0001144204-18-031116.txt : 20180525 0001144204-18-031116.hdr.sgml : 20180525 20180525162118 ACCESSION NUMBER: 0001144204-18-031116 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180525 DATE AS OF CHANGE: 20180525 EFFECTIVENESS DATE: 20180525 FILER: COMPANY DATA: COMPANY CONFORMED NAME: CleanSlate Centers, Inc. CENTRAL INDEX KEY: 0001676302 IRS NUMBER: 464372716 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-313341 FILM NUMBER: 18861801 BUSINESS ADDRESS: STREET 1: 244 MAIN STREET CITY: NORTHAMPTON STATE: MA ZIP: 01061 BUSINESS PHONE: 413-517-6066 MAIL ADDRESS: STREET 1: 244 MAIN STREET CITY: NORTHAMPTON STATE: MA ZIP: 01061 D 1 primary_doc.xml X0708 D LIVE 0001676302 CleanSlate Centers, Inc. 12 CADILLAC DRIVE, SUITE 380 BRENTWOOD TN TENNESSEE 37027 413-517-6066 DELAWARE None None Corporation true 2013 Amanda Wilson 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Director Diane M. Daych 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Director Daniel Kossmann 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Director None except for normal operation expenses Patrick Kennedy 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Director Eugene Fleming 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Director Paul Brown 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Director Christopher Jedrey 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Director Kelly J. Clark 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Executive Officer Gregory C. Marotta 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Executive Officer Director Patrick Murphy 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Executive Officer Paul Chabot 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Executive Officer Mark Brooks 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Director Garheng Kong 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Director Anthony Belott 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Executive Officer Neil Kunkel 12 Cadillac Drive, Suite 380 Brentwood TN TENNESSEE 37027 Executive Officer Other Decline to Disclose 06b false 2018-05-11 false true false 10000000 25000000 25000000 0 false 2 0 0 0 None except for normal operation expenses false CleanSlate Centers, Inc. /s/ Patrick Murphy Patrick Murphy Chief Financial Officer 2018-05-15