0001903514-22-000001.txt : 20220224 0001903514-22-000001.hdr.sgml : 20220224 20220224164635 ACCESSION NUMBER: 0001903514-22-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b ITEM INFORMATION: Section 3(c)(1) FILED AS OF DATE: 20220224 DATE AS OF CHANGE: 20220224 EFFECTIVENESS DATE: 20220224 FILER: COMPANY DATA: COMPANY CONFORMED NAME: 212 IV Jan22, a Series of 212 I, LLC CENTRAL INDEX KEY: 0001903514 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-434925 FILM NUMBER: 22671888 BUSINESS ADDRESS: STREET 1: PO BOX 171305 CITY: SALT LAKE CITY STATE: UT ZIP: 84117 BUSINESS PHONE: (801) 419-0677 MAIL ADDRESS: STREET 1: PO BOX 171305 CITY: SALT LAKE CITY STATE: UT ZIP: 84117 D 1 primary_doc.xml X0708 D LIVE 0001903514 212 IV Jan22, a Series of 212 I, LLC 103 South Church Street PO Box 10240 George Town E9 CAYMAN ISLANDS KY1-1002 (212) 810-9929 DELAWARE None None Limited Liability Company true 2021 null 212 Limited 103 South Church Street PO Box 10240 George Town E9 CAYMAN ISLANDS KY1-1002 Director Issuer's Manager LLC Assure Fund Management II PO Box 171305 Salt Lake City UT UTAH 84117 Executive Officer Issuer's Administrative Manager Richard Thoms PO Box 171305 Salt Lake City UT UTAH 84117 Executive Officer Officer of the Issuer's Administrative Manager Pooled Investment Fund Other Investment Fund false Decline to Disclose 06b 3C.1 false 2022-02-22 false true false 100000 3244921 3244921 0 false 7 0 0 10500 This amount represents a one-time cost to cover fund organizational and operating expenses. 212 IV Jan22, a Series of 212 I, LLC Richard Thoms Richard Thoms Officer of the Issuer's Administrative Manager 2022-02-23