0001653833-15-000001.txt : 20150923 0001653833-15-000001.hdr.sgml : 20150923 20150923112416 ACCESSION NUMBER: 0001653833-15-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06c FILED AS OF DATE: 20150923 DATE AS OF CHANGE: 20150923 EFFECTIVENESS DATE: 20150923 FILER: COMPANY DATA: COMPANY CONFORMED NAME: KB Lake City Dialysis, DST CENTRAL INDEX KEY: 0001653833 IRS NUMBER: 477167960 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-248064 FILM NUMBER: 151120628 BUSINESS ADDRESS: STREET 1: 2801 N. TENAYA WAY CITY: LAS VEGAS STATE: NV ZIP: 89128 BUSINESS PHONE: (702) 454-9000 MAIL ADDRESS: STREET 1: 2801 N. TENAYA WAY CITY: LAS VEGAS STATE: NV ZIP: 89128 D 1 primary_doc.xml X0707 D LIVE 0001653833 KB Lake City Dialysis, DST 2801 N. TENAYA WAY LAS VEGAS NV NEVADA 89128 (702) 454-9000 DELAWARE None None Other Delaware statutory trust true 2015 . Kingsbarn Realty Capital, LLC 2801 N. Tenaya Way Las Vegas NV NEVADA 89128 Promoter . KB Exchange Holdings, LLC 2801 N. Tenaya Way Las Vegas NV NEVADA 89128 Promoter Jeff Pori 2801 N. Tenaya Way Las Vegas NV NEVADA 89128 Executive Officer Promoter Mark Paul 2801 N. Tenaya Way Las Vegas NV NEVADA 89128 Executive Officer Promoter Commercial Decline to Disclose 06c false true false true Beneficial interests in a Delaware statutory trust false 10000 3400000 0 3400000 false 0 0 0 386000 true false KB Lake City Dialysis, DST Jeff Pori Jeff Pori Managing Partner of Sponsor 2015-09-23