| Return Reference | Explanation |
|---|---|
| Form 990-EZ, Part I, Line 8 | Total Insurance $10,987.49, which consists of $1,278.93 of surplus lines and $9,708.56 of 2% premium tax. |
| Form 990-EZ, Part I, Line 16 | Total $6,592.50 which consists of $767.36 in surplus lines and $5,825.14 in 2% premium tax. |
| Schedule B, Part I | There are no contributors during the year. |
| Software ID: | 23018249 |
| Software Version: | v1.00 |