0001636592-16-000002.txt : 20161215 0001636592-16-000002.hdr.sgml : 20161215 20161215154754 ACCESSION NUMBER: 0001636592-16-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161215 DATE AS OF CHANGE: 20161215 EFFECTIVENESS DATE: 20161215 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Product Verification Solutions, Inc. CENTRAL INDEX KEY: 0001636592 IRS NUMBER: 465507600 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-276395 FILM NUMBER: 162053623 BUSINESS ADDRESS: STREET 1: 11512 LAKE MEAD AVENUE, STE 104 CITY: JACKSONVILLE STATE: FL ZIP: 32256 BUSINESS PHONE: 904-363-6178 MAIL ADDRESS: STREET 1: 11512 LAKE MEAD AVENUE, STE 104 CITY: JACKSONVILLE STATE: FL ZIP: 32256 D 1 primary_doc.xml X0707 D LIVE 0001636592 Product Verification Solutions, Inc. 10475 FORTUNE PARKWAY, STE 200 JACKSONVILLE FL FLORIDA 32256 904-363-6178 DELAWARE None None Corporation true 2014 BRUCE R KERN 10475 FORTUNE PARKWAY, STE 200 JACKSONVILLE FL FLORIDA 32256 Executive Officer Director Business Services Decline to Disclose 06b false 2016-12-14 false true true true false 0 3500000 50000 3450000 Sale of Series A Convertible Preferred Stock. Investors from prior note offering have the option to convert principal amount and interest for shares of Series A stock in this Offering. false 1 0 0 0 false Product Verification Solutions, Inc. s/Bruce R. Kern Bruce R. Kern President 2016-12-15