0001691625-16-000001.txt : 20161207 0001691625-16-000001.hdr.sgml : 20161207 20161206190200 ACCESSION NUMBER: 0001691625-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161207 DATE AS OF CHANGE: 20161206 EFFECTIVENESS DATE: 20161207 FILER: COMPANY DATA: COMPANY CONFORMED NAME: AXIAL BIOTHERAPEUTICS, INC. CENTRAL INDEX KEY: 0001691625 IRS NUMBER: 464394856 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-275764 FILM NUMBER: 162037370 BUSINESS ADDRESS: STREET 1: 800 BOYLSTON ST., SUITE 1555 CITY: BOSTON STATE: MA ZIP: 02199 BUSINESS PHONE: (617) 351-2590 MAIL ADDRESS: STREET 1: 800 BOYLSTON ST., SUITE 1555 CITY: BOSTON STATE: MA ZIP: 02199 D 1 primary_doc.xml X0707 D LIVE 0001691625 AXIAL BIOTHERAPEUTICS, INC. 800 BOYLSTON ST., SUITE 1555 BOSTON MA MASSACHUSETTS 02199 (617) 351-2590 DELAWARE NEUROBIOTIX HEALTH, INC. None Corporation true 2013 DAVID H. DONABEDIAN 800 BOYLSTON ST., SUITE 1555 BOSTON MA MASSACHUSETTS 02199 Executive Officer CHIEF EXECUTIVE OFFICER OF THE ISSUER JAMES C. BLAIR ONE PALMER SQUARE PRINCETON NJ NEW JERSEY 08542 Director MICHELLE DIPP 800 BOYLSTON ST., SUITE 1555 BOSTON MA MASSACHUSETTS 02199 Director SARKIS K. MAZMANIAN 3532 EMERALD ISLE DR. GLENDALE CA CALIFORNIA 91203 Director Biotechnology Decline to Disclose 06b false 2016-11-22 false true false 150000 19150000 9575000 9575000 false 16 0 0 0 false AXIAL BIOTHERAPEUTICS, INC. /S/ RICHARD FRIEDMAN RICHARD FRIEDMAN SECRETARY 2016-12-06