0001537182-16-000006.txt : 20160623 0001537182-16-000006.hdr.sgml : 20160623 20160623121435 ACCESSION NUMBER: 0001537182-16-000006 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160623 DATE AS OF CHANGE: 20160623 EFFECTIVENESS DATE: 20160623 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: 021-265638 FILM NUMBER: 161728153 BUSINESS ADDRESS: STREET 1: 3400 STONE WAY N. STREET 2: SUITE 201 CITY: SEATTLE STATE: WA ZIP: 98103 BUSINESS PHONE: (888) 928-7356 MAIL ADDRESS: STREET 1: 3400 STONE WAY N. STREET 2: SUITE 201 CITY: SEATTLE STATE: WA ZIP: 98103 D 1 primary_doc.xml X0707 D LIVE 0001537182 ComponentLab Inc. 3400 STONE WAY N. SUITE 201 SEATTLE WA WASHINGTON 98103 (888) 928-7356 DELAWARE None None Corporation true Manuel Medina c/o ComponentLab Inc. 3400 Stone Way N, Ste 201 Seattle WA WASHINGTON 98103 Executive Officer Director Gordon Leland Hempton c/o ComponentLab Inc. 3400 Stone Way N, Ste 201 Seattle WA WASHINGTON 98103 Director Rajeev Batra c/o ComponentLab Inc. 3400 Stone Way N., Ste 201 Seattle WA WASHINGTON 98103 Director Vijay Nagappan c/o ComponentLab Inc. 3400 Stone Way N., Ste 201 Seattle WA WASHINGTON 98103 Director Pete Price c/o ComponentLab Inc. 3400 Stone Way N., Ste 201 Seattle WA WASHINGTON 98103 Executive Officer Other Technology Decline to Disclose 06b false 2016-06-08 false true true Series B Preferred Stock and Common Stock issuable upon conversion of such Preferred Stock. false 0 17363630 17363630 0 false 11 0 0 0 false ComponentLab Inc. /s/ Pete Price Pete Price CFO 2016-06-23