0001209191-17-063139.txt : 20171201 0001209191-17-063139.hdr.sgml : 20171201 20171201092447 ACCESSION NUMBER: 0001209191-17-063139 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171201 DATE AS OF CHANGE: 20171201 EFFECTIVENESS DATE: 20171201 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Watermark Medical Holdings, Inc. CENTRAL INDEX KEY: 0001573917 IRS NUMBER: 371719099 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-299872 FILM NUMBER: 171232836 BUSINESS ADDRESS: STREET 1: 1641 WORTHINGTON ROAD STREET 2: SUITE 320 CITY: WEST PALM BEACH STATE: FL ZIP: 33409 BUSINESS PHONE: (877) 710-6999 MAIL ADDRESS: STREET 1: 1641 WORTHINGTON ROAD STREET 2: SUITE 320 CITY: WEST PALM BEACH STATE: FL ZIP: 33409 D 1 primary_doc.xml X0708 D LIVE 0001573917 Watermark Medical Holdings, Inc. 1641 Worthington Road Suite 320 West Palm Beach FL FLORIDA 33409 877-710-6999 DELAWARE None None Corporation true 2013 Sean Heyniger 1641 Worthington Road Suite 320 West Palm Beach FL FLORIDA 33409 Executive Officer Director Jack Fiedor 1641 Worthington Road Suite 320 West Palm Beach FL FLORIDA 33409 Executive Officer Greg Poulos 1641 Worthington Road Suite 320 West Palm Beach FL FLORIDA 33409 Executive Officer Dr. Richard Bogan 1641 Worthington Road Suite 320 West Palm Beach FL FLORIDA 33409 Executive Officer Director Don Burton 1641 Worthington Road Suite 320 West Palm Beach FL FLORIDA 33409 Director Peter Callahan 1641 Worthington Road Suite 320 West Palm Beach FL FLORIDA 33409 Director Drew Graham 1641 Worthington Road Suite 320 West Palm Beach FL FLORIDA 33409 Director Jacob Lamm 1641 Worthington Road Suite 320 West Palm Beach FL FLORIDA 33409 Director Dan Ryan 1641 Worthington Road Suite 320 West Palm Beach FL FLORIDA 33409 Director Other Health Care Decline to Disclose 06b false 2017-11-14 false true false 25000 5000000 3250000 1750000 The Total Offering Amount includes a 2% commitment fee to be retained by each investor false 7 0 0 0 false Watermark Medical Holdings, Inc. /s/ Jack Fiedor Jack Fiedor Chief Financial Officer 2017-11-21