0001792754-19-000002.txt : 20191112 0001792754-19-000002.hdr.sgml : 20191112 20191112152828 ACCESSION NUMBER: 0001792754-19-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20191112 DATE AS OF CHANGE: 20191112 EFFECTIVENESS DATE: 20191112 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Illusio, Inc. CENTRAL INDEX KEY: 0001792754 IRS NUMBER: 473181620 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-353150 FILM NUMBER: 191208870 BUSINESS ADDRESS: STREET 1: 222 VIA MALAGA CITY: SAN CLEMENTE STATE: CA ZIP: 92673 BUSINESS PHONE: 844-445-5874 MAIL ADDRESS: STREET 1: 222 VIA MALAGA CITY: SAN CLEMENTE STATE: CA ZIP: 92673 D 1 primary_doc.xml X0708 D LIVE 0001792754 Illusio, Inc. 1211 Puerto del Sol Suite 220 SAN CLEMENTE CA CALIFORNIA 92673 844-445-5874 DELAWARE None None Corporation true 2015 Ethan Winner 1211 Puerto del Sol Suite 220 San Clemente CA CALIFORNIA 92673 Executive Officer Director Jeffrey Stone c/o Illusio, Inc. 1211 Puerto del Sol, Suite 220 San Clemente CA CALIFORNIA 92673 Director Kyle Song c/o Illusio, Inc. 1211 Puerto del Sol, Suite 220 San Clementa CA CALIFORNIA 92673 Director Other Technology Decline to Disclose 06b false 2019-11-03 false true Simple Agreement for Future Equity (SAFE) false 0 1500000 50000 1450000 false 1 0 0 0 false Illusio, Inc. /s/Ethan Winner Ethan Winner Chief Executive Officer 2019-11-12