0001663633-17-000001.txt : 20171103 0001663633-17-000001.hdr.sgml : 20171103 20171103140307 ACCESSION NUMBER: 0001663633-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171103 DATE AS OF CHANGE: 20171103 EFFECTIVENESS DATE: 20171103 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Amperity, Inc. CENTRAL INDEX KEY: 0001663633 IRS NUMBER: 810890699 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-298073 FILM NUMBER: 171175822 BUSINESS ADDRESS: STREET 1: 500 YALE AVE N., SUITE 341 CITY: SEATTLE STATE: WA ZIP: 98109 BUSINESS PHONE: (425) 891-5252 MAIL ADDRESS: STREET 1: 500 YALE AVE N., SUITE 341 CITY: SEATTLE STATE: WA ZIP: 98109 D 1 primary_doc.xml X0708 D LIVE 0001663633 Amperity, Inc. 2101 4th Avenue #1960 SEATTLE WA WASHINGTON 98121 206.432.8302 DELAWARE None None Corporation true 2015 Kabir Shahani c/o Amperity, Inc. 2101 4th Avenue #1960 Seattle WA WASHINGTON 98121 Executive Officer Director Promoter Derek Slager c/o Amperity, Inc. 2101 4th Avenue #1960 Seattle WA WASHINGTON 98121 Executive Officer Director Promoter Matt McIlwain c/o Amperity, Inc. 2101 4th Avenue #1960 Seattle WA WASHINGTON 98121 Director Rajeev Singh c/o Amperity, Inc. 2101 4th Avenue #1960 Seattle WA WASHINGTON 98121 Director Kelly Wright c/o Amperity, Inc. 2101 4th Avenue #1960 Seattle WA WASHINGTON 98121 Director Amy Pelly c/o Amperity, Inc. 2101 4th Avenue #1960 Seattle WA WASHINGTON 98121 Executive Officer Other Technology Decline to Disclose 06b false 2017-10-23 false true false 0 27999993 27999993 0 false 5 0 0 0 false Amperity, Inc. /s/ Kabir Shahani Kabir Shahani Chief Executive Officer and President 2017-11-02