0001520325-17-000002.txt : 20170324 0001520325-17-000002.hdr.sgml : 20170324 20170324121653 ACCESSION NUMBER: 0001520325-17-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170324 DATE AS OF CHANGE: 20170324 EFFECTIVENESS DATE: 20170324 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Cardiva Medical, Inc. CENTRAL INDEX KEY: 0001520325 IRS NUMBER: 300113686 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-283285 FILM NUMBER: 17711867 BUSINESS ADDRESS: STREET 1: 2900 LAKESIDE DRIVE STREET 2: SUITE 160 CITY: SANTA CLARA STATE: CA ZIP: 95054 BUSINESS PHONE: (408) 859-1877 MAIL ADDRESS: STREET 1: 2900 LAKESIDE DRIVE STREET 2: SUITE 160 CITY: SANTA CLARA STATE: CA ZIP: 95054 FORMER COMPANY: FORMER CONFORMED NAME: Cardiva Medical Inc DATE OF NAME CHANGE: 20110510 D 1 primary_doc.xml X0707 D LIVE 0001520325 Cardiva Medical, Inc. 2900 LAKESIDE DRIVE SUITE 160 SANTA CLARA CA CALIFORNIA 95054 (408) 859-1877 DELAWARE Cardiva Medical Inc Corporation true John Russell 2900 Lakeside Drive Suite 160 Santa Clara CA CALIFORNIA 95054 Executive Officer Director Lisa Garrett 2900 Lakeside Drive Suite 160 Santa Clara CA CALIFORNIA 95054 Executive Officer Justin Ballotta 2900 Lakeside Drive Suite 160 Santa Clara CA CALIFORNIA 95054 Executive Officer Rick Anderson 2900 Lakeside Drive Suite 160 Santa Clara CA CALIFORNIA 95054 Director Michael Bornitz 2900 Lakeside Drive Suite 160 Santa Clara CA CALIFORNIA 95054 Director Matthew Crawford 2900 Lakeside Drive Suite 160 Santa Clara CA CALIFORNIA 95054 Director Paul Enever 2900 Lakeside Drive Suite 160 Santa Clara CA CALIFORNIA 95054 Director George Lee 2900 Lakeside Drive Suite 160 Santa Clara CA CALIFORNIA 95054 Director Augustine Lien 2900 Lakeside Drive Suite 160 Santa Clara CA CALIFORNIA 95054 Director Other Health Care Decline to Disclose 06b false 2017-01-30 false true true true false 0 44234211 27985347 16248864 (i) Series 5 Preferred Stock; Common Stock issuable upon conversion, and (ii) Warrants for Series 5 Preferred Stock; Series 5 Preferred Stock issuable upon exercise; Common Stock issuable upon conversion. false 28 0 0 0 true Proceeds will be used for general corporate purposes. false Cardiva Medical, Inc. /s/Lisa Garrett Lisa Garrett CFO 2017-03-23