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Filing ID: 2651799

PDF: https://cal-access.sos.ca.gov/PDFGen/pdfgen.prg?filingid=2651799&amendid=1

Table: cvr_registration
filing_id   2651799   2651799
amend_id   0   1
rec_type   CVR   CVR
form_type   F604   F604
sender_id   E24676   E24676
filer_id   1443346   1443346
entity_cd   LBY   LBY
filer_naml   Crump   Crump
filer_namf   Conrad   Conrad
filer_namt   None   None
filer_nams   None   None
report_num   000   001
rpt_date   2021-12-22 00:00:00   2022-02-25 00:00:00
ls_beg_yr   2021   2021
ls_end_yr   2022   2022
qual_date   2021-12-06 00:00:00   None
eff_date   None   None
bus_city   Sacramento   Sacramento
bus_st   CA   CA
bus_zip4   95814   95814
bus_phon   916 552-2960   916 552-2960
bus_fax   None   None
bus_email   None   None
mail_city   None   None
mail_st   None   None
mail_zip4   None   None
mail_phon   None   None
sig_date   2021-12-10 00:00:00   2022-02-23 00:00:00
sig_loc   Sacramento, CA   Sacramento, CA
sig_naml   Crump   Crump
sig_namf   Conrad   Conrad
sig_namt   None   None
sig_nams   None   None
prn_naml   Crump   Crump
prn_namf   Conrad   Conrad
prn_namt   None   None
prn_nams   None   None
sig_title   None   None
stmt_firm   None   None
ind_cb   None   None
bus_cb   None   None
trade_cb   None   None
oth_cb   None   None
a_b_name   None   None
a_b_city   None   None
a_b_st   None   None
a_b_zip4   None   None
descrip_1   None   None
descrip_2   None   None
c_less50   None   None
c_more50   None   None
ind_class   None   None
ind_descr   None   None
bus_class   None   None
bus_descr   None   None
auth_name   None   None
auth_city   None   None
auth_st   None   None
auth_zip4   None   None
lobby_int   None   None
influen_yn   None   None
firm_name   Blue Shield of California   Blue Shield of California
newcert_cb   X   None
rencert_cb   None   None
complet_dt   None   2022-01-27 00:00:00
lby_reg_cb   X   X
lby_604_cb   None   None
st_leg_yn   None   None
st_agency   None   None
lobby_cb   None   None
l_firm_cb   None   None
Table: filer_filings
filer_id   1443346   1443346
filing_id   2651799   2651799
period_id   249   248
form_id   F604   F604
filing_sequence   1   0
filing_date   2022-02-25 00:00:00   2022-02-23 00:00:00
stmnt_type   10002   10001
stmnt_status   11001   11003
session_id   2021   2021
user_id   MMERCHANT   CAFILER
special_audit   11003   11003
fine_audit   11003   11003
rpt_start   2022-02-25 00:00:00   2021-12-22 00:00:00
rpt_end   2022-02-25 00:00:00   2021-12-22 00:00:00
rpt_date   None   None
filing_type   22001   22001
Table: filings
filing_id   2651799
filing_type   22001
Table: hdr
filing_id   2651799   2651799
amend_id   0   1
rec_type   HDR   HDR
ef_type   CAL   CAL
state_cd   CA   CA
cal_ver   2.01   2.01
soft_name   NETFILE   NETFILE
soft_ver   1809   1809
hdrcomment   None   None
Table: received_filings
filer_id   1443346   1443346
filing_file_name   2651799_0.cal   2651799_1.cal
received_date   2022-02-23 00:00:00   2022-02-25 00:00:00
filing_directory   /cafiler/disclose/ca99/cal   /cafiler/disclose/ca99/cal
filing_id   2651799   2651799
form_id   F604   F604
receive_comment   Filing accepted   Filing accepted