Civic Intelligence

Pbh Housing of Plainfield Inc Co Putnam Baptist Housing Inc

EIN 06-1559506 • 501(c)3 • Putnam, CT

Profile

To provide rental housing to low income elderly

C/O Putnam Baptist Homes Inc 207 SaPutnam, CT 06260

n/A

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

97th percentile

1.51x

Higher debt load relative to assets than 97% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2025

Liabilities / Revenue

99th percentile

13.47x

Higher debt load relative to revenue than 99% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2025

Net Margin

7th percentile

-46%

Higher net margin than 7% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2025

Top Officer Pay

40th percentile

$0

Higher top officer pay than 40% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

501(c)3 • $1M-$5M nonprofits • Source year 2025

Asset Growth

28th percentile

-3.3%

Faster asset growth than 28% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Annualized from 2024 to 2025

Revenue Growth

30th percentile

-4.4%

Faster revenue growth than 30% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Annualized from 2024 to 2025

Assets

Down

$1,502,565

Down $21 (-0.0%) from 2023

Liabilities

Up

$2,171,455

Up $20,311 (+0.9%) from 2023

Net Assets

Down

-$668,890

Down $20,332 (-3.1%) from 2023

Revenue

Down

$170,510

Down $5,760 (-3.3%) from 2023

Expenses

Down

$190,842

Down $19,604 (-9.3%) from 2023

Net Income

Up

-$20,332

Up $13,844 (+41%) from 2023

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$3.0M$2.0M$1.0M$0-$1.0MAssets 2010: $1,770,174Liabilities 2010: $2,039,692Net Assets 2010: -$269,5182010Assets 2012: $1,721,100Liabilities 2012: $2,054,754Net Assets 2012: -$333,6542012Assets 2013: $1,671,002Liabilities 2013: $2,053,874Net Assets 2013: -$382,8722013Assets 2014: $1,686,231Liabilities 2014: $2,056,788Net Assets 2014: -$370,5572014Assets 2015: $1,657,949Liabilities 2015: $2,063,327Net Assets 2015: -$405,3782015Assets 2016: $1,595,854Liabilities 2016: $2,069,885Net Assets 2016: -$474,0312016Assets 2017: $1,584,236Liabilities 2017: $2,094,349Net Assets 2017: -$510,1132017Assets 2018: $1,557,093Liabilities 2018: $2,103,929Net Assets 2018: -$546,8362018Assets 2019: $1,541,935Liabilities 2019: $2,123,165Net Assets 2019: -$581,2302019Assets 2020: $1,526,270Liabilities 2020: $2,121,389Net Assets 2020: -$595,1192020Assets 2021: $1,533,006Liabilities 2021: $2,145,892Net Assets 2021: -$612,8862021Assets 2022: $1,545,056Liabilities 2022: $2,159,438Net Assets 2022: -$614,3822022Assets 2023: $1,502,586Liabilities 2023: $2,151,144Net Assets 2023: -$648,5582023Assets 2024: $1,502,565Liabilities 2024: $2,171,455Net Assets 2024: -$668,8902024

Highlighted filing

2024

Assets$1,502,565
Liabilities$2,171,455
Net Assets-$668,890

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$300K$200K$100K$0-$100KExpenses 2010: $169,6562010Revenue 2012: $135,974Expenses 2012: $169,739Net Income 2012: -$33,7652012Revenue 2013: $131,387Expenses 2013: $180,605Net Income 2013: -$49,2182013Revenue 2014: $195,690Expenses 2014: $183,375Net Income 2014: $12,3152014Revenue 2015: $149,594Expenses 2015: $184,415Net Income 2015: -$34,8212015Revenue 2016: $148,104Expenses 2016: $216,757Net Income 2016: -$68,6532016Revenue 2017: $141,884Expenses 2017: $177,966Net Income 2017: -$36,0822017Revenue 2018: $152,255Expenses 2018: $188,978Net Income 2018: -$36,7232018Revenue 2019: $161,709Expenses 2019: $196,103Net Income 2019: -$34,3942019Revenue 2020: $172,837Expenses 2020: $186,726Net Income 2020: -$13,8892020Revenue 2021: $172,852Expenses 2021: $190,619Net Income 2021: -$17,7672021Revenue 2022: $170,267Expenses 2022: $171,763Net Income 2022: -$1,4962022Revenue 2023: $176,270Expenses 2023: $210,446Net Income 2023: -$34,1762023Revenue 2024: $170,510Expenses 2024: $190,842Net Income 2024: -$20,3322024

