALIFORNIA 94080 Director William Frist PROFUSA, Inc. 345 Allerton Ave. South San Francisco CA CALIFORNIA 94080 Director Other Health Care Decline to Disclose 06b false 2018-05-15 false true false 0 50000000 45061613 4938387 Includes the dollar amount for the conversion of the principal and interest of convertible promissory notes. false 46 0 0 0 The proceeds will be used for working capital and general corporate purposes. false PROFUSA, Inc. /s/ Ben C. Hwang Ben C. Hwang CEO 2018-08-30