0001781048-23-000001.txt : 20230118 0001781048-23-000001.hdr.sgml : 20230118 20230118130742 ACCESSION NUMBER: 0001781048-23-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20230118 DATE AS OF CHANGE: 20230118 EFFECTIVENESS DATE: 20230118 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Fathom, Inc. CENTRAL INDEX KEY: 0001781048 IRS NUMBER: 473644819 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-471034 FILM NUMBER: 23533817 BUSINESS ADDRESS: STREET 1: 1901 HARRISON STREET STREET 2: SUITE 1107 CITY: OAKLAND STATE: CA ZIP: 94612 BUSINESS PHONE: 650-995-4393 MAIL ADDRESS: STREET 1: 1901 HARRISON STREET STREET 2: SUITE 1107 CITY: OAKLAND STATE: CA ZIP: 94612 D 1 primary_doc.xml X0708 D LIVE 0001781048 Fathom, Inc. 1901 HARRISON STREET SUITE 1107 OAKLAND CA CALIFORNIA 94612 650-516-6178 DELAWARE Tiny RX, Inc. None Corporation true ANDREW LOCKHART 1901 HARRISON STREET SUITE 1107 OAKLAND CA CALIFORNIA 94612 Executive Officer Director CHRISTOPHER BOCKMAN 1901 HARRISON STREET SUITE 1107 OAKLAND CA CALIFORNIA 94612 Executive Officer Director RISHI REDDY 1901 HARRISON STREET SUITE 1107 OAKLAND CA CALIFORNIA 94612 Executive Officer Director MARK MCLAUGHLIN 1901 HARRISON STREET SUITE 1107 OAKLAND CA CALIFORNIA 94612 Director GALYM IMANBAYEV 1901 HARRISON STREET SUITE 1107 OAKLAND CA CALIFORNIA 94612 Director Other Technology Decline to Disclose 06b false 2022-11-04 false true false 0 46596083 46296079 300004 Includes $5,678,938.36 in converted promissory notes. false 24 0 0 0 false Fathom, Inc. /s/ Andrew Lockhart Andrew Lockhart Chief Executive Officer 2023-01-18