0001611639-14-000001.txt : 20140626 0001611639-14-000001.hdr.sgml : 20140626 20140625181716 ACCESSION NUMBER: 0001611639-14-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20140626 DATE AS OF CHANGE: 20140625 EFFECTIVENESS DATE: 20140626 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PayActiv, Inc. CENTRAL INDEX KEY: 0001611639 IRS NUMBER: 454058899 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-219834 FILM NUMBER: 14940943 BUSINESS ADDRESS: STREET 1: 4300 STEVENS CREEK BOULEVARD SUITE 190 CITY: SAN JOSE STATE: CA ZIP: 95129 BUSINESS PHONE: (408) 507-9384 MAIL ADDRESS: STREET 1: 4300 STEVENS CREEK BOULEVARD SUITE 190 CITY: SAN JOSE STATE: CA ZIP: 95129 D 1 primary_doc.xml X0707 D LIVE 0001611639 PayActiv, Inc. 4300 STEVENS CREEK BOULEVARD SUITE 190 SAN JOSE CA CALIFORNIA 95129 (408) 507-9384 DELAWARE PayKloud, Inc. None Corporation true 2011 Shah Safwan 4300 STEVENS CREEK BOULEVARD SUITE 190 San Jose CA CALIFORNIA 95129 Executive Officer Director Ajit Medhekar 4300 STEVENS CREEK BOULEVARD SUITE 190 San Jose CA CALIFORNIA 95129 Director Scarlett O'Sullivan 4300 STEVENS CREEK BOULEVARD SUITE 190 San Jose CA CALIFORNIA 95129 Director Kabir Misra 4300 STEVENS CREEK BOULEVARD SUITE 190 San Jose CA CALIFORNIA 95129 Director Other Technology Decline to Disclose 06b false 2014-06-12 false true false 0 5200000 4349998 850002 false 6 0 0 0 false PayActiv, Inc. /s/ Safwan Shah Safwan Shah Chief Executive Officer 2014-06-25