TY 2018 Form 990

(A)
Name and Title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W- 2/1099-MISC)

(E)
Reportable compensation from related organizations (W- 2/1099-MISC)

(F)
Estimated amount of other compensation from the organization and related organizations

(1) KYLE SHORETTE......................................................................
PRESIDENT

30.00
.................

(2) JOSE SEPULVEDA......................................................................
VICE PRESIDE

30.00
.................

(3) MEGAN MEDLEY......................................................................
SECRETARY

30.00
.................

(4) DIANE SAVAGE......................................................................
TREASURER

30.00
.................

(5) ERIC SHORETTE......................................................................
CAPTAIN

30.00
.................

(6) FELIX RUBEN ENCHAUTEGIU......................................................................
TRUSTEE

30.00
.................

(7) JULISA BUCCIERI......................................................................
TRUSTEE

30.00
.................

(8) PATRICIA WILLIAMS......................................................................
ASSISTANT CA

30.00
.................

(9) KRYSTAL SHORETTE......................................................................
LIEUTENANT

30.00
.................

(10) GREGORY CANDELA......................................................................
SERGEANT

30.00
.................

(A)
Name and Title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W- 2/1099-MISC)

(E)
Reportable compensation from related organizations (W- 2/1099-MISC)

(F)
Estimated amount of other compensation from the organization and related organizations

(A)
Name and business address

(B)
Description of services

Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

WALDEN AMBULANCE CORP

Employer identification number

14-6024740

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .	38,336	2,332	14,575	11,552	18,255	85,050
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose	173,639	350,394	428,408	409,349	490,682	1,852,472
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5	211,975	352,726	442,983	420,901	508,937	1,937,522
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)						1,937,522

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...	211,975	352,726	442,983	420,901	508,937	1,937,522
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	4,133	2,802	1,704	3,679	760	13,078
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.	4,133	2,802	1,704	3,679	760	13,078
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..	5,858	9,793				15,651
13	Total support. (Add lines 9, 10c, 11, and 12.)..	221,966	365,321	444,687	424,580	509,697	1,966,251

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

98.540 %

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

98.280 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

1.000 %

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

1.000 %

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
PART III, LINE 12	MISCELLANEOUS INCOME 15,651

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

	(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......	1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................	2e
3	Subtract line 2e from line 1..................	3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................	4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......	5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........	1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................	2e
3	Subtract line 2e from line 1...................	3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................	4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......	5

Return Reference	Explanation
SCHEDULE D, PAGE 3, PART X	THE ORGANIZATION FILES AN ANNUAL FORM 990 AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS SUCH, NO FEDERAL OR NEW YORK STATE TAXES ARE PAID BY THE COMPANY. WITH FEW EXCEPTIONS, THE COMPANY IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS PRIOR TO 2015.

