Form D Raw Data - Electronic Filing Depository

EFDID: 360620EFD: Raw Data

Issuer: Polysign, Inc. (0001722286) - D

Accession: 0001722286-21-000001 () (EDGAR Files) (Form D)

Edgar Posted: Jan. 11, 2021
EFD Posted: Jan. 12, 2021

- < edgarSubmission >

< schemaVersion > X0708 </ schemaVersion >

< submissionType > D </ submissionType >

< testOrLive > LIVE </ testOrLive >

- < primaryIssuer >

< cik > 0001722286 </ cik >

< entityName > Polysign, Inc. </ entityName >

- < issuerAddress >

< street1 > 1700 Broadway, Suite 600 </ street1 >

< city > Oakland </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 94612 </ zipCode >

</ issuerAddress >

< issuerPhoneNumber > 510-596-1754 </ issuerPhoneNumber >

< jurisdictionOfInc > CALIFORNIA </ jurisdictionOfInc >

- < issuerPreviousNameList >

< value > None </ value >

</ issuerPreviousNameList >

- < edgarPreviousNameList >

< value > None </ value >

</ edgarPreviousNameList >

< entityType > Corporation </ entityType >

- < yearOfInc >

< withinFiveYears > true </ withinFiveYears >

< value > 2017 </ value >

</ yearOfInc >

</ primaryIssuer >

- < relatedPersonsList >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Arthur </ firstName >

< lastName > Britto, II </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 1700 Broadway, Suite 600 </ street1 >

< city > Oakland </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 94612 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Executive Officer </ relationship >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Jack </ firstName >

< lastName > McDonald </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 1700 Broadway, Suite 600 </ street1 >

< city > Oakland </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 94612 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Executive Officer </ relationship >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > David </ firstName >

< lastName > Schwartz </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 1700 Broadway, Suite 600 </ street1 >

< city > Oakland </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 94612 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Timothy </ firstName >

< middleName > F. </ middleName >

< lastName > Keaney </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 1700 Broadway, Suite 600 </ street1 >

< city > Oakland </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 94612 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Niraj </ firstName >

< lastName > Mehta </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 1700 Broadway, Suite 600 </ street1 >

< city > Oakland </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 94612 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Ding </ firstName >

< lastName > Chun </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 1700 Broadway, Suite 600 </ street1 >

< city > Oakland </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 94612 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Cherie </ firstName >

< lastName > Porter </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 1700 Broadway, Suite 600 </ street1 >

< city > Oakland </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 94612 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Executive Officer </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Fred </ firstName >

< lastName > Wagner </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > 1700 Broadway, Suite 600 </ street1 >

< city > Oakland </ city >

< stateOrCountry > CA </ stateOrCountry >

< stateOrCountryDescription > CALIFORNIA </ stateOrCountryDescription >

< zipCode > 94612 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Executive Officer </ relationship >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

</ relatedPersonsList >

- < offeringData >

- < industryGroup >

< industryGroupType > Other Technology </ industryGroupType >

</ industryGroup >

- < issuerSize >

< revenueRange > Decline to Disclose </ revenueRange >

</ issuerSize >

- < federalExemptionsExclusions >

< item > 06b </ item >

</ federalExemptionsExclusions >

- < typeOfFiling >

- < newOrAmendment >

< isAmendment > false </ isAmendment >

</ newOrAmendment >

- < dateOfFirstSale >

< value > 2020-12-31 </ value >

</ dateOfFirstSale >

</ typeOfFiling >

- < durationOfOffering >

< moreThanOneYear > false </ moreThanOneYear >

</ durationOfOffering >

- < typesOfSecuritiesOffered >

< isEquityType > true </ isEquityType >

</ typesOfSecuritiesOffered >

- < businessCombinationTransaction >

< isBusinessCombinationTransaction > false </ isBusinessCombinationTransaction >

< clarificationOfResponse />

</ businessCombinationTransaction >

< minimumInvestmentAccepted > 0 </ minimumInvestmentAccepted >

< salesCompensationList />

- < offeringSalesAmounts >

< totalOfferingAmount > 12700000 </ totalOfferingAmount >

< totalAmountSold > 7700000 </ totalAmountSold >

< totalRemaining > 5000000 </ totalRemaining >

< clarificationOfResponse />

</ offeringSalesAmounts >

- < investors >

< hasNonAccreditedInvestors > false </ hasNonAccreditedInvestors >

< totalNumberAlreadyInvested > 8 </ totalNumberAlreadyInvested >

</ investors >

- < salesCommissionsFindersFees >

- < salesCommissions >

< dollarAmount > 0 </ dollarAmount >

</ salesCommissions >

- < findersFees >

< dollarAmount > 0 </ dollarAmount >

</ findersFees >

< clarificationOfResponse />

</ salesCommissionsFindersFees >

- < useOfProceeds >

- < grossProceedsUsed >

< dollarAmount > 0 </ dollarAmount >

</ grossProceedsUsed >

< clarificationOfResponse />

</ useOfProceeds >

- < signatureBlock >

< authorizedRepresentative > false </ authorizedRepresentative >

- < signature >

< issuerName > Polysign, Inc. </ issuerName >

< signatureName > /s/ Cherie Porter </ signatureName >

< nameOfSigner > Cherie Porter </ nameOfSigner >

< signatureTitle > Secretary and General Counsel </ signatureTitle >

< signatureDate > 2021-01-11 </ signatureDate >

</ signature >

</ signatureBlock >

</ offeringData >

</ edgarSubmission >