0001903713-22-000004.txt : 20221229 0001903713-22-000004.hdr.sgml : 20221229 20221229074827 ACCESSION NUMBER: 0001903713-22-000004 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06c FILED AS OF DATE: 20221229 DATE AS OF CHANGE: 20221229 EFFECTIVENESS DATE: 20221229 FILER: COMPANY DATA: COMPANY CONFORMED NAME: JAK23, LLC CENTRAL INDEX KEY: 0001903713 IRS NUMBER: 850541384 STATE OF INCORPORATION: ND FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-428861 FILM NUMBER: 221496338 BUSINESS ADDRESS: STREET 1: 400 10TH STREET SE CITY: MINOT STATE: ND ZIP: 58701 BUSINESS PHONE: 7018523045 MAIL ADDRESS: STREET 1: 400 10TH STREET SE CITY: MINOT STATE: ND ZIP: 58701 FORMER COMPANY: FORMER CONFORMED NAME: Four Points Medical I, LLC DATE OF NAME CHANGE: 20220110 D/A 1 primary_doc.xml X0708 D/A LIVE 0001903713 JAK23, LLC 400 10TH STREET SE MINOT ND NORTH DAKOTA 58701 7018523045 NORTH DAKOTA TPAS, LLC Four Points Medical I, LLC Limited Liability Company true 2020 Amy Hass 745 31st Avenue East, Suite 105 West Fargo ND NORTH DAKOTA 58078 Executive Officer Other Real Estate Decline to Disclose 06c true 0001903713-22-000001 true true true true true false 25000 None None None None 400 10th Street SE Minot ND NORTH DAKOTA 58701 CO COLORADO MN MINNESOTA ND NORTH DAKOTA false 3000000 0 3000000 false 0 0 0 0 false JAK23, LLC Amy Hass Amy Hass Vice President 2022-12-29