Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 2 | MATT STOVERN REBECCA J PERRY PRESIDENT TREASURER FAMILY RELATIONSHIP WILLIAM H PERRY REBECCA J PERRY SECRETARY TREASURER FAMILY RELATIONSHIP REBECCA J PERRY WILLIAM H PERRY TREASURER TREASURER FAMILY RELATIONSHIP |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE COMPLETED 990 IS PROVIDED TO THE GOVERNING BODY PRIOR TO FILING. A PLAN ADMINISTRATOR OFFICER IS RESPONSIBLE FOR SIGNING THE RETURN. |
| FORM 990, PAGE 6, PART VI, LINE 12C | PLAN ADMINISTRATOR INQUIRES AND DOCUMENTS RESPONSES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. THE ORGANIZATION DOES MAKE THEM AVAILABLE TO PARTICIPANTS IN THE GROUP HEALTH PLAN UPON REQUEST. |
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