0001699307-17-000001.txt : 20170525 0001699307-17-000001.hdr.sgml : 20170525 20170525111009 ACCESSION NUMBER: 0001699307-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170525 DATE AS OF CHANGE: 20170525 EFFECTIVENESS DATE: 20170525 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Custom Tuscaloosa Medical, L.L.C. CENTRAL INDEX KEY: 0001699307 IRS NUMBER: 364853210 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-287466 FILM NUMBER: 17868784 BUSINESS ADDRESS: STREET 1: 2901 BUTTERFIELD ROAD CITY: OAK BROOK STATE: IL ZIP: 60523 BUSINESS PHONE: 630-218-8000 MAIL ADDRESS: STREET 1: 2901 BUTTERFIELD ROAD CITY: OAK BROOK STATE: IL ZIP: 60523 D 1 primary_doc.xml X0707 D LIVE 0001699307 Custom Tuscaloosa Medical, L.L.C. 2901 BUTTERFIELD ROAD OAK BROOK IL ILLINOIS 60523 630-218-8000 DELAWARE None None Limited Liability Company true 2016 Capital Corporation Inland Private 2901 Butterfield Road Oak Brook IL ILLINOIS 60523 Promoter Sponsor of the Issuer. Manager, L.L.C. Custom Tuscaloosa 2901 Butterfield Road Oak Brook IL ILLINOIS 60523 Promoter Manager of the Issuer. Other Real Estate Decline to Disclose 06b false 2017-05-11 false true Beneficial interests in the Limited Liability Company reflecting beneficial interest in real estate. false 25000 Larry R. Law 1273118 JRL Capital Corporation 10225 20371 Irvine Ave, Suite A-140 Newport Beach CA CALIFORNIA 92660 CA CALIFORNIA false 8949973 8949973 0 false 1 178999 0 634394 false Custom Tuscaloosa Medical, L.L.C. /s/ Keith Lampi Keith Lampi President of the Sole Memeber of the Manager of the Issuer. 2017-05-25