0001690171-17-000001.txt : 20170301 0001690171-17-000001.hdr.sgml : 20170301 20170301172700 ACCESSION NUMBER: 0001690171-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b ITEM INFORMATION: Investment Company Act Section 3(c) ITEM INFORMATION: Section 3(c)(1) FILED AS OF DATE: 20170301 DATE AS OF CHANGE: 20170301 EFFECTIVENESS DATE: 20170301 FILER: COMPANY DATA: COMPANY CONFORMED NAME: OT Microbiome Fund I, LLC CENTRAL INDEX KEY: 0001690171 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-281595 FILM NUMBER: 17655827 BUSINESS ADDRESS: STREET 1: PO BOX 171305 CITY: SALT LAKE CITY STATE: UT ZIP: 84117 BUSINESS PHONE: 8017133508 MAIL ADDRESS: STREET 1: PO BOX 171305 CITY: SALT LAKE CITY STATE: UT ZIP: 84117 D 1 primary_doc.xml X0707 D LIVE 0001690171 OT Microbiome Fund I, LLC 1642 Federal Ave Unit 402 Los Angeles CA CALIFORNIA 90025 4083963123 DELAWARE None None Limited Liability Company true 2016 LLC OT Management 1642 Federal Ave Unit 402 Los Angeles CA CALIFORNIA 90025 Director Issuer's Manager LLC Assure Fund Management II PO Box 171305 Salt Lake City UT UTAH 84117 Director Issuer's Administrative Manager Mateo Johnson PO Box 171305 Salt Lake City UT UTAH 84117 Executive Officer Officer of the Issuer's Administrative Manager Pooled Investment Fund Private Equity Fund false Decline to Disclose 06b 3C 3C.1 false 2017-02-22 false true false 100000 3145000 3145000 0 false 9 0 0 0 false OT Microbiome Fund I, LLC Mateo Johnson Mateo Johnson Officer of the Issuer's Administrative Manager 2017-03-01