0001914302-22-000001.txt : 20220303 0001914302-22-000001.hdr.sgml : 20220303 20220303163452 ACCESSION NUMBER: 0001914302-22-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20220303 DATE AS OF CHANGE: 20220303 EFFECTIVENESS DATE: 20220303 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Kintsugi Mindful Wellness, Inc. CENTRAL INDEX KEY: 0001914302 IRS NUMBER: 844649357 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-435803 FILM NUMBER: 22709488 BUSINESS ADDRESS: STREET 1: 2737 GARBER STREET, STE. 8 CITY: BERKELEY STATE: CA ZIP: 94705 BUSINESS PHONE: 310-598-1553 MAIL ADDRESS: STREET 1: 2737 GARBER STREET, STE. 8 CITY: BERKELEY STATE: CA ZIP: 94705 D 1 primary_doc.xml X0708 D LIVE 0001914302 Kintsugi Mindful Wellness, Inc. 2737 GARBER STREET, STE. 8 BERKELEY CA CALIFORNIA 94705 310-598-1553 DELAWARE None None Corporation true 2019 Grace Chang c/o Kintsugi Mindful Wellness, Inc. 2737 Garber Street, Ste 8 Berkeley CA CALIFORNIA 94705 Executive Officer Director Rima Seiilova-Olson c/o Kintsugi Mindful Wellness, Inc. 2737 Garber Street, Ste 8 Berkeley CA CALIFORNIA 94705 Director Other Technology Decline to Disclose 06b false 2022-02-01 false true false 0 24981758 24981741 17 false 45 0 0 0 false Kintsugi Mindful Wellness, Inc. /s/ Grace Chang Grace Chang CEO 2022-03-03