0001705834-17-000001.txt : 20170508 0001705834-17-000001.hdr.sgml : 20170508 20170508135034 ACCESSION NUMBER: 0001705834-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170508 DATE AS OF CHANGE: 20170508 EFFECTIVENESS DATE: 20170508 FILER: COMPANY DATA: COMPANY CONFORMED NAME: SimpleDisability, Inc. CENTRAL INDEX KEY: 0001705834 IRS NUMBER: 810911543 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-286227 FILM NUMBER: 17821583 BUSINESS ADDRESS: STREET 1: 440 N WOLFE ROAD CITY: SUNNYVALE STATE: CA ZIP: 94085 BUSINESS PHONE: (650) 804-4200 MAIL ADDRESS: STREET 1: 440 N WOLFE ROAD CITY: SUNNYVALE STATE: CA ZIP: 94085 D 1 primary_doc.xml X0707 D LIVE 0001705834 SimpleDisability, Inc. 440 N WOLFE ROAD SUNNYVALE CA CALIFORNIA 94085 (650) 804-4200 DELAWARE None None Corporation true 2015 Philip Engelhardt Post Office Box 721 Palo Alto CA CALIFORNIA 94302-0721 Executive Officer Insurance Decline to Disclose 06b false 2016-03-08 false true true Issuance of Convertible Promissory Notes and the Preferred Stock to be issued upon conversion and the Common Stock to be issued upon conversion thereof. false 0 1500000 450000 1050000 false 7 0 0 0 false SimpleDisability, Inc. Philip L. Engelhardt Philip L. Engelhardt Chief Executive Officer 2017-05-08