0000925421-21-000195.txt : 20211012 0000925421-21-000195.hdr.sgml : 20211012 20211012111349 ACCESSION NUMBER: 0000925421-21-000195 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20211012 DATE AS OF CHANGE: 20211012 EFFECTIVENESS DATE: 20211012 FILER: COMPANY DATA: COMPANY CONFORMED NAME: KSANA HEALTH INC. CENTRAL INDEX KEY: 0001866217 IRS NUMBER: 842166036 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-416504 FILM NUMBER: 211317707 BUSINESS ADDRESS: STREET 1: 2288 ALDER STREET CITY: EUGENE STATE: OR ZIP: 97405 BUSINESS PHONE: 541-515-9158 MAIL ADDRESS: STREET 1: 2288 ALDER STREET CITY: EUGENE STATE: OR ZIP: 97405 D 1 primary_doc.xml X0708 D LIVE 0001866217 KSANA HEALTH INC. 2288 ALDER STREET EUGENE OR OREGON 97405 541-515-9158 DELAWARE None None Corporation true 2019 Nicholas Allen 2288 Alder Street Eugene OR OREGON 97405 Executive Officer Director Chief Executive Officer William Shortt 2288 Alder Street Eugene OR OREGON 97405 Executive Officer Director Chief Operating Officer Phillip Scripa 2288 Alder Street Eugene OR OREGON 97405 Executive Officer Chief Financial Officer and Secretary Jan Hardorp 2288 Alder Street Eugene OR OREGON 97405 Director Other Technology Decline to Disclose 06b false 2021-10-04 false true true true Series Seed-3 Preferred Stock false 0 Indefinite 999999 Indefinite false 9 0 0 0 false KSANA HEALTH INC. /s/ Nicholas Allen Nicholas Allen Chief Executive Officer 2021-10-04