0001878646-24-000001.txt : 20240105 0001878646-24-000001.hdr.sgml : 20240105 20240105162007 ACCESSION NUMBER: 0001878646-24-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20240105 DATE AS OF CHANGE: 20240105 EFFECTIVENESS DATE: 20240105 FILER: COMPANY DATA: COMPANY CONFORMED NAME: JelliSee Ophthalmics Inc. CENTRAL INDEX KEY: 0002006388 ORGANIZATION NAME: IRS NUMBER: 834120507 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-501749 FILM NUMBER: 24516522 BUSINESS ADDRESS: STREET 1: 8414 HOLLY LEAF DR. CITY: MCLEAN STATE: VA ZIP: 22102 BUSINESS PHONE: 610-640-5435 MAIL ADDRESS: STREET 1: 8414 HOLLY LEAF DR. CITY: MCLEAN STATE: VA ZIP: 22102 D 1 primary_doc.xml X0708 D LIVE 0002006388 JelliSee Ophthalmics Inc. 8414 HOLLY LEAF DR. MCLEAN VA VIRGINIA 22102 216-970-8243 DELAWARE None None Corporation true 2019 Forrest J Ellis 8414 Holly Leaf Dr McLean VA VIRGINIA 22102 Executive Officer Director Amy R. Jeffery 8414 Holly Leaf Dr McLean VA VIRGINIA 22102 Executive Officer Director Michael J. Malesardi 8414 Holly Leaf Dr McLean VA VIRGINIA 22102 Executive Officer Director Dimitri Azar 8414 Holly Leaf Dr McLean VA VIRGINIA 22102 Director Jerry Arthur 8414 Holly Leaf Dr McLean VA VIRGINIA 22102 Director Adrienne Graves 8414 Holly Leaf Dr McLean VA VIRGINIA 22102 Director Biotechnology Decline to Disclose 06b false 2023-12-21 false true true false 0 10000000 1675000 8325000 false 15 0 0 0 false JelliSee Ophthalmics Inc. /s/Forrest J. Ellis Forrest J Ellis Chief Executive Officer 2024-01-05