0001567619-22-008149.txt : 20220406 0001567619-22-008149.hdr.sgml : 20220406 20220406092251 ACCESSION NUMBER: 0001567619-22-008149 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20220406 DATE AS OF CHANGE: 20220406 EFFECTIVENESS DATE: 20220406 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ACTIV Surgical, Inc. CENTRAL INDEX KEY: 0001710426 IRS NUMBER: 472924761 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-440554 FILM NUMBER: 22809576 BUSINESS ADDRESS: STREET 1: 840 SUMMER STREET, SUITE 108 CITY: BOSTON STATE: MA ZIP: 02127 BUSINESS PHONE: (646) 312-9611 MAIL ADDRESS: STREET 1: 840 SUMMER STREET, SUITE 108 CITY: BOSTON STATE: MA ZIP: 02127 FORMER COMPANY: FORMER CONFORMED NAME: Omniboros Inc. DATE OF NAME CHANGE: 20170627 D 1 primary_doc.xml X0708 D LIVE 0001710426 ACTIV Surgical, Inc. 30 THOMPSON PL BOSTON MA MASSACHUSETTS 02210-1281 617-333-8162 DELAWARE OMNIBOROS INC. Omniboros Inc. Corporation true TODD USEN 30 THOMPSON PL BOSTON MA MASSACHUSETTS 02210-1281 Executive Officer Director PETER KIM 30 THOMPSON PL BOSTON MA MASSACHUSETTS 02210-1281 Executive Officer Director TOM CALEF 30 THOMPSON PL BOSTON MA MASSACHUSETTS 02210-1281 Executive Officer PAUL MEISTER 30 THOMPSON PL BOSTON MA MASSACHUSETTS 02210-1281 Director EMILY CASEY 30 THOMPSON PL BOSTON MA MASSACHUSETTS 02210-1281 Director ASHOK KRISHNAMURTHI 30 THOMPSON PL BOSTON MA MASSACHUSETTS 02210-1281 Director AMEENA EL-BIBANY 30 THOMPSON PL BOSTON MA MASSACHUSETTS 02210-1281 Director WILL COWEN 30 THOMPSON PL BOSTON MA MASSACHUSETTS 02210-1281 Director BABAK YAZDANI 30 THOMPSON PL BOSTON MA MASSACHUSETTS 02210-1281 Director HEATHER MANNILA 30 THOMPSON PL BOSTON MA MASSACHUSETTS 02210-1281 Executive Officer Other Health Care Decline to Disclose 06b false 2022-03-22 false true false 0 14569780 14569780 0 false 18 0 0 0 false ACTIV Surgical, Inc. /S/ TODD USEN TODD USEN CHIEF EXECUTIVE OFFICER 2022-04-04