0001589194-16-000002.txt : 20160822 0001589194-16-000002.hdr.sgml : 20160822 20160822162407 ACCESSION NUMBER: 0001589194-16-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160822 DATE AS OF CHANGE: 20160822 EFFECTIVENESS DATE: 20160822 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Sample6, Inc. CENTRAL INDEX KEY: 0001589194 IRS NUMBER: 264479056 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-269352 FILM NUMBER: 161845496 BUSINESS ADDRESS: STREET 1: 27 DRYDOCK AVE CITY: BOSTON STATE: MA ZIP: 02210 BUSINESS PHONE: 617 852 9648 MAIL ADDRESS: STREET 1: 27 DRYDOCK AVE CITY: BOSTON STATE: MA ZIP: 02210 D 1 primary_doc.xml X0707 D LIVE 0001589194 Sample6, Inc. 840 Memorial Drive Cambridge MA MASSACHUSETTS 02139 617-393-7600 DELAWARE None None Corporation true Michael Koeris 840 Memorial Drive 4th Floor Cambridge MA MASSACHUSETTS 02139 Executive Officer Director Stephen Bloch 840 Memorial Drive 4th Floor Cambridge MA MASSACHUSETTS 02139 Director Timothy Lu 840 Memorial Drive 4th Floor Cambridge MA MASSACHUSETTS 02139 Director Andy Ziolkowski 840 Memorial Drive 4th Floor Cambridge MA MASSACHUSETTS 02139 Director Guy Broadbent 840 Memorial Drive 4th Floor Cambridge MA MASSACHUSETTS 02139 Director Sam Kass 840 Memorial Drive 4th Floor Cambridge MA MASSACHUSETTS 02139 Director Other Decline to Disclose 06b false 2016-08-05 false true false 0 13469791 12726357 743434 false 6 0 0 0 false Sample6, Inc. /s/ Michael Koeris Michael Koeris President & Chief Executive Officer 2016-08-22