0001746706-23-000001.txt : 20230103 0001746706-23-000001.hdr.sgml : 20230103 20230103155921 ACCESSION NUMBER: 0001746706-23-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20230103 DATE AS OF CHANGE: 20230103 EFFECTIVENESS DATE: 20230103 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ForMotiv Inc. CENTRAL INDEX KEY: 0001746706 IRS NUMBER: 813221368 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-469505 FILM NUMBER: 23501978 BUSINESS ADDRESS: STREET 1: 123 DEBARAN LANE CITY: BRYN WAWR STATE: PA ZIP: 19010 BUSINESS PHONE: 610-322-0690 MAIL ADDRESS: STREET 1: 123 DEBARAN LANE CITY: BRYN WAWR STATE: PA ZIP: 19010 FORMER COMPANY: FORMER CONFORMED NAME: Formotiv LLC DATE OF NAME CHANGE: 20180716 D 1 primary_doc.xml X0708 D LIVE 0001746706 ForMotiv Inc. 123 DEBARAN LANE BRYN MAWR PA PENNSYLVANIA 19010 610-322-0690 DELAWARE Formotiv LLC Corporation true William Conners III 123 Debaran Lane Bryn Mawr PA PENNSYLVANIA 19010 Executive Officer Director Andrew Schwabe 123 Debaran Lane Bryn Mawr Bryn Mawr PA PENNSYLVANIA 19010 Director John Burke 123 Debaran Lane Bryn Mawr PA PENNSYLVANIA 19010 Director Michael Nugent 123 Debaran Lane Bryn Mawr PA PENNSYLVANIA 19010 Director Other Technology Decline to Disclose 06b false 2022-12-20 false true false 0 2000001 1700438 299563 false 12 0 0 0 false ForMotiv Inc. /s/ William Conners III William Conners III CEO 2023-01-02