Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4D | HEALTH AND WELFARE BENEFIT PLANS |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS NOT FORMALLY REVIEWED BY THE GOVERNING BODY PRIOR TO ITS FILING. HOWEVER, THE FORM IS REVIEWED INTERNALLY BY MEMBERS OF MANAGEMENT PRIOR TO ITS FILING. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE NAMED DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | REDUCTION IN EMPLOYER CONTRIBUTIONS 0 POLICY LOAN 0 CHANGE TO PREFUNDING REQUIREMENT FOR UHC CLAIMS 0 CHANGE IN PAYABLE DUE TO PLAN SPONSOR 0 |
| FORM 990, PART XII | THE SEPARATE INDEPENDENT AUDITED FINANCIAL STATEMENTS WERE OBTAINED AT THE PLAN LEVEL WHICH INCLUDES THE ORGANIZATION. |
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