0001827318-20-000001.txt : 20201007 0001827318-20-000001.hdr.sgml : 20201007 20201007101041 ACCESSION NUMBER: 0001827318-20-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20201007 DATE AS OF CHANGE: 20201007 EFFECTIVENESS DATE: 20201007 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Formulate Labs, Inc. CENTRAL INDEX KEY: 0001827318 IRS NUMBER: 825024304 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-377298 FILM NUMBER: 201228265 BUSINESS ADDRESS: STREET 1: 101 JEFFERSON DR., SUITE 233K CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 312-283-4854 MAIL ADDRESS: STREET 1: 101 JEFFERSON DR., SUITE 233K CITY: MENLO PARK STATE: CA ZIP: 94025 D 1 primary_doc.xml X0708 D LIVE 0001827318 Formulate Labs, Inc. 101 JEFFERSON DR., SUITE 233K MENLO PARK CA CALIFORNIA 94025 312-283-4854 DELAWARE None None Corporation true 2018 Osmaan Shah 101 Jefferson Dr., Suite 233k Menlo Park CA CALIFORNIA 94025 Executive Officer Director Jason Calacanis 101 Jefferson Dr., Suite 233k Menlo Park CA CALIFORNIA 94025 Director Other Decline to Disclose 06b false 2020-09-22 false true false 0 2500000 1443600 1056400 $402,589.04 of the amount sold was pursuant to the cancellation of SAFE's false 7 0 0 0 false Formulate Labs, Inc. /s/ Osmaan Shah Osmaan Shah Chief Executive Officer 2020-10-07