0001716836-17-000001.txt : 20170914 0001716836-17-000001.hdr.sgml : 20170914 20170914143930 ACCESSION NUMBER: 0001716836-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170914 DATE AS OF CHANGE: 20170914 EFFECTIVENESS DATE: 20170914 FILER: COMPANY DATA: COMPANY CONFORMED NAME: EtaGen, Inc. CENTRAL INDEX KEY: 0001716836 IRS NUMBER: 272430529 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-294727 FILM NUMBER: 171085426 BUSINESS ADDRESS: STREET 1: 186 CONSTITUTION DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: (650)752-6678 MAIL ADDRESS: STREET 1: 186 CONSTITUTION DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 D 1 primary_doc.xml X0708 D LIVE 0001716836 EtaGen, Inc. 186 CONSTITUTION DRIVE MENLO PARK CA CALIFORNIA 94025 (650)752-6678 DELAWARE Affinity Power, Inc. None Corporation true Shannon Miller 186 CONSTITUTION DRIVE MENLO PARK CA CALIFORNIA 94025 Executive Officer Director Adam Simpson 186 CONSTITUTION DRIVE MENLO PARK CA CALIFORNIA 94025 Executive Officer Director Samir Kaul 186 CONSTITUTION DRIVE MENLO PARK CA CALIFORNIA 94025 Director Jagdeep Singh 186 CONSTITUTION DRIVE MENLO PARK CA CALIFORNIA 94025 Director Other Decline to Disclose 06b false 2017-08-29 false true true true false 0 40001560 25001553 15000007 false 4 0 0 0 false EtaGen, Inc. /s/ Shannon Miller Shannon Miller Chief Executive Officer 2017-09-14