0001701259-21-000001.txt : 20210520 0001701259-21-000001.hdr.sgml : 20210520 20210520132913 ACCESSION NUMBER: 0001701259-21-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210520 DATE AS OF CHANGE: 20210520 EFFECTIVENESS DATE: 20210520 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Adaptive Phage Therapeutics, Inc. CENTRAL INDEX KEY: 0001701259 IRS NUMBER: 814208730 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-400058 FILM NUMBER: 21943756 BUSINESS ADDRESS: STREET 1: 22 FIRSTFIELD ROAD STREET 2: SUITE 125 CITY: GAITHERSBURG STATE: MD ZIP: 20878 BUSINESS PHONE: 2408992532 MAIL ADDRESS: STREET 1: 22 FIRSTFIELD ROAD STREET 2: SUITE 125 CITY: GAITHERSBURG STATE: MD ZIP: 20878 D 1 primary_doc.xml X0708 D LIVE 0001701259 Adaptive Phage Therapeutics, Inc. 708 Quince Orchard Rd Suite 205 GAITHERSBURG MD MARYLAND 20878 844-972-0500 DELAWARE None None Corporation true 2017 Gregory L. Merril c/o Adaptive Phage Therapeutics, Inc. 708 Quince Orchard Rd., Suite 205 Gaithersburg MD MARYLAND 20878 Executive Officer Director Promoter Carl R. Merril c/o Adaptive Phage Therapeutics, Inc. 708 Quince Orchard Rd., Suite 205 Gaithersburg MD MARYLAND 20878 Executive Officer Director Raymond L. Martz c/o Adaptive Phage Therapeutics, Inc. 708 Quince Orchard Rd., Suite 205 Gaithersburg MD MARYLAND 20878 Director Jonathan Leff c/o Adaptive Phage Therapeutics, Inc. 708 Quince Orchard Rd., Suite 205 Gaithersburg MD MARYLAND 20878 Director Jana Jensen c/o Adaptive Phage Therapeutics, Inc. 708 Quince Orchard Rd., Suite 205 Gaithersburg MD MARYLAND 20878 Director Evan Loh c/o Adaptive Phage Therapeutics, Inc. 708 Quince Orchard Rd., Suite 205 Gaithersburg MD MARYLAND 20878 Director Biotechnology Decline to Disclose 06b false 2021-05-07 false true false 0 53262037 23262000 30000037 The amount sold includes the convertible debt issued in exchange for equity. false 59 0 0 0 false Adaptive Phage Therapeutics, Inc. /s/ Gregory L. Merril Gregory L. Merril Chief Executive Officer 2021-05-20