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 | Harrison relief Assoc. Line 8 Surplus & Premium Tax Surplus Lines 60% assessment $2,690.66 & Net Receipt $1,793.78 Gross Receipt $4,484.44 2% premium Tax 60% $32,814.28 & 40% Net Receipt $21,876.18 Gross Receipt $54,690.46 Total Surplus Lines & Premium Tax Line #8 = $59,174.90 Line #16 Surplus Line & 2% Premium Tax Surplus Lines 60% assessment $2,690.66 2% Premium Tax 60% $32,814.28 Total Surplus Lines & Premium Tax Line # 16 = $ 35,504.94 |
| Form 990-EZ, Part I, Line 16 | Disbursements - $43,794.94 |
| Software ID: | 22015720 |
| Software Version: | v1.00 |