0001702759-17-000002.txt : 20170406 0001702759-17-000002.hdr.sgml : 20170406 20170406164557 ACCESSION NUMBER: 0001702759-17-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170406 DATE AS OF CHANGE: 20170406 EFFECTIVENESS DATE: 20170406 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Acuity EyeCare Rollover, LLC CENTRAL INDEX KEY: 0001702759 IRS NUMBER: 820626008 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-284254 FILM NUMBER: 17746505 BUSINESS ADDRESS: STREET 1: 3889 MAPLE AVENUE STREET 2: PARKLAND HALL, SUITE 220 CITY: DALLAS STATE: TX ZIP: 75219 BUSINESS PHONE: (214) 740-3600 MAIL ADDRESS: STREET 1: 3889 MAPLE AVENUE STREET 2: PARKLAND HALL, SUITE 220 CITY: DALLAS STATE: TX ZIP: 75219 D 1 primary_doc.xml X0707 D LIVE 0001702759 Acuity EyeCare Rollover, LLC 3889 MAPLE AVENUE PARKLAND HALL, SUITE 220 DALLAS TX TEXAS 75219 (214) 740-3600 DELAWARE None None Limited Liability Company true 2017 Jeff S. Fronterhouse 3889 Maple Avenue Parkland Hall, Suite 220 Dallas TX TEXAS 75219 Executive Officer Director Director and Authorized Officer of Acuity EyeCare Parent Holdings, LLC, manager of Acuity EyeCare Rollover, LLC F. Barron Fletcher III 3889 Maple Avenue Parkland Hall, Suite 220 Dallas TX TEXAS 75219 Executive Officer Director Director and Authorized Officer of Acuity EyeCare Parent Holdings, LLC, manager of Acuity EyeCare Rollover, LLC Glenn W. Askew III 3889 Maple Avenue Parkland Hall, Suite 220 Dallas TX TEXAS 75219 Executive Officer Director Director and Authorized Officer of Acuity EyeCare Parent Holdings, LLC, manager of Acuity EyeCare Rollover, LLC Jeff Browning 1717 Main Street Suite 1100 Dallas TX TEXAS 75201 Director Director of Acuity EyeCare Parent Holdings, LLC, manager of Acuity EyeCare Rollover, LLC Charles Matthews 211 East Broadway Alton IL ILLINOIS 62002 Executive Officer Director Director and Chief Executive Officer of Acuity EyeCare Parent Holdings, LLC, manager of Acuity EyeCare Rollover, LLC Douglas C. Shepard 4 Imperial Oaks San Antonio TX TEXAS 78248 Executive Officer Chief Financial Officer of Acuity EyeCare Parent Holdings, LLC, manager of Acuity EyeCare Rollover, LLC Jim Denny 6002 Niblick Way 5 Carrabassett Valley ME MAINE 04947 Director Director of Acuity EyeCare Parent Holdings, LLC, manager of Acuity EyeCare Rollover, LLC George Gebhardt 844 Trail Rock Drive P.O. Box 229 Johnson City TX TEXAS 78636 Director Director of Acuity EyeCare Parent Holdings, LLC, manager of Acuity EyeCare Rollover, LLC Warren Meyer P.O. Box 2750 Kings Beach CA CALIFORNIA 96143 Director Director of Acuity EyeCare Parent Holdings, LLC, manager of Acuity EyeCare Rollover, LLC Other Health Care Decline to Disclose 06b false 2017-03-27 false true false 0 5698943 5698943 0 false 12 0 0 122250 $122,250 will be applied to pay on-boarding fees due to Riata Capital Group, LLC. false Acuity EyeCare Rollover, LLC /s/ Douglas C. Shepard Douglas C. Shepard Chief Financial Officer of Manager of Issuer 2017-04-05