0001179110-19-011978.txt : 20191121 0001179110-19-011978.hdr.sgml : 20191121 20191121164031 ACCESSION NUMBER: 0001179110-19-011978 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191120 FILED AS OF DATE: 20191121 DATE AS OF CHANGE: 20191121 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: 191237822 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: 900316651 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1907 WAYZATA BOULEVARD STREET 2: SUITE 205 CITY: WAYZATA STATE: MN ZIP: 55391 BUSINESS PHONE: (952) 479-1923 MAIL ADDRESS: STREET 1: 1907 WAYZATA BOULEVARD STREET 2: SUITE 205 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 2019-11-20 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 290055 I By Lantern Advisers LLC Common Stock 2019-11-20 4 P 0 4000 .55 A 237364 D Common Stock 2019-11-21 4 P 0 1000 .60 A 238364 D A Minnesota corporation, of which the Reporting Person is founder and Chief Executive Officer. A limited liability company, of which the Reporting Person is a member and a manager. /s/ Douglas M. Polinsky 2019-11-21