0001217315-11-000004.txt : 20110419 0001217315-11-000004.hdr.sgml : 20110419 20110419141651 ACCESSION NUMBER: 0001217315-11-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20110419 DATE AS OF CHANGE: 20110419 EFFECTIVENESS DATE: 20110419 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PROVIDENT MORTGAGE TRUST INC CENTRAL INDEX KEY: 0001217315 IRS NUMBER: 431971360 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-158624 FILM NUMBER: 11767726 BUSINESS ADDRESS: STREET 1: 1633 BAYSHORE HWY SUITE 150 CITY: BURLINGAME STATE: CA ZIP: 94010 BUSINESS PHONE: 650-352-1300 MAIL ADDRESS: STREET 1: 1633 BAYSHORE HWY SUITE 150 CITY: BURLINGAME STATE: CA ZIP: 94010 D 1 primary_doc.xml X0704 D LIVE 0001217315 PROVIDENT MORTGAGE TRUST INC 1633 BAYSHORE HWY SUITE 150 BURLINGAME CA CALIFORNIA 94010 650-352-1300 MARYLAND None None Corporation true R Craig Pica 1633 Bayshore Hwy Suite 150 Burlingame CA CALIFORNIA 94010 Executive Officer Director Promoter Michael Heren 1633 Bayshore Hwy Suite 150 Burlingame CA CALIFORNIA 94010 Executive Officer Director Promoter Michelle Blake 1633 Bayshore Hwy Suite 150 Burlingame CA CALIFORNIA 94010 Executive Officer Director REITS and Finance $5,000,001 - $25,000,000 06 false 2010-11-15 true true false 25000 50000000 8500000 41500000 false 45 0 0 0 false PROVIDENT MORTGAGE TRUST INC Keith Kandarian Keith Kandarian Attorney 2011-04-19