0001560563-12-000002.txt : 20121113 0001560563-12-000002.hdr.sgml : 20121112 20121113123837 ACCESSION NUMBER: 0001560563-12-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20121113 DATE AS OF CHANGE: 20121113 EFFECTIVENESS DATE: 20121113 FILER: COMPANY DATA: COMPANY CONFORMED NAME: FANZO, INC. CENTRAL INDEX KEY: 0001560563 IRS NUMBER: 455303258 STATE OF INCORPORATION: WA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-186842 FILM NUMBER: 121197383 BUSINESS ADDRESS: STREET 1: 5227 111TH LN NE CITY: KIRKLAND STATE: WA ZIP: 98033 BUSINESS PHONE: 206-271-2891 MAIL ADDRESS: STREET 1: 5227 111TH LN NE CITY: KIRKLAND STATE: WA ZIP: 98033 D 1 primary_doc.xml X0706 D LIVE 0001560563 FANZO, INC. 5227 111TH LN NE KIRKLAND WA WASHINGTON 98033 206-271-2891 WASHINGTON None None Corporation true 2012 PAUL INGALLS 5227 111TH LN NE KIRKLAND WA WASHINGTON 98033 Executive Officer Director DANA DYKSTERHUIS 532 9TH AVE KIRKLAND WA WASHINGTON 98033 Executive Officer Director Other Technology Decline to Disclose 06 false 2012-06-14 false true true Debt is convertible, under certain circumstances, into issuer equity false 0 150000 105000 45000 false 4 0 0 0 false FANZO, INC. /s/ Dana Dyksterhuis Dana Dyksterhuis Secretary 2012-11-13