0001782304-21-000002.txt : 20210504 0001782304-21-000002.hdr.sgml : 20210504 20210504170216 ACCESSION NUMBER: 0001782304-21-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210504 DATE AS OF CHANGE: 20210504 EFFECTIVENESS DATE: 20210504 FILER: COMPANY DATA: COMPANY CONFORMED NAME: 4C Health Solutions, Inc. CENTRAL INDEX KEY: 0001782304 IRS NUMBER: 463776816 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-398229 FILM NUMBER: 21889581 BUSINESS ADDRESS: STREET 1: 1201 SYCAMORE SQUARE DRIVE STREET 2: SUITE 623 CITY: MIDLOTHIAN STATE: VA ZIP: 23112 BUSINESS PHONE: 8046012628 MAIL ADDRESS: STREET 1: 1201 SYCAMORE SQUARE DRIVE STREET 2: SUITE 623 CITY: MIDLOTHIAN STATE: VA ZIP: 23112 D 1 primary_doc.xml X0708 D LIVE 0001782304 4C Health Solutions, Inc. 1201 SYCAMORE SQUARE DRIVE SUITE 623 MIDLOTHIAN VA VIRGINIA 23112 8046012628 DELAWARE None None Corporation true Ron Templeton 1201 Sycamore Square Drive Suite 623 Midlothian VA VIRGINIA 23113 Executive Officer Chief Executive Officer of the issuer Clayton Lazenby 1201 Sycamore Square Drive Suite 623 Midlothian VA VIRGINIA 23113 Executive Officer Chief Financial Officer of the issuer Horace Clark 1201 Sycamore Square Drive Suite 623 Midlothian VA VIRGINIA 23113 Director A director of the issuer Ken Lockard 1201 Sycamore Square Drive Suite 623 Midlothian VA VIRGINIA 23113 Director Chairman of the board of directors of the issuer Andy Hanson 1201 Sycamore Square Drive Suite 623 Midlothian VA VIRGINIA 23113 Director A director of the issuer Ruth Fattori 1201 Sycamore Square Drive Suite 623 Midlothian VA VIRGINIA 23113 Director A director of the issuer Steve Bowman 1201 Sycamore Square Drive Suite 623 Midlothian VA VIRGINIA 23113 Director A director of the issuer Other Technology Decline to Disclose 06b false 2021-04-30 true true false 0 20000000 100000 19900000 false 1 0 true 0 true Issuer direct sales. 50000 true organization and offering expenses incurred by the issuer in connection with the offering false 4C Health Solutions, Inc. /s/ Clayton Lazenby Clayton Lazenby Chief Financial Officer 2021-05-04