0001567619-21-000266.txt : 20210105
0001567619-21-000266.hdr.sgml : 20210105
20210105161730
ACCESSION NUMBER: 0001567619-21-000266
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201228
FILED AS OF DATE: 20210105
DATE AS OF CHANGE: 20210105
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DUBIN BRIAN
CENTRAL INDEX KEY: 0001838882
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36803
FILM NUMBER: 21505756
MAIL ADDRESS:
STREET 1: 111 WEST 33RD STREET
STREET 2: SUITE 1910
CITY: NEW YORK
STATE: NY
ZIP: 10120
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: TOWN SPORTS INTERNATIONAL HOLDINGS INC
CENTRAL INDEX KEY: 0001281774
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEMBERSHIP SPORTS & RECREATION CLUBS [7997]
IRS NUMBER: 200640002
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1001 US NORTH HIGHWAY 1
STREET 2: SUITE 201
CITY: JUPITER
STATE: FL
ZIP: 33477
BUSINESS PHONE: (212) 246-6700
MAIL ADDRESS:
STREET 1: 399 EXECUTIVE BOULEVARD
CITY: ELMSFORD
STATE: NY
ZIP: 10523
3
1
doc1.xml
FORM 3
X0206
3
2020-12-28
1
0001281774
TOWN SPORTS INTERNATIONAL HOLDINGS INC
CLUBQ
0001838882
DUBIN BRIAN
111 WEST 33RD STREET, SUITE 1910
NEW YORK
NY
10120
1
0
0
0
/s/ Brian Dubin
2021-01-05