0001833373-23-000002.txt : 20231219 0001833373-23-000002.hdr.sgml : 20231219 20231219162734 ACCESSION NUMBER: 0001833373-23-000002 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: 20231219 DATE AS OF CHANGE: 20231219 EFFECTIVENESS DATE: 20231219 FILER: COMPANY DATA: COMPANY CONFORMED NAME: National CCRC Statutory Tier IV Trust CENTRAL INDEX KEY: 0001833373 ORGANIZATION NAME: IRS NUMBER: 853943847 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-500162 FILM NUMBER: 231497688 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 2020-12-31 true true false 0 Indefinite 30000000 Indefinite false 4 0 0 0 false National CCRC Statutory Tier IV Trust E. Michelle Bohreer E. Michelle Bohreer Authorized Officer 2023-12-19