0000905718-16-001073.txt : 20160119 0000905718-16-001073.hdr.sgml : 20160118 20160119112653 ACCESSION NUMBER: 0000905718-16-001073 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160119 DATE AS OF CHANGE: 20160119 EFFECTIVENESS DATE: 20160119 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PolicyGenius Inc. CENTRAL INDEX KEY: 0001663729 IRS NUMBER: 461553649 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-255406 FILM NUMBER: 161347436 BUSINESS ADDRESS: STREET 1: 240 KENT AVENUE CITY: BROOKLYN STATE: NY ZIP: 11249 BUSINESS PHONE: 855-695-2255 MAIL ADDRESS: STREET 1: 240 KENT AVENUE CITY: BROOKLYN STATE: NY ZIP: 11249 D 1 primary_doc.xml X0707 D LIVE 0001663729 PolicyGenius Inc. 240 KENT AVENUE BROOKLYN NY NEW YORK 11249 855-695-2255 DELAWARE KnowltOwl Inc. None Corporation true 2012 Jennifer Fitzgerald c/o PolicyGenius Inc. 240 Kent Avenue Brooklyn NY NEW YORK 11249 Executive Officer Director Francois de Lame c/o PolicyGenius Inc. 240 Kent Avenue Brooklyn NY NEW YORK 11249 Director Tianxiang Zhuo c/o PolicyGenius Inc. 240 Kent Avenue Brooklyn NY NEW YORK 11249 Director David Golden c/o Revolution Ventures II, LP 1717 Rhode Island Avenue NW, Suite 1000 Washington DC DISTRICT OF COLUMBIA 20036 Director Other Decline to Disclose 06b false 2015-12-18 false true true Series B false 0 16250000 15000000 1250000 Includes conversion of certain indebtedness false 22 0 0 0 true Some of the proceeds may be used for general working capital purposes which may include the payment of salaries and other fees to those listed in Item 3. false PolicyGenius Inc. /s/ Jennifer Fitzgerald Jennifer Fitzgerald Chief Executive Officer 2016-01-19