0001702624-17-000001.txt : 20170403 0001702624-17-000001.hdr.sgml : 20170403 20170403141519 ACCESSION NUMBER: 0001702624-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170403 DATE AS OF CHANGE: 20170403 EFFECTIVENESS DATE: 20170403 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ASC Mercer Island LLC CENTRAL INDEX KEY: 0001702624 IRS NUMBER: 352536783 STATE OF INCORPORATION: WA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-283901 FILM NUMBER: 17733546 BUSINESS ADDRESS: STREET 1: 17602 NE UNION HILL RD. CITY: REDMOND STATE: WA ZIP: 98052 BUSINESS PHONE: (425) 861-9993 MAIL ADDRESS: STREET 1: 17602 NE UNION HILL RD. CITY: REDMOND STATE: WA ZIP: 98052 D 1 primary_doc.xml X0707 D LIVE 0001702624 ASC Mercer Island LLC 17602 NE UNION HILL RD. REDMOND WA WASHINGTON 98052 (425) 861-9993 WASHINGTON None None Limited Liability Company true 2015 Dwayne J. Clark 17602 NE UNION HILL RD. REDMOND WA WASHINGTON 98052 Executive Officer Promoter Manager of Aegis Senior Communities LLC, the manager of Issuer Jerry C. Meyer 17602 NE UNION HILL RD. REDMOND WA WASHINGTON 98052 Executive Officer Promoter Manager of Aegis Senior Communities LLC, the manager of Issuer Edward J. Poplawski 17602 NE UNION HILL RD. REDMOND WA WASHINGTON 98052 Executive Officer Promoter Manager of Aegis Senior Communities LLC, the manager of Issuer Richard Tait 17602 NE UNION HILL RD. REDMOND WA WASHINGTON 98052 Executive Officer Manager of Aegis Senior Communities LLC, the manager of Issuer Other Health Care Decline to Disclose 06b false 2017-03-22 false true false 0 11000000 1925000 9075000 false 9 0 0 2200000 Development fee paid to Aegis Senior Communities LLC or its affiliate false ASC Mercer Island LLC /s/ Dwayne J. Clark Dwayne J. Clark Manager of Aegis Senior Communities LLC, manager of Issuer 2017-04-03