0001691625-19-000002.txt : 20190624 0001691625-19-000002.hdr.sgml : 20190624 20190624100614 ACCESSION NUMBER: 0001691625-19-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190624 DATE AS OF CHANGE: 20190624 EFFECTIVENESS DATE: 20190624 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: 021-342556 FILM NUMBER: 19913836 BUSINESS ADDRESS: STREET 1: 9 FOURTH AVENUE CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: (617) 874-5260 MAIL ADDRESS: STREET 1: 9 FOURTH AVENUE CITY: WALTHAM STATE: MA ZIP: 02451 D 1 primary_doc.xml X0708 D LIVE 0001691625 AXIAL BIOTHERAPEUTICS, INC. 9 FOURTH AVENUE WALTHAM MA MASSACHUSETTS 02451 (617) 874-5260 DELAWARE NEUROBIOTIX HEALTH, INC. None Corporation true DAVID H. DONABEDIAN 9 FOURTH AVENUE WALTHAM MA MASSACHUSETTS 02451 Executive Officer Director JAMES C. BLAIR 9 FOURTH AVENUE WALTHAM MA MASSACHUSETTS 02451 Director RICHARD P. ALDRICH 9 FOURTH AVENUE WALTHAM MA MASSACHUSETTS 02451 Director SARKIS K. MAZMANIAN 9 FOURTH AVENUE WALTHAM MA MASSACHUSETTS 02451 Director Ronald C. Renaud Jr. 9 FOURTH AVENUE WALTHAM MA MASSACHUSETTS 02451 Director Henry C. Wolf 9 FOURTH AVENUE WALTHAM MA MASSACHUSETTS 02451 Director Eric De La Fortelle 9 FOURTH AVENUE WALTHAM MA MASSACHUSETTS 02451 Director SAKAE ASANUMA 9 FOURTH AVENUE WALTHAM MA MASSACHUSETTS 02451 Director JEFFREY YOUNG 9 FOURTH AVENUE WALTHAM MA MASSACHUSETTS 02451 Executive Officer Pharmaceuticals Decline to Disclose 06b false 2019-06-18 false true false 0 10000000 5000000 5000000 false 1 0 0 0 false AXIAL BIOTHERAPEUTICS, INC. /s/ David H. Donabedian David H. Donabedian Chief Executive Officer 2019-06-24