0001516068-20-000003.txt : 20200922 0001516068-20-000003.hdr.sgml : 20200922 20200922084841 ACCESSION NUMBER: 0001516068-20-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20200922 DATE AS OF CHANGE: 20200922 EFFECTIVENESS DATE: 20200922 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Avisa Pharma Inc. CENTRAL INDEX KEY: 0001516068 IRS NUMBER: 273584660 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-375941 FILM NUMBER: 201187980 BUSINESS ADDRESS: STREET 1: 1660A OLD PECOS TRAIL CITY: SANTA FE STATE: NM ZIP: 87505 BUSINESS PHONE: 505-820-1400 MAIL ADDRESS: STREET 1: 1660A OLD PECOS TRAIL CITY: SANTA FE STATE: NM ZIP: 87505 D 1 primary_doc.xml X0708 D LIVE 0001516068 Avisa Pharma Inc. 1660A OLD PECOS TRAIL SANTA FE NM NEW MEXICO 87505 505-820-1400 DELAWARE None None Corporation true David S. Joseph 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Executive Officer Director J. Chuck Morrison 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director Brian P. Birk 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director William A. Miller 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director Thomas R. Morse 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director Matt Culler 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Executive Officer Other Health Care Decline to Disclose 06b false 2020-09-08 false true true true false 0 Haywood Securities (USA) Inc. 42072 None None 200 Burrard Street, Suite 700 Vancouver A1 BRITISH COLUMBIA, CANADA V63 3L6 CA CALIFORNIA IL ILLINOIS NM NEW MEXICO NY NEW YORK PA PENNSYLVANIA TX TEXAS WI WISCONSIN false 734177 734177 0 false 23 58734 true 0 In addition to the cash amount set forth above, sales commissions have been paid in the form 121,488 warrants to purchase shares of common stock of Issuer and 187,500 shares of common stock of Issuer 51150 true false Avisa Pharma Inc. David S. Joseph David S. Joseph CEO and President 2020-09-22