0001179110-17-014687.txt : 20171129
0001179110-17-014687.hdr.sgml : 20171129
20171129135851
ACCESSION NUMBER: 0001179110-17-014687
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171127
FILED AS OF DATE: 20171129
DATE AS OF CHANGE: 20171129
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: POLINSKY DOUGLAS MICHAEL
CENTRAL INDEX KEY: 0001394819
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 814-00991
FILM NUMBER: 171227821
MAIL ADDRESS:
STREET 1: 130 LAKE ST. WEST
CITY: WAYZATA
STATE: MN
ZIP: 55391
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Mill City Ventures III, Ltd
CENTRAL INDEX KEY: 0001425355
STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000]
IRS NUMBER: 204709758
STATE OF INCORPORATION: MN
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 328 BARRY AVENUE
STREET 2: SUITE 210
CITY: WAYZATA
STATE: MN
ZIP: 55391
BUSINESS PHONE: 952 473 3442
MAIL ADDRESS:
STREET 1: 328 BARRY AVENUE
STREET 2: SUITE 210
CITY: WAYZATA
STATE: MN
ZIP: 55391
FORMER COMPANY:
FORMER CONFORMED NAME: POKER MAGIC INC
DATE OF NAME CHANGE: 20080129
4
1
edgar.xml
FORM 4 -
X0306
4
2017-11-27
0
0001425355
Mill City Ventures III, Ltd
MCVT
0001394819
POLINSKY DOUGLAS MICHAEL
328 BARRY AVE, SUITE 210
WAYZATA
MN
55391
1
1
0
0
Chairman and CEO
Common Stock
69411
I
By Great North Capital Corp.
Common Stock
12728
I
By Minor children
Common Stock
290055
I
By Lantern Advisers LLC
Common Stock
2017-11-27
4
P
0
16000
.70
A
203364
D
A Minnesota corporation, of which the Reporting Person is founder and Chief Executive Officer.
The Reporting Person has no pecuniary interest in these shares and disclaims beneficial ownership.
A limited liability company, of which the Reporting Person is a member and a manager.
/s/ Douglas M. Polinsky
2017-11-29