0001664658-21-000001.txt : 20210514 0001664658-21-000001.hdr.sgml : 20210514 20210514110200 ACCESSION NUMBER: 0001664658-21-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210514 DATE AS OF CHANGE: 20210514 EFFECTIVENESS DATE: 20210514 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Ethos Technologies Inc. CENTRAL INDEX KEY: 0001788451 IRS NUMBER: 813181024 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-399410 FILM NUMBER: 21922668 BUSINESS ADDRESS: STREET 1: 460 BRYANT STREET, 3RD FLOOR CITY: SAN FRANCISCO STATE: CA ZIP: 94107 BUSINESS PHONE: (415) 322-2037 MAIL ADDRESS: STREET 1: 460 BRYANT STREET, 3RD FLOOR CITY: SAN FRANCISCO STATE: CA ZIP: 94107 D 1 primary_doc.xml X0708 D LIVE 0001788451 Ethos Technologies Inc. 460 BRYANT STREET, FLOOR 3 SAN FRANCISCO CA CALIFORNIA 94107 (415) 322-2037 DELAWARE Ethos Insurance Corporation None Corporation true 2016 Peter Colis c/o Ethos Technologies Inc. 460 Bryant Street, Floor 3 San Francisco CA CALIFORNIA 94107 Executive Officer Director Lingke Wang c/o Ethos Technologies Inc. 460 Bryant Street, Foor 3 San Francisco CA CALIFORNIA 94107 Executive Officer Director Roelof Botha c/o Ethos Technologies Inc. 460 Bryant Street, Floor 3 San Francisco CA CALIFORNIA 94107 Director Nate Niparko c/o Ethos Technologies Inc. 460 Bryant Street, Floor 3 San Francisco CA CALIFORNIA 94107 Director Tyson Clark c/o Ethos Technologies Inc. 460 Bryant Street, Foor 3 San Francisco CA CALIFORNIA 94107 Director John Kunze c/o Ethos Technologies Inc. 460 Bryant Street, Floor 3 San Francisco CA CALIFORNIA 94107 Director Kyle Doherty c/o Ethos Technologies Inc. 460 Bryant Street, Floor 3 San Francisco CA CALIFORNIA 94107 Director Priscilla Hung c/o Ethos Technologies Inc. 460 Bryant Street, Floor 3 San Francisco CA CALIFORNIA 94107 Director Insurance Decline to Disclose 06b false 2021-04-30 false true true Offering of Series D Preferred Stock (Series D) and the underlying shares of Common Stock issuable upon conversion of Series D. false 0 201999959 201999959 0 false 16 0 0 0 false Ethos Technologies Inc. /s/ Peter Colis Peter Colis Chief Executive Officer, President and Secretary 2021-05-12