0001813960-20-000001.txt : 20200603 0001813960-20-000001.hdr.sgml : 20200603 20200602200814 ACCESSION NUMBER: 0001813960-20-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20200603 DATE AS OF CHANGE: 20200602 EFFECTIVENESS DATE: 20200603 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Pacific Insurance Network Systems, Inc. CENTRAL INDEX KEY: 0001813960 IRS NUMBER: 851233830 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-368173 FILM NUMBER: 20938655 BUSINESS ADDRESS: STREET 1: PO BOX 120662 CITY: SAN DIEGO STATE: CA ZIP: 92112 BUSINESS PHONE: 626.844.1838 MAIL ADDRESS: STREET 1: PO BOX 120662 CITY: SAN DIEGO STATE: CA ZIP: 92112 D 1 primary_doc.xml X0708 D LIVE 0001813960 Pacific Insurance Network Systems, Inc. 101 W Broadway, 3rd Floor Suite 108 SAN DIEGO CA CALIFORNIA 92112 626.844.1838 DELAWARE None None Corporation true 2020 Kathryn McKenzie Rose 101 W Broadway, 3rd Floor, Suite 108 SAN DIEGO CA CALIFORNIA 92112 Executive Officer Director Marshall William Rose 101 W Broadway, 3rd Floor, Suite 108 SAN DIEGO CA CALIFORNIA 92112 Executive Officer Director Jon Woodruff 101 W Broadway, 3rd Floor, Suite 108 SAN DIEGO CA CALIFORNIA 92112 Director Benjamin Bisconti 101 W Broadway, 3rd Floor, Suite 108 SAN DIEGO CA CALIFORNIA 92112 Director Other Technology Decline to Disclose 06b false 2020-05-22 false true false 0 800000 800000 0 false 6 0 0 0 false Pacific Insurance Network Systems, Inc. Kathryn McKenzie Rose Kathryn McKenzie Rose CEO 2020-06-02