0001532854-11-000001.txt : 20111018 0001532854-11-000001.hdr.sgml : 20111018 20111017134456 ACCESSION NUMBER: 0001532854-11-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20111017 DATE AS OF CHANGE: 20111017 EFFECTIVENESS DATE: 20111017 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Blaze Bioscience, Inc. CENTRAL INDEX KEY: 0001532854 IRS NUMBER: 274410926 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-167380 FILM NUMBER: 111143458 BUSINESS ADDRESS: STREET 1: PO BOX 61323 CITY: SEATTLE STATE: WA ZIP: 98141 BUSINESS PHONE: 2068493647 MAIL ADDRESS: STREET 1: PO BOX 61323 CITY: SEATTLE STATE: WA ZIP: 98141 D 1 primary_doc.xml X0704 D LIVE 0001532854 Blaze Bioscience, Inc. 530 Fairview Ave N. Suite 1000 SEATTLE WA WASHINGTON 98109 2068493647 DELAWARE None None Corporation true 2010 Heather Franklin 212 Osprey Lane Brinnon WA WASHINGTON 98320 Executive Officer Director James C. Towne 7225 204th Dr. NE Redmond WA WASHINGTON 98053 Director James M. Olson 4733 Lake Washington Blvd. S. Seattle WA WASHINGTON 98118 Director Biotechnology Decline to Disclose 06 false 2011-10-03 false true true true Promissory Notes convertible into preferred stock false 25000 1500000 725000 775000 false 6 0 0 0 false Blaze Bioscience, Inc. Heather Franklin Heather Franklin President 2011-10-17