0001663923-16-000002.txt : 20161209 0001663923-16-000002.hdr.sgml : 20161209 20161208192916 ACCESSION NUMBER: 0001663923-16-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161209 DATE AS OF CHANGE: 20161208 EFFECTIVENESS DATE: 20161209 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Elysium Health, Inc. CENTRAL INDEX KEY: 0001663923 IRS NUMBER: 462100633 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-275951 FILM NUMBER: 162042592 BUSINESS ADDRESS: STREET 1: 594 BROADWAY, SUITE 707 CITY: NEW YORK STATE: NY ZIP: 10012 BUSINESS PHONE: (888) 220-6436 MAIL ADDRESS: STREET 1: 594 BROADWAY, SUITE 707 CITY: NEW YORK STATE: NY ZIP: 10012 D 1 primary_doc.xml X0707 D LIVE 0001663923 Elysium Health, Inc. 594 BROADWAY, SUITE 707 NEW YORK NY NEW YORK 10012 (888) 220-6436 DELAWARE None None Corporation true 2015 Eric Marcotulli c/o Elysium Health, Inc. 594 Broadway, Suite 707 New York NY NEW YORK 10012 Executive Officer Director Promoter Daniel Alminana c/o Elysium Health, Inc. 594 Broadway, Suite 707 New York NY NEW YORK 10012 Executive Officer Director Promoter Jim P. Manzi c/o Elysium Health, Inc. 594 Broadway, Suite 707 New York NY NEW YORK 10012 Director David Fialkow c/o Elysium Health, Inc. 594 Broadway, Suite 707 New York NY NEW YORK 10012 Director Other Decline to Disclose 06b false 2016-10-27 false true false 0 22000000 19990002 2009998 false 6 0 0 0 false Elysium Health, Inc. /s/ Daniel Alminana Daniel Alminana Chief Operating Officer 2016-12-08