0001720648-17-000003.txt : 20171030
0001720648-17-000003.hdr.sgml : 20171030
20171030172825
ACCESSION NUMBER: 0001720648-17-000003
CONFORMED SUBMISSION TYPE: D
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: Rule 504(b)(1) (not (i), (ii) or (iii))
FILED AS OF DATE: 20171030
DATE AS OF CHANGE: 20171030
EFFECTIVENESS DATE: 20171030
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: Polycomp Administrative Services, Inc.
CENTRAL INDEX KEY: 0001720648
IRS NUMBER: 952889854
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: D
SEC ACT: 1933 Act
SEC FILE NUMBER: 021-297727
FILM NUMBER: 171163414
BUSINESS ADDRESS:
STREET 1: 3000 LAVA RIDGE COURT, NO. 130
CITY: ROSEVILLE
STATE: CA
ZIP: 95661
BUSINESS PHONE: 9167733480
MAIL ADDRESS:
STREET 1: 3000 LAVA RIDGE COURT, NO. 130
CITY: ROSEVILLE
STATE: CA
ZIP: 95661
D
1
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0001720648
Polycomp Administrative Services, Inc.
3000 LAVA RIDGE COURT, NO. 130
ROSEVILLE
CA
CALIFORNIA
95661
9167733480
CALIFORNIA
None
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true
Donna
Harmon
3000 Lava Ridge Court, No. 130
Roseville
CA
CALIFORNIA
95661
Executive Officer
Director
Other Banking and Financial Services
$5,000,001 - $25,000,000
- 04
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2017-01-01
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true
false
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Polycomp Administrative Services, Inc.
Donna Harmon
Donna Harmon
President
2017-10-30