0000892712-15-000943.txt : 20151023 0000892712-15-000943.hdr.sgml : 20151023 20151023105823 ACCESSION NUMBER: 0000892712-15-000943 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20151023 DATE AS OF CHANGE: 20151023 EFFECTIVENESS DATE: 20151023 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ELLI HEALTH, INC. CENTRAL INDEX KEY: 0001604448 IRS NUMBER: 462598681 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-249958 FILM NUMBER: 151172096 BUSINESS ADDRESS: STREET 1: 20935 SWENSON DRIVE STREET 2: #350 CITY: WAUKESHA STATE: WI ZIP: 53186 BUSINESS PHONE: 262-378-0565 MAIL ADDRESS: STREET 1: 20935 SWENSON DRIVE STREET 2: #350 CITY: WAUKESHA STATE: WI ZIP: 53186 D 1 primary_doc.xml X0707 D LIVE 0001604448 ELLI HEALTH, INC. 20935 SWENSON DRIVE #350 WAUKESHA WI WISCONSIN 53186 262-378-0565 WISCONSIN None None Corporation true 2013 Jay C. Mason 20935 Swenson Drive #350 Waukesha WI WISCONSIN 53186 Executive Officer Director Promoter Chief Executive Officer Liem N. Nguyen 20935 Swenson Drive #350 Waukesha WI WISCONSIN 53186 Promoter Mr. Nguyen assisted in the organization of the issuer but is no longer an officer or director. Jeff Miller 20935 Swenson Drive #350 Waukesha WI WISCONSIN 53186 Executive Officer Director Treasurer J. Michael Eaton 20935 Swenson Drive #350 Waukesha WI WISCONSIN 53186 Executive Officer Director W. Drew Palin 20935 Swenson Drive #350 Waukesha WI WISCONSIN 53186 Executive Officer President John Matthews 20935 Swenson Drive #350 Waukesha WI WISCONSIN 53186 Director Secretary Other Technology Decline to Disclose 06b false 2015-10-19 false true true false 0 2500000 375000 2125000 false 5 0 0 0 false ELLI HEALTH, INC. /s/ Jay Mason Jay Mason Chief Executive Officer 2015-10-23