0001564031-12-000001.txt : 20121213 0001564031-12-000001.hdr.sgml : 20121213 20121213131644 ACCESSION NUMBER: 0001564031-12-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20121213 DATE AS OF CHANGE: 20121213 EFFECTIVENESS DATE: 20121213 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Angel Medical Systems Inc CENTRAL INDEX KEY: 0001564031 IRS NUMBER: 522360129 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-188326 FILM NUMBER: 121261632 BUSINESS ADDRESS: STREET 1: 1163 SHREWSBURY AVENUE CITY: SHREWBURY STATE: NJ ZIP: 07702 BUSINESS PHONE: 7325425551 MAIL ADDRESS: STREET 1: 1163 SHREWSBURY AVENUE CITY: SHREWBURY STATE: NJ ZIP: 07702 D 1 primary_doc.xml X0706 D LIVE 0001564031 Angel Medical Systems Inc 1163 SHREWSBURY AVENUE SHREWSBURY NJ NEW JERSEY 07702 7325425551 DELAWARE None None Corporation true David R. Fischell 1163 Shrewsbury Avenue Shrewsbury Business Center Shrewsbury NJ NEW JERSEY 07702 Executive Officer Director Robert E. Fischell 1163 Shrewsbury Avenue Shrewsbury Business Center Shrewsbury NJ NEW JERSEY 07702 Director Steven R. Johnson 1163 Shrewsbury Avenue Shrewsbury Business Center Shrewsbury NJ NEW JERSEY 07702 Executive Officer Dave Keenan 1163 Shrewsbury Avenue Shrewsbury Business Center Shrewsbury NJ NEW JERSEY 07702 Executive Officer Andrew Taylor 1163 Shrewsbury Avenue Shrewsbury Business Center Shrewsbury NJ NEW JERSEY 07702 Executive Officer Eric Fain 1163 Shrewsbury Avenue Shrewsbury Business Center Shrewsbury NJ NEW JERSEY 07702 Director Frank M. Fischer 1163 Shrewsbury Avenue Shrewsbury Business Center Shrewsbury NJ NEW JERSEY 07702 Director Robert J. Flanagan 1163 Shrewsbury Avenue Shrewsbury Business Center Shrewsbury NJ NEW JERSEY 07702 Director Kadir Kadhiresan 1163 Shrewsbury Avenue Shrewsbury Business Center Shrewsbury NJ NEW JERSEY 07702 Director Benjamin Pless 1163 Shrewsbury Avenue Shrewsbury Business Center Shrewsbury NJ NEW JERSEY 07702 Director Victor Whitman 1163 Shrewsbury Avenue Shrewsbury Business Center Shrewsbury NJ NEW JERSEY 07702 Director Other Health Care Decline to Disclose 06 false 2012-12-05 false true true true false 0 17525000 3762500 13762500 (i) Secured Convertible Promissory Notes; (ii) Preferred Stock issuable upon conversion of such notse; (iii) COmmon Stock issuable upon conversion of such Preferred Stock false 17 0 0 0 true Proceeds will be used for, among other things, general corporate purposes including, but not limited to, executive salaries false Angel Medical Systems Inc /s/ Andrew Taylor Andrew Taylor CFO 2012-12-13