0001699017-17-000001.txt : 20170227 0001699017-17-000001.hdr.sgml : 20170227 20170227110421 ACCESSION NUMBER: 0001699017-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170227 DATE AS OF CHANGE: 20170227 EFFECTIVENESS DATE: 20170227 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Claiborne at West Lake, LLC CENTRAL INDEX KEY: 0001699017 IRS NUMBER: 364848901 STATE OF INCORPORATION: MS FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-281352 FILM NUMBER: 17640103 BUSINESS ADDRESS: STREET 1: 11 PARKWAY BOULEVARD CITY: HATTIESBURG STATE: MS ZIP: 39401 BUSINESS PHONE: 601-336-5050 MAIL ADDRESS: STREET 1: 11 PARKWAY BOULEVARD CITY: HATTIESBURG STATE: MS ZIP: 39401 D 1 primary_doc.xml X0707 D LIVE 0001699017 Claiborne at West Lake, LLC 11 PARKWAY BOULEVARD HATTIESBURG MS MISSISSIPPI 39401 601-336-5050 MISSISSIPPI None None Limited Liability Company true 2016 Robert O. Tatum, Jr. 11 Parkway Boulevard Hattiesburg MS MISSISSIPPI 39401 Executive Officer Director Promoter Other Health Care Decline to Disclose 06b false 2017-02-12 false true false 0 4000000 500000 3500000 false 1 0 0 0 false Claiborne at West Lake, LLC Clay W. Escude Clay W. Escude Attorney duly authorized by the Manager of the issuer. 2017-02-27