0001689128-16-000001.txt : 20161103 0001689128-16-000001.hdr.sgml : 20161103 20161103111715 ACCESSION NUMBER: 0001689128-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06c FILED AS OF DATE: 20161103 DATE AS OF CHANGE: 20161103 EFFECTIVENESS DATE: 20161103 FILER: COMPANY DATA: COMPANY CONFORMED NAME: KB Cleveland Dialysis, DST CENTRAL INDEX KEY: 0001689128 IRS NUMBER: 816773419 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-273739 FILM NUMBER: 161970639 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 0001689128 KB Cleveland Dialysis, DST 2801 N. TENAYA WAY LAS VEGAS NV NEVADA 89128 (702) 454-9000 DELAWARE None None Other Delaware statutory trust true 2016 . 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 100000 5230000 0 5230000 false 0 0 0 490000 true false KB Cleveland Dialysis, DST Jeff Pori Jeff Pori Managing Partner of Sponsor 2016-11-03