Form D Raw Data - Electronic Filing Depository

EFDID: 267763EFD: Raw Data

Issuer: CLARIFY MEDICAL, INC. (0001615353) - D

Accession: 0001140361-18-031297 () (EDGAR Files) (Form D)

Edgar Posted: Jul. 3, 2018
EFD Posted: Jul. 3, 2018

- < edgarSubmission >

< schemaVersion > X0708 </ schemaVersion >

< submissionType > D </ submissionType >

< testOrLive > LIVE </ testOrLive >

- < primaryIssuer >

< cik > 0001615353 </ cik >

< entityName > CLARIFY MEDICAL, INC. </ entityName >

- < issuerAddress >

< street1 > 401 W. A Street, Suite 950 </ street1 >

< city > SAN DIEGO </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 92101 </ zipCode >

</ issuerAddress >

< issuerPhoneNumber > 858-348-4959 </ issuerPhoneNumber >

< jurisdictionOfInc > DELAWARE </ jurisdictionOfInc >

- < issuerPreviousNameList >

< value > None </ value >

</ issuerPreviousNameList >

- < edgarPreviousNameList >

< previousName > Clarify Medical, Inc. </ previousName >

< previousName > Skylit Corp </ previousName >

</ edgarPreviousNameList >

< entityType > Corporation </ entityType >

- < yearOfInc >

< withinFiveYears > true </ withinFiveYears >

< value > 2014 </ value >

</ yearOfInc >

</ primaryIssuer >

- < relatedPersonsList >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > George </ firstName >

< lastName > Mahaffey </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 401 W. A Street, Suite 950 </ street1 >

< city > San Diego </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 92101 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

< relationship > Executive Officer </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification > President and Chief Executive Officer </ relationshipClarification >

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Donald </ firstName >

< lastName > Canal </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 401 W. A Street, Suite 950 </ street1 >

< city > San Diego </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 92101 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Executive Officer </ relationship >

</ relatedPersonRelationshipList >

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Rex </ firstName >

< lastName > Bright </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 401 W. A Street, Suite 950 </ street1 >

< city > San Diego </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 92101 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > John </ firstName >

< middleName > T. </ middleName >

< lastName > Buhler </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 401 W. A Street, Suite 950 </ street1 >

< city > San Diego </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 92101 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > David </ firstName >

< middleName > T. </ middleName >

< lastName > Hale </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 401 W. A Street, Suite 950 </ street1 >

< city > San Diego </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 92101 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification > Chairman of the Board </ relationshipClarification >

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Amit </ firstName >

< middleName > G. </ middleName >

< lastName > Pandya, M.D. </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 401 W. A Street, Suite 950 </ street1 >

< city > San Diego </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 92101 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > James </ firstName >

< middleName > M. </ middleName >

< lastName > Sweeney </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 401 W. A Street, Suite 950 </ street1 >

< city > San Diego </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 92101 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Edward </ firstName >

< lastName > Fulham </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 401 W. A Street, Suite 950 </ street1 >

< city > San Diego </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 92101 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Executive Officer </ relationship >

</ relatedPersonRelationshipList >

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Raymond </ firstName >

< lastName > Huggenberger </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 401 W. A Street, Suite 950 </ street1 >

< city > San Diego </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 92101 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

</ relatedPersonInfo >

</ relatedPersonsList >

- < offeringData >

- < industryGroup >

< industryGroupType > Other Health Care </ industryGroupType >

</ industryGroup >

- < issuerSize >

< revenueRange > Decline to Disclose </ revenueRange >

</ issuerSize >

- < federalExemptionsExclusions >

< item > 06b </ item >

</ federalExemptionsExclusions >

- < typeOfFiling >

- < newOrAmendment >

< isAmendment > false </ isAmendment >

</ newOrAmendment >

- < dateOfFirstSale >

< value > 2017-12-22 </ value >

</ dateOfFirstSale >

</ typeOfFiling >

- < durationOfOffering >

< moreThanOneYear > false </ moreThanOneYear >

</ durationOfOffering >

- < typesOfSecuritiesOffered >

< isDebtType > true </ isDebtType >

< isSecurityToBeAcquiredType > true </ isSecurityToBeAcquiredType >

</ typesOfSecuritiesOffered >

- < businessCombinationTransaction >

< isBusinessCombinationTransaction > false </ isBusinessCombinationTransaction >

</ businessCombinationTransaction >

< minimumInvestmentAccepted > 0 </ minimumInvestmentAccepted >

< salesCompensationList />

- < offeringSalesAmounts >

< totalOfferingAmount > 1500000 </ totalOfferingAmount >

< totalAmountSold > 1017000 </ totalAmountSold >

< totalRemaining > 483000 </ totalRemaining >

</ offeringSalesAmounts >

- < investors >

< hasNonAccreditedInvestors > false </ hasNonAccreditedInvestors >

< totalNumberAlreadyInvested > 7 </ totalNumberAlreadyInvested >

</ investors >

- < salesCommissionsFindersFees >

- < salesCommissions >

< dollarAmount > 0 </ dollarAmount >

</ salesCommissions >

- < findersFees >

< dollarAmount > 0 </ dollarAmount >

</ findersFees >

</ salesCommissionsFindersFees >

- < useOfProceeds >

- < grossProceedsUsed >

< dollarAmount > 0 </ dollarAmount >

</ grossProceedsUsed >

</ useOfProceeds >

- < signatureBlock >

< authorizedRepresentative > false </ authorizedRepresentative >

- < signature >

< issuerName > CLARIFY MEDICAL, INC. </ issuerName >

< signatureName > /s/ Edward Fulham </ signatureName >

< nameOfSigner > Edward Fulham </ nameOfSigner >

< signatureTitle > Secretary </ signatureTitle >

< signatureDate > 2018-07-03 </ signatureDate >

</ signature >

</ signatureBlock >

</ offeringData >

</ edgarSubmission >