0001596771-20-000100.txt : 20201029 0001596771-20-000100.hdr.sgml : 20201029 20201029161801 ACCESSION NUMBER: 0001596771-20-000100 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20201029 DATE AS OF CHANGE: 20201029 EFFECTIVENESS DATE: 20201029 FILER: COMPANY DATA: COMPANY CONFORMED NAME: SHOULDER INNOVATIONS, INC. CENTRAL INDEX KEY: 0001699350 IRS NUMBER: 270538764 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-379233 FILM NUMBER: 201272898 BUSINESS ADDRESS: STREET 1: 13827 PORT SHELDON STREET CITY: HOLLAND STATE: MI ZIP: 49424 BUSINESS PHONE: 616-566-0286 MAIL ADDRESS: STREET 1: 13827 PORT SHELDON STREET CITY: HOLLAND STATE: MI ZIP: 49424 D 1 primary_doc.xml X0708 D LIVE 0001699350 SHOULDER INNOVATIONS, INC. 220 Lyon NW Suite 500 Grand Rapids MI MICHIGAN 49503 616-566-0286 DELAWARE None None Corporation true Matthew Ahearn C/O Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Executive Officer Director Robert Ball C/O Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Executive Officer Director David Blue C/O Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Executive Officer Casey Tansey C/O Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Director Mike Carusi C/O Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Director Kevin Sidow c/o Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Director Paul Buckman c/o Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Director Other Health Care Decline to Disclose 06b false 2020-10-22 false true false 0 21550002 21550002 0 false 24 0 0 0 false SHOULDER INNOVATIONS, INC. /s/ Matthew Ahearn Matthew Ahearn COO and CFO 2020-10-29