The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete. | |||||||||||||||||
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM D Notice of Exempt Offering of Securities |
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1. Issuer's Identity
CIK (Filer ID Number) | Previous Names |
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0001473377 |
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Name of Issuer | ||||||||||||||||
MEDRACON, INC. | ||||||||||||||||
Jurisdiction of Incorporation/Organization | ||||||||||||||||
ILLINOIS | ||||||||||||||||
Year of Incorporation/Organization | ||||||||||||||||
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2. Principal Place of Business and Contact Information
Name of Issuer | |||
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MEDRACON, INC. | |||
Street Address 1 | Street Address 2 | ||
1415 WEST 22ND STREET | TOWER FLOOR | ||
City | State/Province/Country | ZIP/PostalCode | Phone Number of Issuer |
OAK BROOK | IL | 60523 | 630-858-4000 |
1. Issuer's Identity
CIK (Filer ID Number) | Previous Names |
| Entity Type | |||||||||||||
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0001452870 |
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Name of Issuer | ||||||||||||||||
PAGODA PHARMA GROUP, INC. | ||||||||||||||||
Jurisdiction of Incorporation/Organization | ||||||||||||||||
VIRGIN ISLANDS, BRITISH | ||||||||||||||||
Year of Incorporation/Organization | ||||||||||||||||
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2. Principal Place of Business and Contact Information
Name of Issuer | |||
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PAGODA PHARMA GROUP, INC. | |||
Street Address 1 | Street Address 2 | ||
1415 W 22ND STREET | TOWER FLOOR | ||
City | State/Province/Country | ZIP/PostalCode | Phone Number of Issuer |
OAK BROOK | IL | 60523 | 630-858-8191 |
3. Related Persons
Last Name | First Name | Middle Name |
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Jaksch | Frank | L |
Street Address 1 | Street Address 2 | |
1415 West 22nd Street | Tower Floor | |
City | State/Province/Country | ZIP/PostalCode |
Oak Brook | IL | 60523 |
Relationship: | X | Executive Officer | X | Director | Promoter |
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Clarification of Response (if Necessary):
Mr. Jaksch is Medracon, Inc.'s Treasurer and its Chairman of the Board of Directors. Additionally, Mr. Jaksch is the Executive Chairman, an Executive Vice President and a Director of Pagoda Pharma Group, Inc.Last Name | First Name | Middle Name |
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Ma | Edward | |
Street Address 1 | Street Address 2 | |
1415 West 22nd Street | Tower Floor | |
City | State/Province/Country | ZIP/PostalCode |
Oak Brook | IL | 60523 |
Relationship: | X | Executive Officer | X | Director | Promoter |
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Clarification of Response (if Necessary):
Dr. Ma is Chief Executive Officer and a Director of both Medracon, Inc. and Pagoda Pharma Group, Inc.Last Name | First Name | Middle Name |
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Corris Coles | Arlene | |
Street Address 1 | Street Address 2 | |
1415 West 22nd Street | Tower Floor | |
City | State/Province/Country | ZIP/PostalCode |
Oak Brook | IL | 60523 |
Relationship: | X | Executive Officer | Director | Promoter |
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Clarification of Response (if Necessary):
Ms. Coles is Medracon, Inc.'s Secretary and Assistant Treasurer. Additionally, Ms. Coles is Pagoda Pharma Group, Inc.'s Vice President of Finance and Corporate Secretary.Last Name | First Name | Middle Name |
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Varvaro | Thomas | |
Street Address 1 | Street Address 2 | |
1415 West 22nd Street | Tower Floor | |
City | State/Province/Country | ZIP/PostalCode |
Oak Brook | IL | 60523 |
Relationship: | Executive Officer | X | Director | Promoter |
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Clarification of Response (if Necessary):
Mr. Varvaro is a Director of Padoga Pharma Group, Inc. Please note: Mr. Varvaro is not a Director of Medracon, Inc.Last Name | First Name | Middle Name |
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Li | Min | |
Street Address 1 | Street Address 2 | |
1415 West 22nd Street | Tower Floor | |
City | State/Province/Country | ZIP/PostalCode |
Oak Brook | IL | 60523 |
Relationship: | Executive Officer | X | Director | Promoter |
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Clarification of Response (if Necessary):
Dr. Li is a Director of Pagoda Pharma Group, Inc. Please note: Dr. Li is not a Director of Medracon, Inc.Last Name | First Name | Middle Name |
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Coles | Eric | |
Street Address 1 | Street Address 2 | |
1415 West 22nd Street | Tower Floor | |
City | State/Province/Country | ZIP/PostalCode |
Oak Brook | IL | 60523 |
Relationship: | X | Executive Officer | Director | Promoter |
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Clarification of Response (if Necessary):
