Form C: Filer Information

Filer CIK:

0001697699

Filer CCC:

XXXXXXXX

Is this a LIVE or TEST Filing?

Radio button checked

LIVE

Radio button not checked

TEST

Is this an electronic copy of an official filing submitted in paper format in connection with a hardship exemption?

Checkbox not checked

Would you like a Return Copy?

Checkbox not checked

Submission Contact Information

Name:

Phone Number:

Contact E-Mail Address:

Notify via Filing Website only?

Checkbox not checked

Form C: Issuer Information

Issuer Information

Name of Issuer:

SEPARATE.US

Legal Status of Issuer:

Form:

Corporation

Jurisdiction of Incorporation/Organization:

DELAWARE

Date of Incorporation/Organization:

10-29-2014

Physical Address of Issuer:

Address 1:

4096 PIEDMONT AVENUE

Address 2:

#325

City:

OAKLAND

State/Country:

CALIFORNIA

Mailing Zip/Postal Code:

94611

Website of Issuer:

www.seperate.us.com

Intermediary through which the Offering will be Conducted:

CIK:

0001603038

Company Name:

SI SECURITIES, LLC

Commission File Number:

008-69440

CRD Number:

000170937

Form C: Offering Information

Offering Information

Amount of compensation to be paid to the intermediary, whether as a dollar amount or a percentage of the offering amount, or a good faith estimate if the exact amount is not available at the time of the filing, for conducting the offering, including the amount of referral and any other fees associated with the offering:

SI Securities, LLC will receive a 5% cash commission and 5% convertible debt commission on all sales through the broker-dealer (e.g., $5,000 cash and $5,000 convertible note on a raise of $100,000)

Any other financial interest in the issuer held by the intermediary, or any arrangement for the intermediary to acquire such an interest:

The intermediary will acquire a convertible note for the issuer valued at 5% of the amount raised through SI Securities, LLC.

Type of Security Offered:

Debt

Price:

1.00000

Target Offering Amount:

100000.00

Maximum Offering Amount (if different from Target Offering Amount):

600000.00

Oversubscriptions Accepted:

Radio button checked

Yes

Radio button not checked

No

If yes, disclose how oversubscriptions will be allocated:

First-come, first-served basis

Deadline to reach the Target Offering Amount:

05-27-2017

NOTE: If the sum of the investment commitments does not equal or exceed the target offering amount at the offering deadline, no securities will be sold in the offering, investment commitments will be cancelled and committed funds will be returned.

Form C: Annual Report Disclosure Requirements

Annual Report Disclosure Requirements

Current Number of Employees:

6

Total Assets Most Recent Fiscal Year-end:

10675.00

Total Assets Prior Fiscal Year-end:

3322.00

Cash and Cash Equivalents Most Recent Fiscal Year-end:

10675.00

Cash and Cash Equivalents Prior Fiscal Year-end:

3322.00

Accounts Receivable Most Recent Fiscal Year-end:

0.00

Accounts Receivable Prior Fiscal Year-end:

0.00

Short-term Debt Most Recent Fiscal Year-end:

158687.00

Short-term Debt Prior Fiscal Year-end:

6528.00

Long-term Debt Most Recent Fiscal Year-end:

0.00

Long-term Debt Prior Fiscal Year-end:

0.00

Revenue/Sales Most Recent Fiscal Year-end:

9876.00

Revenue/Sales Prior Fiscal Year-end:

396.00

Cost of Goods Sold Most Recent Fiscal Year-end:

-3609.00

Cost of Goods Sold Prior Fiscal Year-end:

-79.00

Taxes Paid Most Recent Fiscal Year-end:

0.00

Taxes Paid Prior Fiscal Year-end:

0.00

Net Income Most Recent Fiscal Year-end:

-144761.00

Net Income Prior Fiscal Year-end:

-20662.00

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

ALABAMA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

ALASKA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

ARIZONA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

ARKANSAS

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

CALIFORNIA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

COLORADO

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

CONNECTICUT

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

DELAWARE

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

DISTRICT OF COLUMBIA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

FLORIDA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

GEORGIA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

HAWAII

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

IDAHO

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

ILLINOIS

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

INDIANA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

IOWA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

KANSAS

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

KENTUCKY

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

LOUISIANA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

MAINE

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

MARYLAND

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

MASSACHUSETTS

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

MICHIGAN

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

MINNESOTA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

MISSISSIPPI

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

MISSOURI

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

MONTANA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

NEBRASKA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

NEVADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

NEW HAMPSHIRE

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

NEW JERSEY

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

NEW MEXICO

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

NEW YORK

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

NORTH CAROLINA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

NORTH DAKOTA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

OHIO

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

OKLAHOMA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

OREGON

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

PENNSYLVANIA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

PUERTO RICO

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

RHODE ISLAND

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

SOUTH CAROLINA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

SOUTH DAKOTA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

TENNESSEE

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

TEXAS

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

UTAH

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

VERMONT

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

VIRGINIA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

WASHINGTON

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

WEST VIRGINIA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

WISCONSIN

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

WYOMING

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

ALBERTA, CANADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

BRITISH COLUMBIA, CANADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

MANITOBA, CANADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

NEW BRUNSWICK, CANADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

NEWFOUNDLAND, CANADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

NOVA SCOTIA, CANADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

ONTARIO, CANADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

PRINCE EDWARD ISLAND, CANADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

QUEBEC, CANADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

SASKATCHEWAN, CANADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

YUKON, CANADA

Using the list below, select the jurisdictions in which the issuer intends to offer the securities:

CANADA (FEDERAL LEVEL)

Form C: Signature

Signature

Pursuant to the requirements of Sections 4(a)(6) and 4A of the Securities Act of 1933 and Regulation Crowdfunding (§ 227.100-503), the issuer certifies that it has reasonable grounds to believe that it meets all of the requirements for filing on Form C and has duly caused this Form to be signed on its behalf by the duly authorized undersigned.

Issuer:

SEPARATE.US

Signature:

Sandro Tuzzo

Title:

CEO

Pursuant to the requirements of Sections 4(a)(6) and 4A of the Securities Act of 1933 and Regulation Crowdfunding (§ 227.100-503), this Form C has been signed by the following persons in the capacities and on the dates indicated.

Signature:

Sandro Tuzzo

Title:

Principal Executive Officer, Principal Accounting Officer, Principal Financial Officer , Director

Date:

03-14-2017