0001752666-18-000002.txt : 20180912 0001752666-18-000002.hdr.sgml : 20180912 20180912124923 ACCESSION NUMBER: 0001752666-18-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180912 DATE AS OF CHANGE: 20180912 EFFECTIVENESS DATE: 20180912 FILER: COMPANY DATA: COMPANY CONFORMED NAME: FusiForm, Inc. CENTRAL INDEX KEY: 0001752666 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-321141 FILM NUMBER: 181066388 BUSINESS ADDRESS: STREET 1: 916 NORTH CHARLES STREET CITY: BALTIMORE STATE: MD ZIP: 21201 BUSINESS PHONE: 8334440833 MAIL ADDRESS: STREET 1: 916 NORTH CHARLES STREET CITY: BALTIMORE STATE: MD ZIP: 21201 D 1 primary_doc.xml X0708 D LIVE 0001752666 FusiForm, Inc. 916 NORTH CHARLES STREET BALTIMORE MD MARYLAND 21201 8334440833 DELAWARE None None Corporation true 2017 Param Shah 916 North Charles Street Baltimore MD MARYLAND 21201 Executive Officer Director Alex Mathews 916 North Charles Street Baltimore MD MARYLAND 21201 Executive Officer Director John Cammack 916 North Charles Street Baltimore MD MARYLAND 21201 Director Other Technology Decline to Disclose 06b false 2018-08-28 false true false 0 6022546 5822546 200000 false 11 0 0 0 false FusiForm, Inc. Param Shah Param Shah President and Chief Executive Officer 2018-09-12