0001717881-19-000002.txt : 20190416 0001717881-19-000002.hdr.sgml : 20190416 20190415185016 ACCESSION NUMBER: 0001717881-19-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190416 DATE AS OF CHANGE: 20190415 EFFECTIVENESS DATE: 20190416 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ClearSurance, Inc. CENTRAL INDEX KEY: 0001717881 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-337376 FILM NUMBER: 19749598 BUSINESS ADDRESS: STREET 1: 50 HIGH STREET, SUITE 25 CITY: NORTH ANDOVER STATE: MA ZIP: 01845 BUSINESS PHONE: 978-655-7456 MAIL ADDRESS: STREET 1: 50 HIGH STREET, SUITE 25 CITY: NORTH ANDOVER STATE: MA ZIP: 01845 D 1 primary_doc.xml X0708 D LIVE 0001717881 ClearSurance, Inc. 50 HIGH STREET, SUITE 25 NORTH ANDOVER MA MASSACHUSETTS 01845 877-373-5936 DELAWARE None None Corporation true 2017 Michael Crowe 50 High Street, Suite 25 North Andover MA MASSACHUSETTS 01845 Executive Officer Director Andrea Keyo 50 High Street, Suite 25 North Andover MA MASSACHUSETTS 01845 Executive Officer Timothy Hey 50 High Street, Suite 25 North Andover MA MASSACHUSETTS 01845 Executive Officer Henry Neal Connolly 50 High Street, Suite 25 North Andover MA MASSACHUSETTS 01845 Director Chris Chouinard 50 High Street, Suite 25 North Andover MA MASSACHUSETTS 01845 Director Charles Wallace 50 High Street, Suite 25 North Andover MA MASSACHUSETTS 01845 Director Kabir Syed 50 High Street, Suite 25 North Andover MA MASSACHUSETTS 01845 Director Andy Singleton 50 High Street, Suite 25 North Andover MA MASSACHUSETTS 01845 Director Other Decline to Disclose 06b false 2019-04-02 false true false 0 3000006 2415219 584787 false 17 0 0 0 false ClearSurance, Inc. /s/ Michael Crowe Michael Crowe Chief Executive Officer 2019-04-15