0000905718-17-000584.txt : 20170525 0000905718-17-000584.hdr.sgml : 20170525 20170525153707 ACCESSION NUMBER: 0000905718-17-000584 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170525 DATE AS OF CHANGE: 20170525 EFFECTIVENESS DATE: 20170525 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PolicyGenius Inc. CENTRAL INDEX KEY: 0001663729 IRS NUMBER: 461553649 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-287501 FILM NUMBER: 17869798 BUSINESS ADDRESS: STREET 1: 22 W. 19TH ST. STREET 2: 8TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10011 BUSINESS PHONE: 855-695-2255 MAIL ADDRESS: STREET 1: 22 W. 19TH ST. STREET 2: 8TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10011 D 1 primary_doc.xml X0707 D LIVE 0001663729 PolicyGenius Inc. 22 WEST 19TH STREET, FLOOR 8 NEW YORK NY NEW YORK 10011 855-695-2255 DELAWARE KnowltOwl Inc. None Corporation true 2012 Jennifer Fitzgerald c/o PolicyGenius Inc. 22 West 19th Street, Floor 8 New York NY NEW YORK 10011 Executive Officer Director Francois de Lame c/o PolicyGenius Inc. 22 West 19th Street, Floor 8 New York NY NEW YORK 10011 Director Tianxiang Zhuo c/o PolicyGenius Inc. 22 West 19th Street, Floor 8 New York NY NEW YORK 10011 Director David Golden c/o PolicyGenius Inc. 22 West 19th Street, Floor 8 Washington DC DISTRICT OF COLUMBIA 20036 Director Parker Barrile c/o PolicyGenius Inc. 22 West 19th Street, Floor 8 New York NY NEW YORK 10011 Director Jay Mandelbaum c/o PolicyGenius Inc. 22 West 19th Street, Floor 8 New York NY NEW YORK 10011 Director Other Decline to Disclose 06b false 2017-05-05 false true true Series C Preferred Stock false 0 29999998 29999998 0 false 9 0 0 0 true Some of the proceeds may be used for general working capital purposes which may include the payment of salaries and other fees to those listed in Item 3. false PolicyGenius Inc. /s/ Jennifer Fitzgerald Jennifer Fitzgerald Chief Executive Officer 2017-05-25