0001217315-17-000002.txt : 20171011 0001217315-17-000002.hdr.sgml : 20171011 20171011162137 ACCESSION NUMBER: 0001217315-17-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171011 DATE AS OF CHANGE: 20171011 EFFECTIVENESS DATE: 20171011 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: 021-296430 FILM NUMBER: 171132821 BUSINESS ADDRESS: STREET 1: 851 TRAEGER AVENUE, SUITE 100 CITY: SAN BRUNO STATE: CA ZIP: 94066 BUSINESS PHONE: 650-352-1300 MAIL ADDRESS: STREET 1: 851 TRAEGER AVENUE, SUITE 100 CITY: SAN BRUNO STATE: CA ZIP: 94066 D 1 primary_doc.xml X0708 D 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 Michael Heren 851 Traeger Avenue, Suite 100 San Bruno CA CALIFORNIA 94066 Executive Officer Director Michelle Blake 851 Traeger Avenue, Suite 100 San Bruno CA CALIFORNIA 94066 Executive Officer REITS and Finance Decline to Disclose 06b false 2017-09-30 true true false 100000 250000000 2860000 247140000 false 17 0 0 0 false PROVIDENT MORTGAGE TRUST INC Keith Kandarian Keith Kandarian Attorney 2017-10-11