0001890299-21-000001.txt : 20211026 0001890299-21-000001.hdr.sgml : 20211026 20211026092407 ACCESSION NUMBER: 0001890299-21-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06c FILED AS OF DATE: 20211026 DATE AS OF CHANGE: 20211026 EFFECTIVENESS DATE: 20211026 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Trailblazer Insurance Technology Inc. CENTRAL INDEX KEY: 0001890299 IRS NUMBER: 872268895 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-418485 FILM NUMBER: 211346409 BUSINESS ADDRESS: STREET 1: 6 BRUNDIGE DRIVE CITY: GOLDENS BRIDGE STATE: NY ZIP: 10526 BUSINESS PHONE: 914-837-0264 MAIL ADDRESS: STREET 1: 6 BRUNDIGE DRIVE CITY: GOLDENS BRIDGE STATE: NY ZIP: 10526 D 1 primary_doc.xml X0708 D LIVE 0001890299 Trailblazer Insurance Technology Inc. 6 BRUNDIGE DRIVE GOLDENS BRIDGE NY NEW YORK 10526 914-837-0264 DELAWARE None None Corporation true 2021 Aaron Shapiro 6 Brundige Drive Goldens Bridge NY NEW YORK 10526 Executive Officer Director Matthew Kinley c/o Trailblazer Ins. Technology Inc. 6 Brunidge Drive Goldens Bridge NY NEW YORK 10526 Director Computers Decline to Disclose 06c false 2021-10-13 false true false 250000 None None None None N/A N/A NY NEW YORK 10526 IA IOWA false 1500000 1500000 0 false 1 0 0 None 0 None false Trailblazer Insurance Technology Inc. /s/ Aaron Shapiro Aaron Shapiro CEO 2021-10-26