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