# Derby Insurance Services, Inc. — Form D

Derby Insurance Services, Inc. of SIOUX CITY, IA, a company, filed a Form D exempt-offering notice with the SEC on 2012-10-12. $125K was reported sold. Industry: Insurance.

## Offering

- Filed: 2012-10-12
- Form: D
- Accession: 0001560012-12-000001
- Industry: Insurance
- Exemptions: 04
- Amount sold: $125K
- Investors: 5
- Date of first sale: 2012-09-30
- Security types: equity
- Revenue range: $1 - $1,000,000
- SEC file number: 021-185456

## Issuer

- Name: Derby Insurance Services, Inc.
- CIK: 0001560012
- Entity type: Corporation
- Jurisdiction: NEBRASKA
- Incorporated: 2012
- Address: 5529 MILITARY ROAD, SIOUX CITY, IA, 51109
- Phone: (712) 233-2838

## Officers, directors & promoters (6)

| Name | Role | Location |
| --- | --- | --- |
| Matthew Anderson | Director | Indianapolis, IN |
| Richard Boxum | Director | Sioux City, IA |
| Kevin Dorn | Director | Sioux City, IA |
| Tad Edeal | Director | Sioux City, IA |
| Todd Whitehill | Director | Sioux City, IA |
| Tad Edeal | Executive Officer | Sioux City, IA |

## More

- [CIK 1560012 on SEC EDGAR (source of record)](https://www.sec.gov/cgi-bin/browse-edgar?action=getcompany&CIK=1560012&type=&dateb=&owner=include&count=40)
- [This page as markdown (for LLM agents)](https://search.stillhousedata.com/formd/0001560012-12-000001.md)
- [Search all SEC filings, advisers and people on Adviser Search](https://search.stillhousedata.com/)

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