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

WALDEN AMBULANCE CORP

Employer identification number

14-6024740

Return Reference	Explanation
FORM 990, PAGE 1, ITEM C	TOWN OF MONTGOMERY AMBULANCE
FORM 990, PAGE 1, ITEM B	THE 2018 FORM 990 IS BEING AMENDED TO REFLECT CORRECT PROGRAM SERVICE REVENUE THAT WAS EARNED BY THE TAXPAYER. THE CHANGES ARE AS FOLLOWS: FORM 990, PAGE 1, LINE G, GROSS RECEIPTS: PER ORIGINAL RETURN: 561,283 PER AMENDED RETURN: 509,697 DECREASE: 51,586 FORM 990, PAGE 1, LINE 9, PROGRAM SERVICE REVENUE: PER ORIGINAL RETURN: 541,949 PER AMENDED RETURN: 490,363 DECREASE: 51,586 FORM 990, PAGE 1, LINE 12, TOTAL REVENUE: PER ORIGINAL RETURN: 561,283 PER AMENDED RETURN: 509,697 DECREASE: 51,586 FORM 990, PAGE 1, LINE 19, REVENUE LESS EXPENSES: PER ORIGINAL RETURN: 4,532 PER AMENDED RETURN: ( 47,054) DECREASE: 51,586 FORM 990, PAGE 1, LINE 20, TOTAL ASSETS: PER ORIGINAL RETURN: 241,243 PER AMENDED RETURN: 189,657 DECREASE: 51,586 FORM 990, PAGE 1, LINE 22, NET ASSETS OR FUND BALANCES: PER ORIGINAL RETURN: 143,426 PER AMENDED RETURN: 91,840 DECREASE: 51,586 FORM 990, PART III, STATEMENT OF REVENUE, LINE 4A, REVENUE: PER ORIGINAL RETURN: 541,949 PER AMENDED RETURN: 490,363 DECREASE: 51,586 FORM 990, PART VIII, STATEMENT OF REVENUE, LINE 2A, COLUMN A AND COLUMN B: PER ORIGINAL RETURN: 541,949 PER AMENDED RETURN: 490,363 DECREASE: 51,586 FORM 990, PART VIII, STATEMENT OF REVENUE, LINE 2G, COLUMN A: PER ORIGINAL RETURN: 541,949 PER AMENDED RETURN: 490,363 DECREASE: 51,586 FORM 990, PART VIII, STATEMENT OF REVENUE, LINE 12, COLUMN A: PER ORIGINAL RETURN: 561,283 PER AMENDED RETURN: 509,697 DECREASE: 51,586 FORM 990, PART VIII, STATEMENT OF REVENUE, LINE 12, COLUMN B: PER ORIGINAL RETURN: 542,268 PER AMENDED RETURN: 490,682 DECREASE: 51,586 FORM 990, PART X, BALANCE SHEET, LINE 1, COLUMN B: PER ORIGINAL RETURN: 14,932 PER AMENDED RETURN: 14,933 INCREASE: 1 FORM 990, PART X, BALANCE SHEET, LINE 2, COLUMN B: PER ORIGINAL RETURN: 58,737 PER AMENDED RETURN: 7,150 DECREASE: 51,587 FORM 990, PART X, BALANCE SHEET, LINE 16, COLUMN B: PER ORIGINAL RETURN: 241,243 PER AMENDED RETURN: 189,657 DECREASE: 51,586 FORM 990, PART X, BALANCE SHEET, LINE 32, COLUMN B: PER ORIGINAL RETURN: 143,426 PER AMENDED RETURN: 91,840 DECREASE: 51,586 FORM 990, PART X, BALANCE SHEET, LINE 33, COLUMN B: PER ORIGINAL RETURN: 143,426 PER AMENDED RETURN: 91,840 DECREASE: 51,586 FORM 990, PART X, BALANCE SHEET, LINE 34, COLUMN B: PER ORIGINAL RETURN: 241,243 PER AMENDED RETURN: 189,657 DECREASE: 51,586 FORM 990, PART XI, RECONCILIATION OF NET ASSETS, LINE 1: PER ORIGINAL RETURN: 561,283 PER AMENDED RETURN: 509,697 DECREASE: 51,586 FORM 990, PART XI, RECONCILIATION OF NET ASSETS, LINE 3: PER ORIGINAL RETURN: 4,532 PER AMENDED RETURN: ( 47,054) DECREASE: 51,586 FORM 990, PART XI, RECONCILIATION OF NET ASSETS, LINE 10: PER ORIGINAL RETURN: 143,426 PER AMENDED RETURN: 91,840 DECREASE: 51,586 FORM 990, SCHEDULE A, PART III, LINE 2, COLUMN E: PER ORIGINAL RETURN: 542,268 PER AMENDED RETURN: 490,682 DECREASE: 51,586 FORM 990, SCHEDULE A, PART III, LINE 2, COLUMN F: PER ORIGINAL RETURN: 1,904,058 PER AMENDED RETURN: 1,852,472 DECREASE: 51,586 FORM 990, SCHEDULE A, PART III, LINE 6, COLUMN E: PER ORIGINAL RETURN: 560,523 PER AMENDED RETURN: 508,937 DECREASE: 51,586 FORM 990, SCHEDULE A, PART III, LINE 6, LINE 8, LINE 9, COLUMN F: PER ORIGINAL RETURN: 1,989,108 PER AMENDED RETURN: 1,937,522 DECREASE: 51,586 FORM 990, SCHEDULE A, PART III, LINE 13, COLUMN F: PER ORIGINAL RETURN: 2,017,837 PER AMENDED RETURN: 1,966,251 DECREASE: 51,586 FORM 990, SCHEDULE A, PART III, LINE 15: PER ORIGINAL RETURN: 98.58% PER AMENDED RETURN: 98.54% DECREASE: 0.04% THE INFORMATION RETURN HAS BEEN UPDATED TO REFLECT THE CHANGES ABOVE.
