Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS A STOCKHOLDERS AND MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE TAX RETURN. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO INFORMATION IS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | STOCK REFUND FROM MEMBERS -100. EXCESS TAXABLE DISTRIBUTIONS GAINS - JACKSON LIFE INSURANCE -165,200. |
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