Dr. Coles is a Senior Vice President of Pagoda Pharma Group, Inc. Please note: Dr. Coles is not an Executive Officer of Medracon, Inc.4. Industry Group
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5. Issuer Size
Revenue Range | OR | Aggregate Net Asset Value Range | ||
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No Revenues | No Aggregate Net Asset Value | |||
$1 - $1,000,000 | $1 - $5,000,000 | |||
$1,000,001 - $5,000,000 | $5,000,001 - $25,000,000 | |||
$5,000,001 - $25,000,000 | $25,000,001 - $50,000,000 | |||
$25,000,001 - $100,000,000 | $50,000,001 - $100,000,000 | |||
Over $100,000,000 | Over $100,000,000 | |||
X | Decline to Disclose | Decline to Disclose | ||
Not Applicable | Not Applicable |
6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
Rule 504(b)(1) (not (i), (ii) or (iii)) | Rule 505 | |||||||||||||||||||||||||||||||||||
Rule 504 (b)(1)(i) | X | Rule 506 | ||||||||||||||||||||||||||||||||||
Rule 504 (b)(1)(ii) | Securities Act Section 4(5) | |||||||||||||||||||||||||||||||||||
Rule 504 (b)(1)(iii) | Investment Company Act Section 3(c) | |||||||||||||||||||||||||||||||||||
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7. Type of Filing
X | New Notice | Date of First Sale | X | First Sale Yet to Occur | ||||
Amendment |
8. Duration of Offering
Does the Issuer intend this offering to last more than one year? |
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9. Type(s) of Securities Offered (select all that apply)
Equity | Pooled Investment Fund Interests | ||
X | Debt | Tenant-in-Common Securities | |
X | Option, Warrant or Other Right to Acquire Another Security | Mineral Property Securities | |
Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security | Other (describe) | ||
10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? |
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Clarification of Response (if Necessary):
11. Minimum Investment
Minimum investment accepted from any outside investor | $25,000 | USD |
12. Sales Compensation
Recipient |
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Street Address 1 | Street Address 2 | ||||||
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City | State/Province/Country | ZIP/Postal Code | |||||
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13. Offering and Sales Amounts
Total Offering Amount | $6,000,000 | USD |
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Total Amount Sold | $0 | USD | ||||
Total Remaining to be Sold | $6,000,000 | USD |
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Clarification of Response (if Necessary):
14. Investors
Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors, and enter the number of such non-accredited investors who already have invested in the offering. | |||
Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: |
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15. Sales Commissions & Finder's Fees Expenses
Provide separately the amounts of sales commissions and finders fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
Sales Commissions | $600,000 | USD |
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Finders' Fees | $0 | USD |
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Clarification of Response (if Necessary):
The Company has not yet retained any broker-dealers, but expects to do so and to pay commissions of up to ten percent of sales.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. If the amount is unknown, provide an estimate and check the box next to the amount.
$0 | USD |
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Clarification of Response (if Necessary):
No compensation is expected to be paid directly from the raise; proceeds are to be loaned by the Company to members of its affiliated group for repayment of bank debt, working capital, possible securities repurchase and a possible licensing transaction.Signature and Submission
Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice.
Terms of Submission
In submitting this notice, each issuer named above is: |
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Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person.
For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature.
Issuer | Signature | Name of Signer | Title | Date |
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MEDRACON, INC. | /s/ Arlene Corris Coles | Arlene Corris Coles | Secretary | 2009-10-07 |
PAGODA PHARMA GROUP, INC. | /s/ Arlene Corris Coles | Arlene Corris Coles | Corporate Secretary | 2009-10-07 |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
* This undertaking does not affect any limits Section 102(a) of the National Securities Markets Improvement Act of 1996 ("NSMIA") [Pub. L. No. 104-290, 110 Stat. 3416 (Oct. 11, 1996)] imposes on the ability of States to require information. As a result, if the securities that are the subject of this Form D are "covered securities" for purposes of NSMIA, whether in all instances or due to the nature of the offering that is the subject of this Form D, States cannot routinely require offering materials under this undertaking or otherwise and can require offering materials only to the extent NSMIA permits them to do so under NSMIA's preservation of their anti-fraud authority.