Highlighted filing

2024

Revenue$170,510
Expenses$190,842
Net Income-$20,332

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Detailed filing. Detailed filing data is available for this year.$1.50$2.17$0.67$0.17$0.19$0.02
2023Detailed filing. Detailed filing data is available for this year.$1.50$2.15$0.65$0.18$0.21$0.03
2022XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.55$2.16$0.61$0.17$0.17$0.00
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.53$2.15$0.61$0.17$0.19$0.02
2020Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.53$2.12$0.60$0.17$0.19$0.01
2019XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.54$2.12$0.58$0.16$0.20$0.03
2018Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.56$2.10$0.55$0.15$0.19$0.04
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.58$2.09$0.51$0.14$0.18$0.04
2016Import issue. A filing source exists for this year, but detailed import did not complete cleanly.$1.60$2.07$0.47$0.15$0.22$0.07
2015Import issue. A filing source exists for this year, but detailed import did not complete cleanly.$1.66$2.06$0.41$0.15$0.18$0.03
2014Detailed filing. Detailed filing data is available for this year.$1.69$2.06$0.37$0.20$0.18$0.01
2013Detailed filing. Detailed filing data is available for this year.$1.67$2.05$0.38$0.13$0.18$0.05
2012Summary only. Only limited summary data is available for this year.$1.72$2.05$0.33$0.14$0.17$0.03
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.77$2.04$0.27$0.17
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2024 to Dec 31, 2024
Signed
Apr 7, 2025
Return Version
2024v5.1
Gross Receipts
$170,510
Mission and Program Overview

Mission

To provide rental housing to low income elderly

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$1,106,810$1,066,408▼ $40,402
Accounts Receivable$168,683$212,422▲ $43,739
Savings and Temporary Cash Investments$201,285$211,997▲ $10,712
Cash and Non-Interest-Bearing Accounts$21,638$9,236▼ $12,402
Prepaid Expenses and Deferred Charges$4,170$2,502▼ $1,668
Total Assets$1,502,586$1,502,565▼ $21
Liabilities
Grants Payable$2,016,800$2,016,800→ $0
Accounts Payable and Accrued Expenses$125,926$146,396▲ $20,470
Other Liabilities$8,418$8,259▼ $159
Total Liabilities$2,151,144$2,171,455▲ $20,311
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$-648,558$-668,890▼ $20,332
Total Net Assets Fund Balance$-648,558$-668,890▼ $20,332
Total Liabilities and Net Assets / Fund Balance$1,502,586$1,502,565▼ $21

Asset Categories

AssetBook ValueDepreciationBasis
Buildings$790,322$970,236$1,760,558
Land$270,000-$270,000
Equipment$6,086$8,030$14,116
Other Land Buildings$0$3,995$3,995
Compensation and Service Providers

Board Members and Trustees

NameTitle
Kevin ShawPresident
Steven FarnerVice President
Gary BrownSecretary
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$169,999
Investment Income
$511
Other Revenue
$0
Change in Net Assets
$-20,332

Audited Revenue Reconciliation

Revenue per Audited Statements
$170,510
Total Revenue per Audited Statements
$170,510
Total Revenue per Form 990
$170,510
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$190,842
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Occupancy$76,104$0$0$76,104
Depreciation Depletion$46,477$0$0$46,477
Insurance$27,594$0$0$27,594
Fees for Services Management$0$18,870$0$18,870
Fees for Services Accounting$0$6,000$0$6,000
Fees for Services Other$0$3,600$0$3,600
All Other Expenses$0$912$0$912
Other Expenses$240$0$0$240
Interest$3$0$0$3
Total Functional Expenses$161,460$29,382$0$190,842

Audited Expense Reconciliation

Line ItemAmount
Expenses per Audited Statements$190,842
Total Expenses per Audited Statements$190,842
Total Expenses per Form 990$190,842
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Tenant Deposits Held in Trust$8,259
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Audit committee
Yes
Backup withholding compliance
No
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
No
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
Yes
Filing and Contact Details

