0001606857-17-000002.txt : 20170922 0001606857-17-000002.hdr.sgml : 20170922 20170922114753 ACCESSION NUMBER: 0001606857-17-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170922 DATE AS OF CHANGE: 20170922 EFFECTIVENESS DATE: 20170922 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ForSight VISION6, Inc. CENTRAL INDEX KEY: 0001606857 IRS NUMBER: 465332553 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-295213 FILM NUMBER: 171097014 BUSINESS ADDRESS: STREET 1: 171 JEFFERSON DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 6503252815 MAIL ADDRESS: STREET 1: 171 JEFFERSON DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 D 1 primary_doc.xml X0708 D LIVE 0001606857 ForSight VISION6, Inc. 171 JEFFERSON DRIVE MENLO PARK CA CALIFORNIA 94025 6503252815 DELAWARE None None Corporation true 2014 Eugene de Juan, Jr., M.D. c/o ForSight VISION6, Inc. 171 Jefferson Drive Menlo Park CA CALIFORNIA 94025 Executive Officer Director K. Angela Macfarlane c/o ForSight VISION6, Inc. 171 Jefferson Drive Menlo Park CA CALIFORNIA 94025 Director Richard Lindstrom c/o ForSight VISION6, Inc. 171 Jefferson Drive Menlo Park CA CALIFORNIA 94025 Director William J. Link, Ph.D. c/o ForSight VISION6, Inc. 171 Jefferson Drive Menlo Park CA CALIFORNIA 94025 Director Andy Corley c/o ForSight VISION6, Inc. 171 Jefferson Drive Menlo Park CA CALIFORNIA 94025 Director Warren Thaler c/o ForSight VISION6, Inc. 171 Jefferson Drive Menlo Park CA CALIFORNIA 94025 Director Asaf Shinar c/o ForSight VISION6, Inc. 171 Jefferson Drive Menlo Park CA CALIFORNIA 94025 Director Lihu Avitov c/o ForSight VISION6, Inc. 171 Jefferson Drive Menlo Park CA CALIFORNIA 94025 Director Other Health Care Decline to Disclose 06b false 2017-09-12 false true false 0 5999998 2999999 2999999 false 9 0 0 0 false ForSight VISION6, Inc. /s/ Eugene de Juan, Jr., M.D. Eugene de Juan, Jr., M.D. Chief Executive Officer 2017-09-22