Form D
View Original Filing
Notice of Exempt Offering of Securities
Item 1. Issuer's Identity
Name of Issuer:
ADAPTIVE TCR CORP
Jurisdiction of Incorporation/Organization
WA
Year of Incorporation/Organization
2009
Item 2 Issuer Principal Place of Business and Contact Information
C/0 BYRON DAILEY 701 FIFTH AVENUE
SUITE 7000
SEATTLE, WA 98104
Phone Number:
subscription required
Item 3. Related Persons
Name
CHAD ROBINS
Address
subscription required
Relationship(s)
- EXECUTIVE OFFICER
- DIRECTOR
Clarification of Response
Item 3. Related Persons
Name
HARLAN ROBINS
Address
subscription required
Relationship(s)
- EXECUTIVE OFFICER
- DIRECTOR
Clarification of Response
Item 3. Related Persons
Name
CHRIS CARLSON
Address
subscription required
Relationship(s)
Clarification of Response
Item 4. Industry Group
OTHER
Item 5. Issuer Size
Revenue Range (for issuer not specifying "hedge" or "other investment" fund in Item 4 above)
DECLINE TO DISCLOSE
Item 6. Federal Exemptions and Exclusions Claimed
Item 7. Type of Filing
New Notice
Date of First Sale in this Offering:
12/17/2009
Item 8. Duration of Offering
Does the issuer intend this offering to last more than one year?
No
Item 9. Type(s) of Securities Offered
Item 10. Business Combination Transaction
Is this offering being made in connection with a business combination
transaction, such as a merger, acquisition or exchange offer?
No
Clarification of Response
Item 11. Minimum Investment
Minimum Investment accepted from any outside investor
0
Item 13. Offering and Sales Amounts
Total Offering Amount
5000000
Total Amount Sold
3955000
Total Remaining to be Sold
1045000
Clarification of Response
Item 14. Investors
Securities in the offering have been or may be sold to persons
who do not qualify as accredited investors,
Number of non-accredited investors who already have invested in the offering:
Total number of investors who already have invested in the offering:
50
Item 15. Sales Commissions and Finders' Fees Expenses
Sales Commissions:
0.0
Finders' Fees
0.0
Clarification of Response
Item 16. Use of Proceeds
Provide the amount of the gross proceeds of the offering
that has been or is proposed to be used for payments to any of the persons required
to be named as executive officers,directors or promoters in response to Item 3 above.
300000.0 Is an estimate
Clarification of Response
PROCEEDS MAY BE USED TO PAY ORDINARY SALARIES OF EXECUTIVE OFFICERS.
Signature and Submission
Issuer Name
ADAPTIVE TCR CORP
Issuer Signature
/S/ CHAD ROBINS
Signer Name
CHAD ROBINS
Signer Title
PRESIDENT AND CEO
Signature Date
12/28/2009
