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, PART VI, SECTION B, LINE 11 | CO-TRUSTEES REVIEW THE FORM 990 FOR COMPLETENESS AND ACCURACY PRIOR TO SUBMISSION TO IRS. |
| FORM 990, PART VI, SECTION C, LINE 18 | NOT APPLICABLE. THE ORGANIZATION NEITHER SOLICITS NOR RECEIVES CONTRIBUTIONS FROM THE GENERAL PUBLIC. THE ORGANIZATION PROVIDES MEDICAL BENEFITS TO ELIGIBLE MEMBERS. |
| FORM 990, PART VI, SECTION C, LINE 19 | NOT APPLICABLE. THE ORGANIZATION NEITHER SOLICITS NOR RECEIVES CONTRIBUTIONS FROM THE GENERAL PUBLIC. THE ORGANIZATION PROVIDES MEDICAL BENEFITS TO ELIGIBLE MEMBERS. |
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