0001624178-17-000001.txt : 20171121 0001624178-17-000001.hdr.sgml : 20171121 20171121134937 ACCESSION NUMBER: 0001624178-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171121 DATE AS OF CHANGE: 20171121 EFFECTIVENESS DATE: 20171121 FILER: COMPANY DATA: COMPANY CONFORMED NAME: eyeBrain Medical, Inc. CENTRAL INDEX KEY: 0001624178 IRS NUMBER: 455334353 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-299288 FILM NUMBER: 171216201 BUSINESS ADDRESS: STREET 1: 540 SAN BERNADINO AVENUE CITY: NEWPORT BEACH STATE: CA ZIP: 92663 BUSINESS PHONE: (949) 677-2017 MAIL ADDRESS: STREET 1: 540 SAN BERNADINO AVENUE CITY: NEWPORT BEACH STATE: CA ZIP: 92663 D 1 primary_doc.xml X0708 D LIVE 0001624178 eyeBrain Medical, Inc. 3184 Airway Avenue Suite C Costa Mesa CA CALIFORNIA 92626 (949) 677-2017 DELAWARE Yelroc Neuro, Inc. None Corporation true 2012 Davis Corley c/o eyeBrain Medical, Inc. 3184 Airway Avenue, Suite C Costa Mesa CA CALIFORNIA 92626 Executive Officer Director J. Andy Corley c/o eyeBrain Medical, Inc. 3184 Airway Avenue, Suite C Costa Mesa CA CALIFORNIA 92626 Executive Officer Director Dean Butler c/o eyeBrain Medical, Inc. 3184 Airway Avenue, Suite C Costa Mesa CA CALIFORNIA 92626 Director Daniel Perales c/o eyeBrain Medical, Inc. 3184 Airway Avenue, Suite C Costa Mesa CA CALIFORNIA 92626 Executive Officer Tom Frinzi c/o eyeBrain Medical, Inc. 3184 Airway Avenue, Suite C Costa Mesa CA CALIFORNIA 92626 Director Steve T. Kirby c/o eyeBrain Medical, Inc. 3184 Airway Avenue, Suite C Costa Mesa CA CALIFORNIA 92626 Director Biotechnology Decline to Disclose 06b false 2017-11-07 false true false 0 14000000 7521913 6478087 $1,521,917.80 in conversion of promissory notes; $5,999,995.94 in new money. false 13 0 0 0 false eyeBrain Medical, Inc. /s/ Davis Corley Davis Corley President 2017-11-21