0001710119-18-000002.txt : 20180423 0001710119-18-000002.hdr.sgml : 20180423 20180420174445 ACCESSION NUMBER: 0001710119-18-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180423 DATE AS OF CHANGE: 20180420 EFFECTIVENESS DATE: 20180423 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Xomi, Inc. CENTRAL INDEX KEY: 0001710119 IRS NUMBER: 821621607 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-310743 FILM NUMBER: 18767644 BUSINESS ADDRESS: STREET 1: 10235 S. JORDAN GATEWAY, SUITE 500 CITY: SOUTH JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 801-753-0800 MAIL ADDRESS: STREET 1: 10235 S. JORDAN GATEWAY, SUITE 500 CITY: SOUTH JORDAN STATE: UT ZIP: 84095 FORMER COMPANY: FORMER CONFORMED NAME: Xomi Holdings LLC DATE OF NAME CHANGE: 20170622 D 1 primary_doc.xml X0708 D LIVE 0001710119 Xomi, Inc. 10235 S. JORDAN GATEWAY, SUITE 500 SOUTH JORDAN UT UTAH 84095 801-753-0800 DELAWARE Xomi Holdings LLC Corporation true 2017 David Wilkes 10235 S. Jordan Gateway, Suite 500 South Jordan UT UTAH 84095 Executive Officer Director Promoter Khalid El-Awady 10235 S. Jordan Gateway, Suite 500 South Jordan UT UTAH 84095 Executive Officer Promoter Thomas Ball 10235 S. Jordan Gateway, Suite 500 South Jordan UT UTAH 84095 Director Gavin Christensen 10235 S. Jordan Gateway, Suite 500 South Jordan UT UTAH 84095 Director Other Technology Decline to Disclose 06b false 2018-04-13 false true false 0 7086812 5136812 1950000 Includes shares issued upon conversion of outstanding indebtedness and Simple Agreements for Future Equity (S.A.F.E.s). false 8 0 0 0 false Xomi, Inc. /s/ David Wilkes David Wilkes Chief Executive Officer 2018-04-20