Filer

Filer Name
Pbh Housing of Plainfield Inc
EIN
06-1559506
Phone
8605640838
Address
C/O PUTNAM BAPTIST HOMES INC 207 SA, PUTNAM, CT 06260

Signing Officer

Name
Pauline a Galbreath
Title
Management Agent
Phone
8605640838
Signed
2025-04-07
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Kevin Shaw
Formed
2000
Legal Domicile
Ct
Voting Board Members
3
Independent Board Members
3
Employees
0
Volunteers
0

Preparer

Firm
Ral CPA LLC
Address
238 West Town St, NORWICH, CT 06360
Preparer
Robert a Lasaracina
Phone
8608865186
Supplemental Narrative

Additional Explanations

Pt VI, Line 3

Management duties are delegated to professional management company, rural consulting & management. Duities include tenant selection, certification, rent collection, and arrangement for required services and payment of bills.

Pt VI, Line 11B

Management company reviews 990 prior to submission

Pt VI, Line 18

Form 990 available on guidestar.org

Pt VI, Line 19

Financial statements available upon request

Raw XML AppendixShowing 400 of 408 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearMinus2YearsAmt0296
IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearMinus3YearsAmt0239
IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearMinus4YearsAmt0287
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IRS990ScheduleA/InvestmentIncomeCYPct00.00210
IRS990ScheduleA/InvestmentIncomePYPct00.00180
IRS990ScheduleA/OtherSupportSumAmt00
IRS990ScheduleA/PubliclySupportedOrg509a2Ind0X
IRS990ScheduleA/PublicSupportCY170Pct00
IRS990ScheduleA/PublicSupportCY509Pct00.99790
IRS990ScheduleA/PublicSupportPY509Pct00.99820
IRS990ScheduleA/PublicSupportTotal509Amt0860954
IRS990ScheduleA/SubstAndDsqlfyPrsnsTotGrp/TotalAmt00
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IRS990ScheduleA/ThirtyThrPctSuprtTestsCY509Ind0X
IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt0169999
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt0175821
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt0169971
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt0172613
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt0172550
IRS990ScheduleA/Total509Grp/TotalAmt0860954
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt0862736
IRS990/ScheduleBRequiredInd0false
IRS990ScheduleD/BuildingsGrp/BookValueAmt0790322
IRS990ScheduleD/BuildingsGrp/DepreciationAmt0970236
IRS990ScheduleD/BuildingsGrp/OtherCostOrOtherBasisAmt01760558
IRS990ScheduleD/EquipmentGrp/BookValueAmt06086
IRS990ScheduleD/EquipmentGrp/DepreciationAmt08030
IRS990ScheduleD/EquipmentGrp/OtherCostOrOtherBasisAmt014116
IRS990ScheduleD/ExpensesSubtotalAmt0190842
IRS990ScheduleD/LandGrp/BookValueAmt0270000
IRS990ScheduleD/LandGrp/InvestmentCostOrOtherBasisAmt00
IRS990ScheduleD/LandGrp/OtherCostOrOtherBasisAmt0270000
IRS990ScheduleD/OtherLandBuildingsGrp/BookValueAmt00
IRS990ScheduleD/OtherLandBuildingsGrp/DepreciationAmt03995
IRS990ScheduleD/OtherLandBuildingsGrp/OtherCostOrOtherBasisAmt03995
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt08259
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc0TENANT DEPOSITS HELD IN TRUST
IRS990ScheduleD/RevenueSubtotalAmt0170510
IRS990ScheduleD/TotalBookValueLandBuildingsAmt01066408
IRS990ScheduleD/TotalExpensesPerForm990Amt0190842
IRS990ScheduleD/TotalLiabilityAmt08259
IRS990ScheduleD/TotalRevenuePerForm990Amt0170510
IRS990ScheduleD/TotalRevEtcAuditedFinclStmtAmt0170510
IRS990ScheduleD/TotExpnsEtcAuditedFinclStmtAmt0190842
IRS990/ScheduleJRequiredInd0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0MANAGEMENT DUTIES ARE DELEGATED TO PROFESSIONAL MANAGEMENT COMPANY, RURAL CONSULTING & MANAGEMENT. DUITIES INCLUDE TENANT SELECTION, CERTIFICATION, RENT COLLECTION, AND ARRANGEMENT FOR REQUIRED SERVICES AND PAYMENT OF BILLS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1MANAGEMENT COMPANY REVIEWS 990 PRIOR TO SUBMISSION
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2FORM 990 AVAILABLE ON GUIDESTAR.ORG
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3FINANCIAL STATEMENTS AVAILABLE UPON REQUEST
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Pt VI, Line 3
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Pt VI, Line 11b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2Pt VI, Line 18
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3Pt VI, Line 19
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IRS990ScheduleR/AssetPurchaseFromOtherOrgInd0false
IRS990ScheduleR/AssetSaleToOtherOrgInd0false
