0000914760-15-000170.txt : 20150511 0000914760-15-000170.hdr.sgml : 20150511 20150511125550 ACCESSION NUMBER: 0000914760-15-000170 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150511 DATE AS OF CHANGE: 20150511 EFFECTIVENESS DATE: 20150511 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PellePharm, Inc. CENTRAL INDEX KEY: 0001611568 IRS NUMBER: 460616581 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-239545 FILM NUMBER: 15849767 BUSINESS ADDRESS: STREET 1: 275 MIDDLEFIELD ROAD, STE. 100 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: (650) 815-7404 MAIL ADDRESS: STREET 1: 275 MIDDLEFIELD ROAD, STE. 100 CITY: MENLO PARK STATE: CA ZIP: 94025 D 1 primary_doc.xml X0707 D LIVE 0001611568 PellePharm, Inc. C/O P. DESTEFANO, 275 MIDDLEFIELD ROAD SUITE 100 MENLO PARK CA CALIFORNIA 94025 (650) 815-7404 DELAWARE None None Corporation true 2012 Mark de Souza 904 Alvarado Road Berkeley CA CALIFORNIA 94705 Executive Officer Ervin Epstein 553A Miner Road Orinda CA CALIFORNIA 94563 Executive Officer Director Jean Tang 853 Esplanada Way Stanford CA CALIFORNIA 94305 Director Katrin Andreasson 928 Mears Court Stanford CA CALIFORNIA 94305 Director Biotechnology Decline to Disclose 06b false 2015-01-08 false true false 0 118625 118625 0 false 1 0 0 0 CEO received shares in the value of $118,625. false PellePharm, Inc. /s/ Mark De Souza Mark de Souza Chief Executive Officer 2015-05-11