0001743315-19-000001.txt : 20190723 0001743315-19-000001.hdr.sgml : 20190723 20190723165147 ACCESSION NUMBER: 0001743315-19-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190723 DATE AS OF CHANGE: 20190723 EFFECTIVENESS DATE: 20190723 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Augustine Surgical, Inc. CENTRAL INDEX KEY: 0001743315 IRS NUMBER: 830706195 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-344893 FILM NUMBER: 19968248 BUSINESS ADDRESS: STREET 1: 6581 CITY WEST PARKWAY CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 BUSINESS PHONE: 9524653500 MAIL ADDRESS: STREET 1: 6581 CITY WEST PARKWAY CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 D 1 primary_doc.xml X0708 D LIVE 0001743315 Augustine Surgical, Inc. 6581 CITY WEST PARKWAY EDEN PRAIRIE MN MINNESOTA 55344 9524653500 DELAWARE None None Corporation true 2018 Scott D Augustine 6581 City West Parkway Eden Prairie MN MINNESOTA 55344 Executive Officer Director Brent M Augustine 6581 City West Parkway Eden Prairie MN MINNESOTA 55344 Executive Officer Director Garrett J Augustine 6581 City West Parkway Eden Prairie MN MINNESOTA 55344 Executive Officer Director J. Randall Benham 6581 City West Parkway Eden Prairie MN MINNESOTA 55344 Executive Officer Susan Augustine 6581 City West Parkway Eden Prairie MN MINNESOTA 55344 Director Mark Kravik 6581 City West Parkway Eden Prairie MN MINNESOTA 55344 Director James Fonger, MD 6581 City West Parkway Eden Prairie MN MINNESOTA 55344 Director Robert A Stevens 6581 City West Parkway Eden Prairie MN MINNESOTA 55344 Director Paul Molloy 6581 City West Parkway Eden Prairie MN MINNESOTA 55344 Director Other Health Care Decline to Disclose 06b false 2019-07-15 true true true true false 10000 not applicable None None None not applicable not applicable not applicable XX Unknown na All States false 6000000 1000000 5000000 The first $1,000,000 of $6,000,000 is offered as a convertible note; an additional $2,000,000 may be offered with a warrant option false 6 0 true 0 true 0 true false Augustine Surgical, Inc. Scott Augustine Scott Augustine Chief Executive Officier 2019-07-23