0001140361-17-015139.txt : 20170406 0001140361-17-015139.hdr.sgml : 20170406 20170406161302 ACCESSION NUMBER: 0001140361-17-015139 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: MOD Super Fast Pizza Intermediate Holdings I, LLC CENTRAL INDEX KEY: 0001702982 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-284244 FILM NUMBER: 17746101 BUSINESS ADDRESS: STREET 1: 2035 158TH COURT NE, SUITE 200 CITY: BELLEVUE STATE: WA ZIP: 98008 BUSINESS PHONE: (888) 770-6637 MAIL ADDRESS: STREET 1: 2035 158TH COURT NE, SUITE 200 CITY: BELLEVUE STATE: WA ZIP: 98008 D 1 primary_doc.xml X0707 D LIVE 0001702982 MOD Super Fast Pizza Intermediate Holdings I, LLC 2035 158th Court NE, Ste. 200 Bellevue WA WASHINGTON 98008 (888) 770-6637 DELAWARE None None Limited Liability Company true 2017 Scott Svenson c/o MOD Super Fast Pizza Holdings, LLC 2035 158th Court NE, Ste. 200 Bellevue WA WASHINGTON 98008 Executive Officer Director Robert Barton c/o MOD Super Fast Pizza Holdings, LLC 2035 158th Court NE, Ste. 200 Bellevue WA WASHINGTON 98008 Executive Officer Director Chris Schultz c/o MOD Super Fast Pizza Holdings, LLC 2035 158th Court NE, Ste. 200 Bellevue WA WASHINGTON 98008 Executive Officer Restaurants Decline to Disclose 06b false 2017-03-27 false true false 0 400000 400000 0 false 2 0 0 0 false MOD Super Fast Pizza Intermediate Holdings I, LLC /s/ Scott Svenson Scott Svenson President and Chief Executive Officer 2017-04-06