0001625988-17-000001.txt : 20170118 0001625988-17-000001.hdr.sgml : 20170118 20170118164422 ACCESSION NUMBER: 0001625988-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170118 DATE AS OF CHANGE: 20170118 EFFECTIVENESS DATE: 20170118 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Qualtrax, Inc. CENTRAL INDEX KEY: 0001694185 IRS NUMBER: 541935742 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-278714 FILM NUMBER: 17533880 BUSINESS ADDRESS: STREET 1: 105 E ROANOKE STREET CITY: BLACKSBURG STATE: VA ZIP: 24060 BUSINESS PHONE: 540-260-9961 MAIL ADDRESS: STREET 1: 105 E ROANOKE STREET CITY: BLACKSBURG STATE: VA ZIP: 24060 D 1 primary_doc.xml X0707 D LIVE 0001694185 Qualtrax, Inc. 105 E ROANOKE STREET BLACKSBURG VA VIRGINIA 24060 540-260-9961 DELAWARE Qualtrax Incorporated None Corporation true Amy Ankrum 105 E. Roanok Street Blacksburg VA VIRGINIA 24060 Executive Officer Director Timothy Lawson 2285 Prospect Drive Christiansburg VA VIRGINIA 24073 Executive Officer Director Martin Muscatello 2285 Prospect Drive Christiansburg VA VIRGINIA 24073 Executive Officer Director Jonathan Hagmaier 2965 Colonnade Drive Roanoke VA VIRGINIA 24018 Director My Le Nguyen 388 Market Street, Ste. 1300 San Francisco CA CALIFORNIA 94111 Director Other Technology Decline to Disclose 06b false 2017-01-11 true true false 499986 2999917 999972 1999945 false 2 0 0 0 false Qualtrax, Inc. /Amy Ankrum/ Amy Ankrum President 2017-01-18