FORM 990 - ORGANIZATION'S MISSION	THE MISSION OF THE TOWN OF MONTGOMERY AMBULANCE CORPS SHALL BE TO PROVIDE QUALITY EMERGENCY CARE TO SICK OR INJURED PERSONS WITHIN ITS RESPONSE DISTRICT. TO MEET THIS GOAL, THE CORPS SHALL ENSURE THE EDUCATION OF ALL ITS MEMBERS AND PROVIDE CPR AND FIRST AID EDUCATIONAL OPPORTUNITIES TO COMMUNITY MEMBERS WITHIN OUR JURISDICTION.
FORM 990, PAGE 6, PART VI, LINE 2	KYLE SHORETTE PRESIDENT FAMILY RELATIONSHIP ERIC SHORETTE CAPTAIN FAMILY RELATIONSHIP KRYSTAL SHORETTE LIEUTENANT FAMILY RELATIONSHIP
FORM 990, PAGE 6, PART VI, LINE 6	CLASSES OF MEMBERSHIP: MEMBERSHIP IN THIS ORGANIZATION SHALL BE DIVIDED INTO TWO CLASSES: A. ACTIVE (EMT, DRIVER, CREW AND APPRENTICE) MEMBERS WHO HAVE VOTING PRIVILEGES. I. EMERGENCY MEDICAL TECHNICIAN - MUST BE OF GOOD MORAL CHARACTER, AND BE APPROVED BY A MAJORITY VOTE BY BALLOT AT A REGULAR OR ANNUAL MEETING. HE/SHE MUST MAINTAIN CURRENT NYS EMT-B CERTIFICATION, CURRENT CPR CERTIFICATION, MEET THE MEDICAL REQUIREMENTS OF THE CORPS AND APPLICABLE STATE LAW. HE/SHE SHALL BE REQUIRED TO PERFORM THE FULL DUTIES OF AN AMBULANCE CORPS MEMBER, AND SHALL ATTEND MEETINGS, DRILLS, AND SCHOOLS OF INSTRUCTION REQUIRED BY THE CORPS. ALL PERSONS REACHING THE AGE OF 65 YEARS MAY BE REQUIRED TO MEET ADDITIONAL OR SPECIAL REQUIREMENTS PRESCRIBED BY THE INSURANCE CARRIER INSURING THE CORPS. II. DRIVER - MEMBER MUST BE AT LEAST 21 YEARS OF AGE, OF GOOD MORAL CHARACTER, AND BE APPROVED BY A MAJORITY VOTE BY BALLOT AT A REGULAR OR ANNUAL MEETING. HE/SHE MUST MAINTAIN CURRENT CPR CERTIFICATION, AND MEET THE MEDICAL REQUIREMENTS OF THE CORPS AND APPLICABLE STATE LAW. HE/SHE SHALL BE REQUIRED TO PERFORM THE FULL DUTIES OF AN AMBULANCE CORPS MEMBER, AND SHALL ATTEND MEETINGS, DRILLS, AND SCHOOLS OF INSTRUCTION REQUIRED BY THE CORPS. ALL PERSONS REACHING THE AGE OF 65 YEARS MAY BE REQUIRED TO MEET ADDITIONAL OR SPECIAL REQUIREMENTS PRESCRIBED BY THE INSURANCE CARRIER INSURING THE CORPS. III. CREW - MEMBER MUST BE AT LEAST 18 YEARS OF AGE, OF GOOD MORAL CHARACTER, AND BE APPROVED BY A MAJORITY VOTE BY BALLOT AT A REGULAR OR ANNUAL MEETING. HE/SHE MUST MAINTAIN CURRENT CPR CERTIFICATION, AND MEET THE MEDICAL REQUIREMENTS OF THE CORPS AND APPLICABLE STATE LAW. HE/SHE SHALL BE REQUIRED TO PERFORM THE FULL DUTIES OF AN AMBULANCE CORPS MEMBER, AND SHALL ATTEND MEETINGS, DRILLS, AND SCHOOLS OF INSTRUCTION REQUIRED BY THE CORPS. ALL PERSONS REACHING THE AGE OF 65 YEARS MAY BE REQUIRED TO MEET ADDITIONAL OR SPECIAL REQUIREMENTS PRESCRIBED BY THE INSURANCE CARRIER INSURING THE CORPS. IV. APPRENTICE MEMBER - MEMBER MUST BE AT LEAST 16 YEARS OF AGE, OF GOOD MORAL CHARACTER, AND BE APPROVED BY A MAJORITY VOTE BY BALLOT AT A REGULAR OR ANNUAL MEETING. HE/SHE MUST MEET THE MEDICAL REQUIREMENTS OF THE CORPS AND APPLICABLE STATE LAW. THIS CLASS OF MEMBER MAY RIDE AS A THIRD OR FOURTH MEMBER ON THE AMBULANCE. HE/SHE SHALL BE REQUIRED TO PERFORM THE FULL DUTIES OF AN AMBULANCE CORPS MEMBER, AND SHALL ATTEND MEETINGS, DRILLS, AND SCHOOLS OF INSTRUCTION AS REQUIRED BY THE CORPS. APPRENTICE STATUS IS IN EFFECT UNTIL A MEMBER REACHES THE AGE