Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990-EZ, PART I, LINE 8 | REIMBURSEMENT 21 TOTAL 21 |
| FORM 990-EZ, PART I, LINE 16 | EXPENSES SUPPLIES 41 BANK FEE 58 TV 1,849 NON-INVESTMENT DEPRECIATION 62 TOTAL 2,010 |
| FORM 990-EZ, PART I, LINE 20 | CHANGE IN MARKET VALUE -12,501 |
| FORM 990-EZ, PART II, LINE 24 | PLEDGES RECEIVABLE 22,074 22,074 LAP TOP 1,801 1,801 LESS ACCUMULATED DEPRECIATION 1,739 1,801 TOTAL 22,136 22,074 |
| 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. |
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