0001739414-18-000003.txt : 20180522 0001739414-18-000003.hdr.sgml : 20180522 20180522143219 ACCESSION NUMBER: 0001739414-18-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180522 DATE AS OF CHANGE: 20180522 EFFECTIVENESS DATE: 20180522 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Provista Diagnostics Inc. CENTRAL INDEX KEY: 0001539252 IRS NUMBER: 274282214 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-312969 FILM NUMBER: 18852096 BUSINESS ADDRESS: STREET 1: 17301 N. PERIMETER DRIVE, SUITE 100 CITY: SCOTTSDALE STATE: AZ ZIP: 85085 BUSINESS PHONE: 602-224-5500 MAIL ADDRESS: STREET 1: 17301 N. PERIMETER DRIVE, SUITE 100 CITY: SCOTTSDALE STATE: AZ ZIP: 85085 D 1 primary_doc.xml X0708 D LIVE 0001539252 Provista Diagnostics Inc. 17301 N. PERIMETER DRIVE, SUITE 100 SCOTTSDALE AZ ARIZONA 85255 602-224-5500 DELAWARE None None Corporation true Gary Altman 17301 N. Perimeter Drive, Suite 100 Scottsdale AZ ARIZONA 85255 Executive Officer Director Uriel E. Kusiatin 55 Broad Street, 18th Floor New York NY NEW YORK 10004 Executive Officer Cynthia Collins 17301 N. Perimeter Drive, Suite 100 Scottsdale AZ ARIZONA 85255 Director Jeffrey R. Gilman 17301 N. Perimeter Drive, Suite 100 Scottsdale AZ ARIZONA 85255 Director Robert J. Hariri 17301 N. Perimeter Drive, Suite 100 Scottsdale AZ ARIZONA 85255 Director Jack Levine 17301 N. Perimeter Drive, Suite 100 Scottsdale AZ ARIZONA 85255 Director John Macaskill 17301 N. Perimeter Drive, Suite 100 Scottsdale AZ ARIZONA 85255 Director Thomas G. Mendell 17301 N. Perimeter Drive, Suite 100 Scottsdale AZ ARIZONA 85255 Director Yoji Nimura 17301 N. Perimeter Drive, Suite 100 Scottsdale AZ ARIZONA 85255 Director John Zicarelli 17301 N. Perimeter Drive, Suite 100 Scottsdale AZ ARIZONA 85255 Director Rao Mulpuri 17301 N. Perimeter Drive, Suite 100 Scottsdale AZ ARIZONA 85255 Executive Officer John Fermanis 17301 N. Perimeter Drive, Suite 100 Scottsdale AZ ARIZONA 85255 Executive Officer Biotechnology Decline to Disclose 06b false 2018-05-17 false true true false 0 5000000 2205633 2794367 The Issuer is offering up to $5,000,000 in principal amount of convertible notes. This Form D is also intended to cover the underlying equity securities. A portion of the total amount sold was funded by cancellation of indebtedness and a note exchange. false 6 0 0 0 false Provista Diagnostics Inc. /s/ Uriel E. Kusiatin Uriel E. Kusiatin Chief Financial Officer 2018-05-22