OF 18. B. SUPPORTING MEMBERS (SOCIAL, HONORARY AND JUNIOR). I. SOCIAL - MEMBER WHO CONTRIBUTES TO THE EXISTENCE AND THE WELL-BEING OF THE TOWN OF MONTGOMERY AMBULANCE CORPS AND WHO HAS BEEN APPROVED BY A MAJORITY VOTE BY BALLOT AT A REGULAR OR ANNUAL MEETING. SUCH MEMBERS SHALL HAVE THE RIGHT TO PARTICIPATE IN ALL SOCIAL FUNCTIONS. SUCH MEMBERS SHALL NOT PERFORM AMBULANCE DUTIES. SUCH MEMBERS SHALL NOT HOLD OFFICE OR HAVE VOTING PRIVILEGES. II. HONORARY - MEMBER WHO HAS BEEN ON THE ACTIVE ROLLS FOR AT LEAST 10 YEARS, WHO HAS REQUESTED IN WRITING AND BEEN APPROVED BY A MAJORITY VOTE BY BALLOT AT A REGULAR OR ANNUAL MEETING. AN HONORARY MEMBER SHALL HAVE THE RIGHT TO ATTEND ALL MEETINGS, PARTICIPATE IN ALL SOCIAL FUNCTIONS, AND ALL CORPS ACTIVITIES INCLUDING AMBULANCE DUTIES, IF PROPERLY QUALIFIED. HOWEVER, HE/SHE IS NOT OBLIGATED TO BE ON CALL ON ANY REGULAR BASIS. AS LONG AS AN HONORARY MEMBER MEETS ALL OTHER REQUIREMENTS FOR GOOD STANDING (MEETING AND DRILL ATTENDANCE), AN HONORARY MEMBER WILL RETAIN ALL PRIVILEGES OF BEING IN GOOD STANDING. III. JUNIOR MEMBER - MEMBER MUST BE AT LEAST 14 YEARS OF AGE, OF GOOD MORAL CHARACTER, AND BE APPROVED BY A MAJORITY VOTE BY BALLOT AT A REGULAR OR ANNUAL MEETING. SUCH MEMBERS SHALL HAVE THE RIGHT TO PARTICIPATE IN ALL SOCIAL FUNCTIONS, AND SHALL ATTEND MEETINGS, DRILLS, AND SCHOOLS OF INSTRUCTION AS REQUIRED BY THE CORPS. SUCH MEMBERS SHALL NOT PERFORM AMBULANCE DUTIES. SUCH MEMBERS SHALL NOT HOLD OFFICE OR HAVE VOTING PRIVILEGES. JUNIOR STATUS IS IN EFFECT UNTIL A MEMBER REACHES THE AGE OF 16.
FORM 990, PAGE 6, PART VI, LINE 7A	ALL OFFICERS SHALL BE ELECTED BY BALLOT AT THE ANNUAL MEETING BY A MAJORITY VOTE OF ALL THE MEMBERS IN GOOD STANDING.
FORM 990, PAGE 6, PART VI, LINE 11B	THE 990 IS REVIEWED BY THE PRESIDENT WITH THE EXECUTIVE BOARD OFFICERS BEFORE IT IS FILED.
FORM 990, PAGE 6, PART VI, LINE 12C	ANNUALLY, EVERY MEMBER OF THE CORPS MUST SIGN A DOCUMENT THAT DISCLOSES ANY POTENTIAL OR EXISTING CONFLICTS OF INTEREST. THIS DISCLOSURE IS REVIEWED BY THE EXECUTIVE BOARD AND STORED IN THE CORPS FILES.
FORM 990, PAGE 6, PART VI, LINE 19	THESE DOCUMENTS ARE AVAILABLE UPON REQUEST AT THE OFFICE OF THE ORGANIZATION IN WALDEN, NY.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDES EMERGENCY MEDICAL SERVICES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	7
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	7
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	26
6	Total number of volunteers (estimate if necessary) .............	6	30
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	11,552	18,255
9	Program service revenue (Part VIII, line 2g) .........	408,473	490,363
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	299	110
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	4,256	969
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	424,580	509,697
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)		192,144
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 2,352
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	412,169	364,607
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	412,169	556,751
19	Revenue less expenses. Subtract line 18 from line 12.......	12,411	-47,054
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	262,112	189,657
21	Total liabilities (Part X, line 26).............	123,218	97,817
22	Net assets or fund balances. Subtract line 21 from line 20.....	138,894	91,840

