0001536255-14-000003.txt : 20140818 0001536255-14-000003.hdr.sgml : 20140818 20140818171521 ACCESSION NUMBER: 0001536255-14-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20140818 DATE AS OF CHANGE: 20140818 EFFECTIVENESS DATE: 20140818 FILER: COMPANY DATA: COMPANY CONFORMED NAME: MIMOSA MEDICAL, INC. CENTRAL INDEX KEY: 0001536255 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-223175 FILM NUMBER: 141049891 BUSINESS ADDRESS: STREET 1: 3475 EDISON WAY STREET 2: SUITE O CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-678-8918 MAIL ADDRESS: STREET 1: 3475 EDISON WAY STREET 2: SUITE O CITY: MENLO PARK STATE: CA ZIP: 94025 D 1 primary_doc.xml X0707 D LIVE 0001536255 MIMOSA MEDICAL, INC. 3475 EDISON WAY SUITE O MENLO PARK CA CALIFORNIA 94025 650-678-8918 DELAWARE None None Corporation true 2010 DOUG KOO 3475 EDISON WAY SUITE O MENLO PARK CA CALIFORNIA 94025 Executive Officer DUKE ROHLEN 3475 EDISON WAY SUITE O MENLO PARK CA CALIFORNIA 94025 Director ANTHONY J. NATALE C/O 3475 EDISON WAY SUITE O MENLO PARK CA CALIFORNIA 94025 Director RICHARD B. EMMITT C/O 3475 EDISON WAY SUITE O MENLO PARK CA CALIFORNIA 94025 Director DONALD GONZALES C/O 3475 EDISON WAY SUITE O MENLO PARK CA CALIFORNIA 94025 Executive Officer Director Other Health Care Decline to Disclose 06b false 2014-08-06 false true false 0 500000 445000 55000 false 9 0 0 0 false MIMOSA MEDICAL, INC. /s/ Doug Koo Doug Koo Chief Financial Officer 2014-08-18