0001140361-17-047614.txt : 20171228 0001140361-17-047614.hdr.sgml : 20171228 20171228165240 ACCESSION NUMBER: 0001140361-17-047614 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171228 DATE AS OF CHANGE: 20171228 EFFECTIVENESS DATE: 20171228 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Clinical Ink, Inc. CENTRAL INDEX KEY: 0001496558 IRS NUMBER: 272987645 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-301916 FILM NUMBER: 171278861 BUSINESS ADDRESS: STREET 1: 525 VINE STREET, SUITE 130 CITY: WINSTON-SALEM STATE: NC ZIP: 27101 BUSINESS PHONE: 336-464-0702 MAIL ADDRESS: STREET 1: 525 VINE STREET, SUITE 130 CITY: WINSTON-SALEM STATE: NC ZIP: 27101 D 1 primary_doc.xml X0708 D LIVE 0001496558 Clinical Ink, Inc. 525 VINE STREET, SUITE 130 WINSTON-SALEM NC NORTH CAROLINA 27101 336-464-0702 DELAWARE None None Corporation true 2013 Edward S. Seguine, Jr. 525 Vine Street, Suite 130 Winston-Salem NC NORTH CAROLINA 27101 Executive Officer Director Chief Executive Officer Tony Rosenberg 525 Vine Street, Suite 130 Winston-Salem NC NORTH CAROLINA 27101 Director Phil Waugh 525 Vine Street, Suite 130 Winston, Salem NC NORTH CAROLINA 27101 Director Todd Foley 525 Vine Street, Suite 130 Winston-Salem NC NORTH CAROLINA 27101 Director Matt King 525 Vice Street, Suite 130 Winston-Salem NC NORTH CAROLINA 27101 Director Richard Malcolm 525 Vine Street, Suite 130 Winston-Salem NC NORTH CAROLINA 27101 Director Scott Miltenberger 525 Vine Street, Suite 130 Winston-Salem NC NORTH CAROLINA 27101 Executive Officer Chief Financial Officer Other Decline to Disclose 06b false 2017-12-13 false true true true false 0 2500000 1700000 800000 false 9 0 0 0 false Clinical Ink, Inc. /s/ Scott Miltenberger Scott Miltenberger Chief Financial Officer 2017-12-28