0001639542-20-000004.txt : 20201106 0001639542-20-000004.hdr.sgml : 20201106 20201106115437 ACCESSION NUMBER: 0001639542-20-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20201106 DATE AS OF CHANGE: 20201106 EFFECTIVENESS DATE: 20201106 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Olive AI, Inc. CENTRAL INDEX KEY: 0001639542 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-379933 FILM NUMBER: 201293214 BUSINESS ADDRESS: STREET 1: 99 EAST MAIN STREET CITY: COLUMBUS STATE: OH ZIP: 43215 BUSINESS PHONE: (800) 501-3161 MAIL ADDRESS: STREET 1: 99 EAST MAIN STREET CITY: COLUMBUS STATE: OH ZIP: 43215 FORMER COMPANY: FORMER CONFORMED NAME: CrossChx, Inc. DATE OF NAME CHANGE: 20150414 D 1 primary_doc.xml X0708 D LIVE 0001639542 Olive AI, Inc. 99 EAST MAIN STREET COLUMBUS OH OHIO 43215 (800) 501-3161 DELAWARE CrossChx, Inc. Corporation true Sean Lane 99 East Main Street Columbus OH OHIO 43215 Executive Officer Director Billy Deitch 99 East Main Street Columbus OH OHIO 43215 Director John Kuelper 99 East Main Street Columbus OH OHIO 43215 Director Christopher Olsen 99 East Main Street Columbus OH OHIO 43215 Director Brock Wanless 99 East Main Street Columbus OH OHIO 43215 Executive Officer David Agus 99 East Main Street C OH OHIO 43215 Director George S. Barrett 99 East Main Street Columbus OH OHIO 43215 Director Ronald A. Paulus 99 East Main Street Columbus OH OHIO 43215 Director Other Technology Decline to Disclose 06b false 2020-10-23 false true true Series F Preferred Stock and Common Stock issuable upon conversion false 0 46358835 46358835 0 false 9 0 0 0 false Olive AI, Inc. /s/ Brock Wanless Brock Wanless Secretary and General Counsel 2020-11-05