0001592473-16-000007.txt : 20161107 0001592473-16-000007.hdr.sgml : 20161107 20161107145711 ACCESSION NUMBER: 0001592473-16-000007 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161107 DATE AS OF CHANGE: 20161107 EFFECTIVENESS DATE: 20161107 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Brookhaven Medical, Inc. CENTRAL INDEX KEY: 0001592473 IRS NUMBER: 900959093 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-273945 FILM NUMBER: 161977745 BUSINESS ADDRESS: STREET 1: 3424 PEACHTREE ROAD, NW STREET 2: SUITE 1150 CITY: ATLANTA STATE: GA ZIP: 30326 BUSINESS PHONE: 404-205-8282 MAIL ADDRESS: STREET 1: 3424 PEACHTREE ROAD, NW STREET 2: SUITE 1150 CITY: ATLANTA STATE: GA ZIP: 30326 FORMER COMPANY: FORMER CONFORMED NAME: Brookhaven Medical,Inc DATE OF NAME CHANGE: 20131120 D 1 primary_doc.xml X0707 D LIVE 0001592473 Brookhaven Medical, Inc. 3424 PEACHTREE ROAD, NE SUITE 1150 ATLANTA GA GEORGIA 30326 404-205-8282 DELAWARE Brookhaven Medical,Inc Corporation true 2013 John D. Feltman 3424 Peachtree Road, NE Suite 1150 Atlanta GA GEORGIA 30326 Executive Officer Director Stephen Warner 3424 Peachtree Road, NE Suite 1150 Atlanta GA GEORGIA 30326 Director James S. Johnson 3424 Peachtree Road, NE Suite 1150 Atlanta GA GEORGIA 30326 Director Allen B. Boswell 3424 Peachtree Road, NE Suite 1150 Atlanta GA GEORGIA 30326 Director John Ramey 3424 Peachtree Road, NE Suite 1150 Atlanta GA GEORGIA 30326 Director Robert E. Altenbach 3424 Peachtree Road, NE Suite 1150 Atlanta GA GEORGIA 30326 Executive Officer Marc Morin 3424 Peachtree Road, NE Suite 1150 Atlanta GA GEORGIA 30326 Executive Officer Scott C. Jones 3424 Peachtree Road, NE Suite 1150 Atlanta GA GEORGIA 30326 Executive Officer Other Health Care $25,000,001 - $100,000,000 06b false 2016-10-24 false true true false 25000 10000000 300000 9700000 The Issuer is offering up to $10,000,000 in principal amount of 8% convertible notes. The Form D is also intended to cover the underlying shares of common stock. false 3 800000 true 0 The Issuer may engage broker-dealers to offer and sell the 8% convertible notes, who may be paid commissions up to 8% of the principal amount of the notes. 0 false Brookhaven Medical, Inc. /s/ John D. Feltman John D. Feltman Chairman and Chief Executive Officer 2016-11-07