# Provenance Blockchain Labs, Inc. — Form D

Provenance Blockchain Labs, Inc. of MONMOUTH BEACH, NJ, a company, filed a Form D exempt-offering notice with the SEC on 2024-11-26. The offering totals $10.0M, of which $2.6M was reported sold. Industry: Other Technology.

## Offering

- Filed: 2024-11-26
- Form: D
- Accession: 0001829126-24-007825
- Industry: Other Technology
- Exemptions: 06b
- Total offering: $10.0M
- Amount sold: $2.6M
- Remaining: $7.3M
- Minimum investment: $100K
- Investors: 14
- Date of first sale: 2024-11-12
- Security types: equity
- Revenue range: No Revenues
- SEC file number: 021-530487

## Issuer

- Name: Provenance Blockchain Labs, Inc.
- CIK: 0002043053
- Entity type: Corporation
- Jurisdiction: DELAWARE
- Incorporated: 2024
- Address: 36 BEACH RD #178, MONMOUTH BEACH, NJ, 07750
- Phone: 917-476-2790

## Officers, directors & promoters (8)

| Name | Role | Location |
| --- | --- | --- |
| Mike M Cagney | Director | Monmouth Beach, NJ |
| Dr. Sachin M Jaitly | Director | Monmouth Beach, NJ |
| Alfred M Macdaniel, Jr. | Director | Austin, TX |
| Anthony Moro | Director | Monmouth Beach, NJ |
| June M Ou | Director | Monmouth Beach, NJ |
| Dan Garzia | Executive Officer | Monmouth Beach, NJ |
| Ira Miller | Executive Officer | Monmouth Beach, NJ |
| Anthony Moro | Executive Officer | Monmouth Beach, NJ |

## Other filings by this issuer (1)

| Filed | Form | Offering | Sold |
| --- | --- | --- | --- |
| [2024-11-08](https://search.stillhousedata.com/formd/0001829126-24-007365) | D | $15.0M | $15.0M |

## More

- [CIK 2043053 on SEC EDGAR (source of record)](https://www.sec.gov/cgi-bin/browse-edgar?action=getcompany&CIK=2043053&type=&dateb=&owner=include&count=40)
- [This page as markdown (for LLM agents)](https://search.stillhousedata.com/formd/0001829126-24-007825.md)
- [Search all SEC filings, advisers and people on Adviser Search](https://search.stillhousedata.com/)

---

Source: public SEC filing data via Adviser Search (https://search.stillhousedata.com).
Agents: this data is also queryable via MCP tools and read-only SQL — see https://search.stillhousedata.com/llms.txt.