0001437749-25-012428.txt : 20250421 0001437749-25-012428.hdr.sgml : 20250421 20250421113028 ACCESSION NUMBER: 0001437749-25-012428 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20250421 DATE AS OF CHANGE: 20250421 EFFECTIVENESS DATE: 20250421 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Contamination Source Identification Inc. CENTRAL INDEX KEY: 0001788640 ORGANIZATION NAME: EIN: 000000000 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-480621 FILM NUMBER: 25851659 BUSINESS ADDRESS: STREET 1: 326 DOGWOOD DRIVE CITY: HERSHEY STATE: PA ZIP: 17033 BUSINESS PHONE: 717-574-7083 MAIL ADDRESS: STREET 1: 326 DOGWOOD DRIVE CITY: HERSHEY STATE: PA ZIP: 17033 FORMER COMPANY: FORMER CONFORMED NAME: Contamination Source Identification LLC DATE OF NAME CHANGE: 20190918 D/A 1 primary_doc.xml X0708 D/A LIVE 0001788640 Contamination Source Identification Inc. 326 Dogwood Drive Hershey PA PENNSYLVANIA 17033 717-574-7083 DELAWARE None Contamination Source Identification LLC Corporation true Gary J. Shope 326 Dogwood Drive Hershey PA PENNSYLVANIA 17033 Executive Officer Director Gautam Patel 326 Dogwood Drive Hershey PA PENNSYLVANIA 17033 Director Thomas Santone 326 Dogwood Drive Hershey PA PENNSYLVANIA 17033 Director Randy Haluck 326 Dogwood Drive Hershey PA PENNSYLVANIA 17033 Director Biotechnology Decline to Disclose 06b true 0001437749-24-013740 2023-04-19 true true true false 0 2500000 1670000 830000 false 13 0 0 0 false Contamination Source Identification Inc. /s/ Gary J. Shope Gary J. Shope Chief Executive Officer 2025-04-21