0001719371-24-000001.txt : 20240916 0001719371-24-000001.hdr.sgml : 20240916 20240916172013 ACCESSION NUMBER: 0001719371-24-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20240916 DATE AS OF CHANGE: 20240916 EFFECTIVENESS DATE: 20240916 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Bloomlife, Inc. CENTRAL INDEX KEY: 0001719371 ORGANIZATION NAME: IRS NUMBER: 464825448 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-524167 FILM NUMBER: 241301946 BUSINESS ADDRESS: STREET 1: 1931 MCALLISTER ST STREET 2: SUITE D CITY: SAN FRANCISCO STATE: CA ZIP: 94115 BUSINESS PHONE: 415-215-4251 MAIL ADDRESS: STREET 1: 1931 MCALLISTER ST STREET 2: SUITE D CITY: SAN FRANCISCO STATE: CA ZIP: 94115 D 1 primary_doc.xml X0708 D LIVE 0001719371 Bloomlife, Inc. 181 2nd Street San Francisco CA CALIFORNIA 94105 (415) 215-4251 DELAWARE Bloom Technologies, Inc. None Corporation true Eric Dy c/o Bloomlife, Inc. 181 2nd Street San Francisco CA CALIFORNIA 94105 Executive Officer Director Julien Penders c/o Bloomlife, Inc. 181 2nd Street San Francisco CA CALIFORNIA 94105 Executive Officer Director Charlotte Owens c/o Bloomlife, Inc. 181 2nd Street San Francisco CA CALIFORNIA 94105 Director Xavier Peters c/o Bloomlife, Inc. 181 2nd Street San Francisco CA CALIFORNIA 94105 Director Uriridiakoghene Onovakpuri c/o Bloomlife, Inc. 181 2nd Street San Francisco CA CALIFORNIA 94105 Director Other Technology Decline to Disclose 06b false 2024-08-28 false true false 0 14886953 12929458 1957495 This filing covers the sale and purchase of Series B Preferred Stock, and the Common Stock issuable upon conversion thereof. false 50 0 0 0 false Bloomlife, Inc. /s/ Eric Dy Eric Dy Chief Executive Officer 2024-09-16