0001775649-24-000001.txt : 20240314 0001775649-24-000001.hdr.sgml : 20240314 20240313193822 ACCESSION NUMBER: 0001775649-24-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20240314 DATE AS OF CHANGE: 20240313 EFFECTIVENESS DATE: 20240314 FILER: COMPANY DATA: COMPANY CONFORMED NAME: FormAssembly, Inc. CENTRAL INDEX KEY: 0001775649 ORGANIZATION NAME: IRS NUMBER: 901115819 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-507538 FILM NUMBER: 24747510 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. 101 W. Kirkwood Avenue #224 BLOOMINGTON IN INDIANA 47404 812-297-9228 DELAWARE None None Corporation true Cedric Savarese 101 Kirkwood Avenue #224 Bloomington IN INDIANA 47404 Executive Officer Director Nick Berardo 101 Kirkwood Avenue #224 Bloomington IN INDIANA 47404 Director Lou Desiderio 101 W. Kirkwood Avenue #224 Bloomington IN INDIANA 47404 Executive Officer Other Technology Decline to Disclose 06b false 2024-02-28 false true false 0 4000000 4000000 0 false 1 0 0 40000000 true false FormAssembly, Inc. /s/ Cedric Savarese Cedric Savarese CEO 2024-03-13