0001710426-19-000001.txt : 20190701 0001710426-19-000001.hdr.sgml : 20190701 20190701154423 ACCESSION NUMBER: 0001710426-19-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190701 DATE AS OF CHANGE: 20190701 EFFECTIVENESS DATE: 20190701 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ACTIV Surgical, Inc. CENTRAL INDEX KEY: 0001710426 IRS NUMBER: 472924761 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-343229 FILM NUMBER: 19933091 BUSINESS ADDRESS: STREET 1: 840 SUMMER STREET, SUITE 108 CITY: BOSTON STATE: MA ZIP: 02127 BUSINESS PHONE: (646) 312-9611 MAIL ADDRESS: STREET 1: 840 SUMMER STREET, SUITE 108 CITY: BOSTON STATE: MA ZIP: 02127 FORMER COMPANY: FORMER CONFORMED NAME: Omniboros Inc. DATE OF NAME CHANGE: 20170627 D 1 primary_doc.xml X0708 D LIVE 0001710426 ACTIV Surgical, Inc. 840 SUMMER STREET, SUITE 108 BOSTON MA MASSACHUSETTS 02127 617-333-8162 DELAWARE Omniboros Inc. Corporation true Todd Usen 840 Summer Street, Suite 108 c/o Activ Surgical, Inc. Boston MA MASSACHUSETTS 02127 Executive Officer Director Peter Kim 840 Summer Sreet, Suite 108 c/o ACTIV Surgical, Inc. Boston MA MASSACHUSETTS 02127 Director David Wells 840 Summer Street, Suite 108 c/o ACTIV Surgical, Inc. Boston MA MASSACHUSETTS 02127 Director Michael Ruehlman 840 Summer Street, Suite 108 c/o ACTIV Surgical, Inc. Boston MA MASSACHUSETTS 02127 Executive Officer Emily Casey 840 Summer Street, Suite 108 c/o ACTIV Surgical, Inc. Boston MA MASSACHUSETTS 02127 Director Ashok Krishnamurthi 840 Summer Street, Suite 108 c/o ACTIV Surgical, Inc. Boston MA MASSACHUSETTS 02127 Director Other Health Care Decline to Disclose 06b false 2019-06-19 false true false 0 18533366 12900038 5633328 false 8 0 0 0 false ACTIV Surgical, Inc. Todd Usen Todd Usen President & Chief Executive Officer 2019-07-01