0001567619-19-009639.txt : 20190502 0001567619-19-009639.hdr.sgml : 20190502 20190502152226 ACCESSION NUMBER: 0001567619-19-009639 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190502 DATE AS OF CHANGE: 20190502 EFFECTIVENESS DATE: 20190502 FILER: COMPANY DATA: COMPANY CONFORMED NAME: FormAssembly, Inc. CENTRAL INDEX KEY: 0001775649 IRS NUMBER: 901115819 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-338690 FILM NUMBER: 19791561 BUSINESS ADDRESS: STREET 1: 885 S COLLEGE MALL ROAD, #399 CITY: BLOOMINGTON STATE: IN ZIP: 47404 BUSINESS PHONE: 812-297-9228 MAIL ADDRESS: STREET 1: 885 S COLLEGE MALL ROAD, #399 CITY: BLOOMINGTON STATE: IN ZIP: 47404 D 1 primary_doc.xml X0708 D LIVE 0001775649 FormAssembly, Inc. 885 S COLLEGE MALL ROAD, #399 BLOOMINGTON IN INDIANA 47404 812-297-9228 DELAWARE Veer West LLC None Corporation true Cedric Savarese 885 S College Mall Road, #399 Bloomington IN INDIANA 47404 Executive Officer Director George McCulloch 885 S College Mall Road, #399 Bloomington IN INDIANA 47404 Director Other Technology Decline to Disclose 06b false 2019-04-19 false true false 0 13000000 13000000 0 false 1 0 0 3000000 Amount used to redeem shares of the Chief Executive Officer false FormAssembly, Inc. Cedric Savarese Cedric Savarese Chief Executive Officer 2019-05-02