0001217315-12-000001.txt : 20120418 0001217315-12-000001.hdr.sgml : 20120418 20120418143115 ACCESSION NUMBER: 0001217315-12-000001 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20120418 DATE AS OF CHANGE: 20120418 EFFECTIVENESS DATE: 20120418 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/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-158624 FILM NUMBER: 12765633 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/A 1 primary_doc.xml X0705 D/A LIVE 0001217315 PROVIDENT MORTGAGE TRUST INC 851 Traeger Avenue, Suite 100 San Bruno CA CALIFORNIA 94066 650 352 1300 MARYLAND None None Corporation true R Craig Pica 851 Traeger Avenue, Suite 100 San Bruno CA CALIFORNIA 94066 Executive Officer Director Promoter Michael Heren 851 Traeger Avenue, Suite 100 San Bruno CA CALIFORNIA 94066 Executive Officer Director Promoter Michelle Blake 851 Traeger Avenue, Suite 100 San Bruno CA CALIFORNIA 94066 Executive Officer Director REITS and Finance $5,000,001 - $25,000,000 06 true 0001217315-11-000004 2010-11-15 true true false 25000 50000000 26500000 23500000 false 99 0 0 0 false PROVIDENT MORTGAGE TRUST INC Keith Kandarian Keith Kandarian Attorney 2012-04-18