Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990-EZ, PART I, LINE 16 | EXPENSES SUPPLIES 268 151 BONDING 184 STATE ANNUAL FEE 20 MEALS 110 INVESTMENT ACCOUNT FEES 44 CORPORATE RECORDS EXP 125 MEETINGS 96 RETIREE SEARCH 35 NON-INVESTMENT DEPRECIATION 945 TOTAL 1,978 |
| FORM 990-EZ, PART I, LINE 20 | CHANGE IN MARKET VALUE 28,369 |
| FORM 990-EZ, PART II, LINE 24 | PLEDGES RECEIVABLE 0 1,862 LAP TOP 0 1,801 LESS ACCUMULATED DEPRECIATION 0 945 TOTAL 0 2,718 |
| FORM 990-EZ, PART III | TO PROVIDE DEATH BENEFITS TO MEMBERS & A BENEFICIARY OF A MEMBER. TO PROVIDE DURABLE MEDICAL EQUIPMENT FOR USE BY ITS MEMBERS, SUCH AS WHEEL CHAIRS, WALKERS, CANES. TO PROVIDE TELEVISION AND TELEPHONE RENTALS TO MEMBER PATIENTS AS REQUESTED. |
| Software ID: | |
| Software Version: |
| Person Name | Explanation |
|---|---|
| MATT HOLZHEI | |
| PATRICK WIEFERICH | |
| LAWRENCE GOFF | |
| CARL SCHULTZ | |
| KRISTIAN SINGH | |
| CHARLES STADT | |
| LARRY HUFNAGEL | |
| LAWRENCE PUNG | |
| PETE WILSON |