0001231919-17-000044.txt : 20171012 0001231919-17-000044.hdr.sgml : 20171012 20171012104302 ACCESSION NUMBER: 0001231919-17-000044 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171012 DATE AS OF CHANGE: 20171012 EFFECTIVENESS DATE: 20171012 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Boost Insurance USA, Inc. CENTRAL INDEX KEY: 0001716228 IRS NUMBER: 821404234 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-296471 FILM NUMBER: 171133979 BUSINESS ADDRESS: STREET 1: 419 PARK AVENUE SOUTH CITY: NEW YORK STATE: NY ZIP: 10016 BUSINESS PHONE: 973-219-7362 MAIL ADDRESS: STREET 1: 419 PARK AVENUE SOUTH CITY: NEW YORK STATE: NY ZIP: 10016 D 1 primary_doc.xml X0708 D LIVE 0001716228 Boost Insurance USA, Inc. 419 PARK AVENUE SOUTH NEW YORK NY NEW YORK 10016 973-219-7362 DELAWARE None None Corporation true 2017 Alex Maffeo c/o Boost Insurance USA, Inc. 419 PARK AVENUE SOUTH New York NY NEW YORK 10016 Executive Officer Director Promoter Andrew Lerner c/o Boost Insurance USA, Inc. 419 PARK AVENUE SOUTH New York NY NEW YORK 10016 Executive Officer Director Jared Hyatt c/o Boost Insurance USA, Inc. 419 PARK AVENUE SOUTH New York NY NEW YORK 10016 Director Luke Ledbetter c/o Boost Insurance USA, Inc. 419 PARK AVENUE SOUTH New York NY NEW YORK 10016 Director Other Technology Decline to Disclose 06b false 2017-08-25 false true true true false 0 2999996 2999996 0 false 5 0 0 0 false Boost Insurance USA, Inc. /s/ Alex Maffeo Alex Maffeo Chief Executive Officer 2017-10-12