0001665160-23-000100.txt : 20230119
0001665160-23-000100.hdr.sgml : 20230119
20230119091556
ACCESSION NUMBER: 0001665160-23-000100
CONFORMED SUBMISSION TYPE: C
PUBLIC DOCUMENT COUNT: 2
FILED AS OF DATE: 20230119
DATE AS OF CHANGE: 20230119
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: SAMPLESERVE, INC.
CENTRAL INDEX KEY: 0001759863
IRS NUMBER: 383634872
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: C
SEC ACT: 1933 Act
SEC FILE NUMBER: 020-31635
FILM NUMBER: 23536083
BUSINESS ADDRESS:
STREET 1: 101 N. PARK STREET
CITY: TRAVERSE CITY
STATE: MI
ZIP: 49684
BUSINESS PHONE: 231-933-7035
MAIL ADDRESS:
STREET 1: 800 COTTAGEVIEW DR
STREET 2: STE. 1090
CITY: TRAVERSE CITY
STATE: MI
ZIP: 49684
C
1
primary_doc.xml
C
0001759863
XXXXXXXX
LIVE
false
false
false
SampleServe, Inc.
Corporation
DE
11-15-2018
444 Cass St., Ste. 203-B
Traverse City
MI
49684
https://www.sampleserve.com/
N
StartEngine Capital, LLC
0001665160
007-00007
up to 9% percent
We charge 3% commission paid in equity or securities at the same rate as this offering.
Common Stock
9708
1.03000
N/A
9999.24
Y
Other
At issuer's discretion, with priority given to StartEngine Owners
1199999.44
03-20-2023
5
3373569.00
5703583.00
2118.00
16417.00
6813.00
8722.00
232510.00
408405.00
0.00
0.00
184694.00
237544.00
0.00
14161.00
0.00
0.00
-345064.00
-646699.00
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
SampleServe, Inc.
A. Russell Schindler
CEO, President and Chairman of the Board
A. Russell Schindler
CEO, President and Chairman of the Board
01-19-2023
Paul R. Goudreault
Board Member
01-19-2023
Eric Bergsma
Board Member and Controller
01-19-2023
Erik A. Johnson
Board Member
01-19-2023
EX-99
2
offeringmemoformc.pdf
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