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 341,882 including grants of $ ) (Revenue $ 490,363 )
	THE ORGANIZATION PROVIDES EMERGENCY MEDICAL SERVICES TO THE COMMUNITIES OF MONTGOMERY, WALDEN, MAYBROOK, COLDENHAM AND PORTIONS OF HAMPTONBURGH.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses341,882

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	18,255

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		18,255

		Business Code
2a	PATIENT BILLINGS	621910	490,363	490,363
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		490,363

3 Investment income (including dividends, interest, and othersimilar amounts) ......			110			110
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		650
b	Less: rental expenses
c	Rental income or (loss)		650
d	Net rental income or (loss)......			650			650
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss).....
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	MISCELLANEOUS			319	319
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			319
12	Total revenue. See Instructions......			509,697	490,682		760

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to domestic individuals. See Part IV, line 22
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	174,534	174,534
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	175	175
10	Payroll taxes ...........	17,435	17,435
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........	6,460		6,460
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	49,522		49,522
12	Advertising and promotion ....
13	Office expenses .......	9,038	7,721	1,317
14	Information technology ......	1,232	142	1,090
15	Royalties ..
16	Occupancy ...........	26,085	18,885	7,200
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	504	504
20	Interest ...........	5,147		5,147
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	36,830	36,830
23	Insurance ...	64,599		64,599
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	ALS AGENCY SERVICES	77,182		77,182
b	AMBULENCE FUEL & MAINT	37,152	37,152
c	MEDICAL SUPPLIES	18,923	18,923
d	PAYROLL PROCESSING FEES	12,631	12,631
e	All other expenses	19,302	16,950		2,352
25	Total functional expenses. Add lines 1 through 24e	556,751	341,882	212,517	2,352
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			33,773	1	14,933
2	Savings and temporary cash investments .........			52,691	2	7,150
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............				4
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........				8
9	Prepaid expenses and deferred charges ......				9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	635,926
b	Less: accumulated depreciation	10b	468,352	175,648	10c	167,574
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........				15
16	Total assets. Add lines 1 through 15 (must equal line 34)...			262,112	16	189,657

17	Accounts payable and accrued expenses .....		17
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	123,218	23	97,817
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	123,218	26	97,817

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets		27
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds	138,894	32	91,840
33	Total net assets or fund balances ...........	138,894	33	91,840
34	Total liabilities and net assets/fund balances ........	262,112	34	189,657

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

1a	Land .....
b	Buildings ....	65,200	57,490	7,710
c	Leasehold improvements
d	Equipment ....	570,726	410,862	159,864
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				167,574

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII