0001140361-17-040476.txt : 20171101 0001140361-17-040476.hdr.sgml : 20171101 20171101144604 ACCESSION NUMBER: 0001140361-17-040476 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171101 DATE AS OF CHANGE: 20171101 EFFECTIVENESS DATE: 20171101 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ClaimKit, Inc. CENTRAL INDEX KEY: 0001618395 IRS NUMBER: 454037055 STATE OF INCORPORATION: DE FISCAL YEAR END: 1214 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-297900 FILM NUMBER: 171168553 BUSINESS ADDRESS: STREET 1: 6811 SHAWNEE MISSION PARKWAY SUITE 211 CITY: OVERLAND PARK STATE: KS ZIP: 66202 BUSINESS PHONE: 9132135933 MAIL ADDRESS: STREET 1: 6811 SHAWNEE MISSION PARKWAY SUITE 211 CITY: OVERLAND PARK STATE: KS ZIP: 66202 FORMER COMPANY: FORMER CONFORMED NAME: ClaimKit LLC DATE OF NAME CHANGE: 20140902 D 1 primary_doc.xml X0708 D LIVE 0001618395 ClaimKit, Inc. 6811 Shawnee Mission Parkway Suite 211 Overland Park KS KANSAS 66202 9132135933 DELAWARE None ClaimKit LLC Corporation true Christopher Cheatham 6811 Shawnee Mission Parkway Suite 211 Overland Park KS KANSAS 66202 Executive Officer Director Kevin Rauckman 12113 Haskins Street Overland Park KS KANSAS 66213 Director Douglas Reiser 11 Wake Robin Way Asheville NC NORTH CAROLINA 28805 Executive Officer Director Keith Molzer 5700 W. 112 Street Suite 500 Overland Park KS KANSAS 66211 Director Dan Burtchett 3265 W. Primrose Street Springfield MO MISSOURI 65807 Executive Officer John Beckman Level 19, 55 Water Street New York NY NEW YORK 10041 Director Other Technology Decline to Disclose 06b false 2017-10-19 false true false 13318 2948335 2948335 0 false 9 0 0 0 false ClaimKit, Inc. /s/ Christopher Cheatham Christopher Cheatham President & CEO 2017-10-19