0001635104-15-000001.txt : 20150312 0001635104-15-000001.hdr.sgml : 20150312 20150312150539 ACCESSION NUMBER: 0001635104-15-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150312 DATE AS OF CHANGE: 20150312 EFFECTIVENESS DATE: 20150312 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PotaVida, Inc. CENTRAL INDEX KEY: 0001635104 IRS NUMBER: 452488446 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-235786 FILM NUMBER: 15695663 BUSINESS ADDRESS: STREET 1: 1302 NW 70TH STREET CITY: SEATTLE STATE: WA ZIP: 98117 BUSINESS PHONE: (206) 406-3558 MAIL ADDRESS: STREET 1: 1302 NW 70TH STREET CITY: SEATTLE STATE: WA ZIP: 98117 D 1 primary_doc.xml X0707 D LIVE 0001635104 PotaVida, Inc. 1302 NW 70TH STREET SEATTLE WA WASHINGTON 98117 (206) 406-3558 DELAWARE None None Corporation true 2011 Charles Matlack c/o PotaVida, Inc. 1302 NW 70th Street Seattle WA WASHINGTON 98117 Executive Officer Director Promoter Tyler Davis c/o PotaVida, Inc. 1302 NW 70th Street Seattle WA WASHINGTON 98117 Executive Officer Director Promoter Jacqueline Linnes c/o PotaVida, Inc. 1302 NW 70th Street Seattle WA WASHINGTON 98117 Executive Officer Director Promoter Other Technology Decline to Disclose 06b false 2015-02-27 false true false 0 500020 200004 300016 false 13 0 0 0 false PotaVida, Inc. /s/ Charles Matlack Charles Matlack Chief Executive Officer 2015-03-11