0001874628-21-000002.txt : 20210913 0001874628-21-000002.hdr.sgml : 20210913 20210913151931 ACCESSION NUMBER: 0001874628-21-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210913 DATE AS OF CHANGE: 20210913 EFFECTIVENESS DATE: 20210913 FILER: COMPANY DATA: COMPANY CONFORMED NAME: IrisVision, Inc CENTRAL INDEX KEY: 0001874628 IRS NUMBER: 822354891 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-413155 FILM NUMBER: 211249517 BUSINESS ADDRESS: STREET 1: 5994 WEST LAS POSITAS BLVD STREET 2: SUITE 219 CITY: PLEASANTON STATE: CA ZIP: 94588 BUSINESS PHONE: 650-248-8056 MAIL ADDRESS: STREET 1: 5994 WEST LAS POSITAS BLVD STREET 2: SUITE 219 CITY: PLEASANTON STATE: CA ZIP: 94588 FORMER COMPANY: FORMER CONFORMED NAME: IrisVision Inc DATE OF NAME CHANGE: 20210722 D 1 primary_doc.xml X0708 D LIVE 0001874628 IrisVision, Inc 5994 WEST LAS POSITAS BLVD SUITE 219 PLEASANTON CA CALIFORNIA 94588 650-248-8056 DELAWARE IrisVision Inc Corporation true 2017 Ammad Khan 5994 West Las Positas Blvd Suite 219 Pleasanton CA CALIFORNIA 94588 Executive Officer Director Matthew Johnson 5994 West Las Positas Blvd Suite 219 Pleasanton CA CALIFORNIA 94588 Director Narendra Mulani 5994 West Las Positas Blvd Suite 219 Pleasanton CA CALIFORNIA 94588 Director Frank Werblin 5994 West Las Positas Blvd Suite 219 Pleasanton CA CALIFORNIA 94588 Director Larry Leisure 5994 West Las Positas Blvd Suite 219 Pleasanton CA CALIFORNIA 94588 Director Other Decline to Disclose 06b false 2021-09-09 false true false 0 12908776 10008799 2899977 Series A and Series A-1 Preferred Stock; Common Stock issuable upon conversion false 27 0 0 0 false IrisVision, Inc /s/Ammad Khan Ammad Khan President and CEO 2021-09-13