0001217315-21-000002.txt : 20211008 0001217315-21-000002.hdr.sgml : 20211008 20211008105627 ACCESSION NUMBER: 0001217315-21-000002 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20211008 DATE AS OF CHANGE: 20211008 EFFECTIVENESS DATE: 20211008 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: 021-296430 FILM NUMBER: 211314308 BUSINESS ADDRESS: STREET 1: 1235 NORTH DUTTON AVENUE, SUITE E CITY: SANTA ROSA STATE: CA ZIP: 95401 BUSINESS PHONE: 650-352-1300 MAIL ADDRESS: STREET 1: 1235 NORTH DUTTON AVENUE, SUITE E CITY: SANTA ROSA STATE: CA ZIP: 95401 D/A 1 primary_doc.xml X0708 D/A LIVE 0001217315 PROVIDENT MORTGAGE TRUST INC 1235 NORTH DUTTON AVENUE, SUITE E SANTA ROSA CA CALIFORNIA 95401 650-352-1300 MARYLAND None None Corporation true R. Craig Pica 1235 North Dutton Avenue, Suite E Santa Rosa CA CALIFORNIA 95401 Executive Officer Director Michael Heren 1235 North Dutton Avenue, Suite E Santa Rosa CA CALIFORNIA 95401 Executive Officer Director Nathaniel Chaney 1235 North Dutton Avenue, Suite E Santa Rosa CA CALIFORNIA 95401 Executive Officer REITS and Finance Decline to Disclose 06b true 0001217315-20-000002 2017-09-30 true true false 100000 250000000 37082770 212917230 false 99 0 0 0 false PROVIDENT MORTGAGE TRUST INC Keith Kandarian Keith Kandarian Attorney 2021-10-08