Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| PART I LINE 16 | INSURANCE EXPENSES |
| PART II LINE 22 | BEGINNING AND ENDING ACCOUNT BALANCES |
| PART IV | LIST OF OFFICERS AND VOLUNTEER HOURS |
| PART III | PROGRAM PURPOSE |
| Software ID: | |
| Software Version: |