0001692278-21-000001.txt : 20211029 0001692278-21-000001.hdr.sgml : 20211029 20211029150848 ACCESSION NUMBER: 0001692278-21-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20211029 DATE AS OF CHANGE: 20211029 EFFECTIVENESS DATE: 20211029 FILER: COMPANY DATA: COMPANY CONFORMED NAME: HEALTHY ROSTER, INC. CENTRAL INDEX KEY: 0001692278 IRS NUMBER: 474154256 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-419260 FILM NUMBER: 211362719 BUSINESS ADDRESS: STREET 1: 20 NORTH STREET CITY: DUBLIN STATE: OH ZIP: 43017 BUSINESS PHONE: 614-505-7427 MAIL ADDRESS: STREET 1: 20 NORTH STREET CITY: DUBLIN STATE: OH ZIP: 43017 D 1 primary_doc.xml X0708 D LIVE 0001692278 HEALTHY ROSTER, INC. 7335 Badenoch Dr DUBLIN OH OHIO 43017 614-505-7427 DELAWARE None None Corporation true Nathan Heerdt PO BOX 1114 Dublin OH OHIO 43017 Executive Officer Director Dan Fronczak PO Box 1114 Dublin OH OHIO 43017 Executive Officer Director Shawn Price PO Box 1114 Dublin OH OHIO 43017 Executive Officer Director Theodore Capossela PO Box 1114 Dublin OH OHIO 43017 Director Ryan Helon 1275 Kinnear Road Columbus OH OHIO 43212 Director Mark Shary 6565 Plesenton Drive Worthington OH OHIO 43085 Director Dave Blom PO Box 1114 Dublin OH OHIO 43017 Director Other Technology Decline to Disclose 06b false 2021-10-21 false true Convertible Security false 5000 5000000 2069577 2930423 false 28 0 0 450000 true The invested funds are being used to fund general working capital. The payments described in this Item 16 include only payments to executive officers described in Item 3 above. false HEALTHY ROSTER, INC. /s/ Nathan Heerdt Nathan Heerdt by Joshua Borean, Attorney in Fact Chief Executive Officer 2021-10-29