0001537182-11-000001.txt : 20111214 0001537182-11-000001.hdr.sgml : 20111214 20111214123715 ACCESSION NUMBER: 0001537182-11-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20111214 DATE AS OF CHANGE: 20111214 EFFECTIVENESS DATE: 20111214 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ComponentLab Inc. CENTRAL INDEX KEY: 0001537182 IRS NUMBER: 450914779 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-170038 FILM NUMBER: 111260403 BUSINESS ADDRESS: STREET 1: 511 BOREN AVE N CITY: SEATTLE STATE: WA ZIP: 98109 BUSINESS PHONE: 360-460-8098 MAIL ADDRESS: STREET 1: 511 BOREN AVE N CITY: SEATTLE STATE: WA ZIP: 98109 D 1 primary_doc.xml X0704 D LIVE 0001537182 ComponentLab Inc. 511 BOREN AVE N SEATTLE WA WASHINGTON 98109 360-460-8098 DELAWARE None None Corporation true 2011 Manuel Medina 511 Boren Ave N Seattle WA WASHINGTON 98109 Executive Officer Director Wesley Hather 511 Boren Ave N Seattle WA WASHINGTON 98019 Executive Officer Director Gordon L. Hempton 511 Boren Ave N Seattle WA WASHINGTON 98019 Executive Officer Director Andrew Kinzer 511 Boren Ave N Seattle WA WASHINGTON 98109 Executive Officer Director Other Technology Decline to Disclose 06 false 2011-12-01 false true true true true Convertible Notes false 20000 Indefinite 20000 Indefinite false 1 0 0 0 false ComponentLab Inc. Manuel Medina Manuel Medina CEO 2011-12-12