0001652565-19-000003.txt : 20190805 0001652565-19-000003.hdr.sgml : 20190805 20190805111639 ACCESSION NUMBER: 0001652565-19-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190805 DATE AS OF CHANGE: 20190805 EFFECTIVENESS DATE: 20190805 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Persivia Inc. CENTRAL INDEX KEY: 0001652565 IRS NUMBER: 473914583 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-345760 FILM NUMBER: 19997904 BUSINESS ADDRESS: STREET 1: 4 MOUNT ROYAL AVENUE, 4TH FL. CITY: MARLBOROUGH STATE: MA ZIP: 01752 BUSINESS PHONE: 978-856-4599 MAIL ADDRESS: STREET 1: 4 MOUNT ROYAL AVENUE, 4TH FL. CITY: MARLBOROUGH STATE: MA ZIP: 01752 FORMER COMPANY: FORMER CONFORMED NAME: Persivia Holdings Inc. DATE OF NAME CHANGE: 20150904 D 1 primary_doc.xml X0708 D LIVE 0001652565 Persivia Inc. 4 MOUNT ROYAL AVENUE, 4TH FL. MARLBOROUGH MA MASSACHUSETTS 01752 978-856-4599 DELAWARE M. Khan Holdings Inc. Persivia Holdings Inc. Corporation true 2015 Mansoor A. Khan 4 Mount Royal Avenue, 4th Fl. Marlborough MA MASSACHUSETTS 01752 Executive Officer Director Fauzia Khan 4 Mount Royal Avenue, 4th Fl. Marlborough MA MASSACHUSETTS 01752 Director Ron Zwanziger 4 Mount Royal Avenue, 4th Fl. Marlborough MA MASSACHUSETTS 01752 Director Edward Cahill 4 Mount Royal Avenue, 4th Fl. Marlborough MA MASSACHUSETTS 01752 Director Tadd Wessel 4 Mount Royal Avenue, 4th Fl. Marlborough MA MASSACHUSETTS 01752 Director Other Decline to Disclose 06b false 2019-07-25 false true false 0 3749996 1874998 1874998 false 1 0 0 0 false Persivia Inc. /s/ Mansoor A. Khan Mansoor A. Khan President 2019-08-05