0001833373-20-000002.txt : 20201218 0001833373-20-000002.hdr.sgml : 20201218 20201218143607 ACCESSION NUMBER: 0001833373-20-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b ITEM INFORMATION: Investment Company Act Section 3(c) ITEM INFORMATION: Section 3(c)(1) ITEM INFORMATION: Section 3(c)(10) FILED AS OF DATE: 20201218 DATE AS OF CHANGE: 20201218 EFFECTIVENESS DATE: 20201218 FILER: COMPANY DATA: COMPANY CONFORMED NAME: National CCRC Statutory Tier IV Trust CENTRAL INDEX KEY: 0001833373 IRS NUMBER: 853943847 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-383711 FILM NUMBER: 201399760 BUSINESS ADDRESS: STREET 1: 701 MAIDEN CHOICE LANE CITY: BALTIMORE STATE: MD ZIP: 21228 BUSINESS PHONE: 410-402-2495 MAIL ADDRESS: STREET 1: 701 MAIDEN CHOICE LANE CITY: BALTIMORE STATE: MD ZIP: 21228 D 1 primary_doc.xml X0708 D LIVE 0001833373 National CCRC Statutory Tier IV Trust 701 MAIDEN CHOICE LANE BALTIMORE MD MARYLAND 21228 410-402-2495 MARYLAND None None Business Trust true 2020 Eileen Erstad c/o National CCRC Statutory Tier IV Trus 701 Maiden Choice Lane Baltimore MD MARYLAND 21228 Executive Officer Promoter Barbara Bisgaier c/o National CCRC Statutory Tier IV Trus 701 Maiden Choice Lane Baltimore MD MARYLAND 21228 Executive Officer Promoter E. Michelle Bohreer c/o National CCRC Statutory Tier IV Trus 701 Maiden Choice Lane Baltimore MD MARYLAND 21228 Executive Officer Promoter Frederick W. Haas c/o National CCRC Statutory Tier IV Trus 701 Maiden Choice Lane Baltimore MD MARYLAND 21228 Executive Officer Promoter Pooled Investment Fund Other Investment Fund false Decline to Disclose 06b 3C 3C.1 3C.10 false true true true false 0 Indefinite 0 Indefinite false 0 0 0 0 false National CCRC Statutory Tier IV Trust E. Michelle Bohreer E. Michelle Bohreer authorized officer 2020-12-18