0001697698-17-000002.txt : 20170214 0001697698-17-000002.hdr.sgml : 20170214 20170214163107 ACCESSION NUMBER: 0001697698-17-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170214 DATE AS OF CHANGE: 20170214 EFFECTIVENESS DATE: 20170214 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Bloom Automation, Inc. CENTRAL INDEX KEY: 0001697698 IRS NUMBER: 812298889 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-280682 FILM NUMBER: 17609467 BUSINESS ADDRESS: STREET 1: 54 FOREST ST STREET 2: UNIT 118 CITY: MEDFORD STATE: MA ZIP: 02155 BUSINESS PHONE: 2672438661 MAIL ADDRESS: STREET 1: 54 FOREST ST STREET 2: UNIT 118 CITY: MEDFORD STATE: MA ZIP: 02155 D 1 primary_doc.xml X0707 D LIVE 0001697698 Bloom Automation, Inc. 54 FOREST ST UNIT 118 MEDFORD MA MASSACHUSETTS 02155 2672438661 DELAWARE None None Corporation true 2016 Jon Thomas Gowa 54 Forest St Unit 118 Medford MA MASSACHUSETTS 02155 Executive Officer Anderew Jay Gowa 770 Periwinkle Lane Wynnewood PA PENNSYLVANIA 19096 Director Other Technology No Revenues 06b false 2017-02-03 false true false 5000 30000 30000 0 false 1 0 0 12000 true false Bloom Automation, Inc. Jon Gowa Jon Gowa CEO 2017-02-14