IRS990ScheduleR/DivRelatedOrganizationInd0false
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd0false
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd0false
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd0false
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt0NA
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt0PUTNAM BAPTIST HOMES INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN0237431290
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt0501C3
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd0CT
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt0SUBSIDIZED LOW INCOME & ELDERLY HOUSING
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PublicCharityStatusTxt0ACTIVE
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt0207 SABIN STREET
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm0PUTNAM
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd0CT
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd006260
IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd0false
IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd0false
IRS990ScheduleR/PaidEmployeesSharingInd0false
IRS990ScheduleR/PerformOfServicesByOtherOrgInd0false
IRS990ScheduleR/PerformOfServicesForOthOrgInd0false
IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd0false
IRS990ScheduleR/ReimbursementPaidByOtherOrgInd0false
IRS990ScheduleR/ReimbursementPaidToOtherOrgInd0false
IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd0false
IRS990ScheduleR/RentalOfFcltsFromOthOrgInd0false
IRS990ScheduleR/SharingOfFacilitiesInd0false
IRS990ScheduleR/TransferFromOtherOrgInd0false
IRS990ScheduleR/TransferToOtherOrgInd0false
IRS990/SchoolOperatingInd0false
IRS990/SignificantChangeInd0false
IRS990/SignificantNewProgramSrvcInd0false
IRS990/SubjectToProxyTaxInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt01502586
IRS990/TotalAssetsEOYAmt01502565
IRS990/TotalAssetsGrp/BOYAmt01502586
IRS990/TotalAssetsGrp/EOYAmt01502565
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt029382
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0161460
IRS990/TotalFunctionalExpensesGrp/TotalAmt0190842
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt02151144
IRS990/TotalLiabilitiesEOYAmt02171455
IRS990/TotalLiabilitiesGrp/BOYAmt02151144
IRS990/TotalLiabilitiesGrp/EOYAmt02171455
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0-648558
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0-668890
IRS990/TotalProgramServiceExpensesAmt0161460
IRS990/TotalProgramServiceRevenueAmt0169999
IRS990/TotalRevenueGrp/ExclusionAmt0511
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt0169999
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0170510
IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt00
IRS990/TotalVolunteersCnt00
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt01502586
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt01502565
IRS990/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt030 STONE HILL RD
IRS990/USAddress/CityNm0WOODSTOCK
IRS990/USAddress/StateAbbreviationCd0CT
IRS990/USAddress/ZIPCd006281
IRS990/VotingMembersGoverningBodyCnt03
IRS990/VotingMembersIndependentCnt03
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd0false
ReturnHeader/BuildTS02025-03-06 01:10:19Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0PAULINE A GALBREATH
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0MANAGEMENT AGENT
ReturnHeader/BusinessOfficerGrp/PhoneNum08605640838
ReturnHeader/BusinessOfficerGrp/SignatureDt02025-04-07
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0PBH HOUSING OF PLAINFIELD INC
ReturnHeader/Filer/BusinessNameControlTxt0PBHH
ReturnHeader/Filer/EIN0061559506
ReturnHeader/Filer/PhoneNum08605640838
ReturnHeader/Filer/USAddress/AddressLine1Txt0C/O PUTNAM BAPTIST HOMES INC 207 SA
ReturnHeader/Filer/USAddress/CityNm0PUTNAM
ReturnHeader/Filer/USAddress/StateAbbreviationCd0CT
ReturnHeader/Filer/USAddress/ZIPCd006260
ReturnHeader/IRSResponsiblePrtyInfoCurrInd0true
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0273823827
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0RAL CPA LLC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0238 West Town St
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0NORWICH
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0CT
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd006360
ReturnHeader/PreparerPersonGrp/PhoneNum08608865186

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