Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Pt III, Line 31 | INSURANCE TAX |
| Pt IV | LIST OF OFFICERS |
| Pt V, Line 35b | NO UNRELATED BUSINESS INCOME |
| Form 990EZ, Part I, Line 8 | 2% INSURANCE TAX 39152. |
| Form 990EZ, Part I, Line 8 | SURPLUS LINES 2995. |
| Form 990EZ, Part I, Line 16 | ASSESSMENT, CONVENTION EXPENSES, AND FILING FEES 31855. |
| Form 990EZ, Part I, Line 16 | PROFESSIONAL FEES 300. |
| Software ID: | 22015534 |
| Software Version: |