Civic Intelligence

Room Circus Medical Clowing

EIN 20-3534374 • 501(c)3 • Seattle, WA

Profile

Our mission is to alleviate the stress and isolation of hospitalized children and their families through the healing art of Clown, and to promote laughter and play as vital components of health and well-being.

PO Box 15434Seattle, WA 98115

www.roomcircus.org

Siviq Scores

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

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on the latest valid filing.

Source year 2021

Liabilities / Revenue

Score unavailable

No value available

Liabilities-to-revenue requires both liabilities and revenue on the latest valid filing.

Source year 2021

Net Margin

16th percentile

-41%

Higher net margin than 16% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2021

Top Officer Pay

86th percentile

$14,708

Higher top officer pay than 86% of similar nonprofits.

Top officer pay equals 17.9% of source-year revenue.

501(c)3 • <$500k nonprofits • Source year 2021

Asset Growth

10th percentile

-100%

Faster asset growth than 10% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2020 to 2021

Revenue Growth

92nd percentile

119%

Faster revenue growth than 92% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2020 to 2021

Balance Sheet
Liabilities / AssetsScore unavailable

Assets

Down

$0

Down $33,443 (-100%) from 2020

Liabilities

-

No earlier filing loaded for comparison.

Net Assets

Down

$0

Down $33,275 (-100%) from 2020

Operations
Liabilities / RevenueScore unavailableNet Margin16th percentile

Revenue

Up

$82,095

Up $44,532 (+119%) from 2020

Expenses

Up

$115,370

Up $83,229 (+259%) from 2020

Net Income

Down

-$33,275

Down $38,697 (-714%) from 2020

Trend Graphs

Balance Sheet Trend

Asset Growth10th percentile

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

$40K$30K$20K$10K$0Assets 2014: $38,490Net Assets 2014: $38,4902014Assets 2015: $39,532Net Assets 2015: $39,5322015Assets 2016: $28,367Net Assets 2016: $28,3672016Assets 2017: $20,042Liabilities 2017: $741Net Assets 2017: $19,3012017Assets 2018: $33,946Liabilities 2018: $345Net Assets 2018: $33,6012018Assets 2019: $28,626Liabilities 2019: $773Net Assets 2019: $27,8532019Assets 2020: $33,443Liabilities 2020: $168Net Assets 2020: $33,2752020Assets 2021: $0Net Assets 2021: $02021

Highlighted filing

2021

Assets$0
Liabilities-
Net Assets$0
Open 2021 Filing

Operations Trend

Revenue Growth92nd percentile

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

$150K$100K$50K$0-$50KRevenue 2014: $67,136Expenses 2014: $39,506Net Income 2014: $27,6302014Revenue 2015: $71,230Expenses 2015: $70,188Net Income 2015: $1,0422015Revenue 2016: $63,363Expenses 2016: $74,528Net Income 2016: -$11,1652016Revenue 2017: $57,836Expenses 2017: $66,902Net Income 2017: -$9,0662017Revenue 2018: $47,669Expenses 2018: $33,637Net Income 2018: $14,0322018Revenue 2019: $25,940Expenses 2019: $31,731Net Income 2019: -$5,7912019Revenue 2020: $37,563Expenses 2020: $32,141Net Income 2020: $5,4222020Revenue 2021: $82,095Expenses 2021: $115,370Net Income 2021: -$33,2752021

Highlighted filing

2021

Revenue$82,095
Expenses$115,370
Net Income-$33,275
Open 2021 Filing

Filings

Most recent year

2021 • Form 990EZDetailed filing. Detailed filing data is available for this year.

Open filing
Assets
$0
Liabilities
-
Net assets
$0
Revenue
$82,095
Expenses
$115,370
Net income
-$33,275
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2021Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.82$1.15$0.33
2020Detailed filing. Detailed filing data is available for this year.$0.33$0.00$0.33$0.38$0.32$0.05
2019Detailed filing. Detailed filing data is available for this year.$0.29$0.01$0.28$0.26$0.32$0.06
2018Detailed filing. Detailed filing data is available for this year.$0.34$0.00$0.34$0.48$0.34$0.14
2017Detailed filing. Detailed filing data is available for this year.$0.20$0.01$0.19$0.58$0.67$0.09
2016Detailed filing. Detailed filing data is available for this year.$0.28$0.28$0.63$0.75$0.11
2015Detailed filing. Detailed filing data is available for this year.$0.40$0.40$0.71$0.70$0.01
2014Detailed filing. Detailed filing data is available for this year.$0.38$0.38$0.67$0.40$0.28
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Oct 1, 2020 to Sep 30, 2021
Signed
Nov 18, 2002
Return Version
2020v4.1
Gross Receipts
$82,095
Mission and Program Overview

Mission

Our mission is to alleviate the stress and isolation of hospitalized children and their families through the healing art of Clown, and to promote laughter and play as vital components of health and well-being.

Our mission is to enhance health and well-being through laughter and joy.

Program Services

DescriptionGrantsExpenses
SEE ATTACHED STATEMENT$0$115,370
Compensation and Service Providers
Top Officer Pay86th percentile

Employees

NameTitleFull / Part TimeBaseOtherTotal
LINDA SEVERTDirector/Vice PresidentPT$14,708-$14,708
AMANDA SMITHPresident-$0--
NANCY WEIR-WEYNATreasurer-$0--
RUBAB AZEEMSecretary-$0--
Filing and Contact Details

Filer

Filer Name
Room Circus Medical Clowing
EIN
20-3534374
Phone
2064466522
Address
PO BOX 15434, Seattle, WA 98115

Signing Officer

Name
Linda Severt
Title
Director
Phone
2064466522
Signed
2002-11-18
Discuss with paid preparer
Yes

Preparer

Firm
Sylvia Kealy Ea
Address
17922 TALBOT RD, EDMONDS, WA 98026
Preparer
Sylvia Kealy EA
Phone
4252187737
Supplemental Narrative

Additional Explanations

Form 990EZ, Part I, Line 16

“Education and development 250.”

Form 990EZ, Part I, Line 16

“COSTUMES AND PROPS 565.”

Form 990EZ, Part I, Line 16

“Dues and subscriptions 209.”

Form 990EZ, Part I, Line 16

“FLOWERS 536.”

Form 990EZ, Part I, Line 16

“INSURANCE 1058.”

Form 990EZ, Part I, Line 16

“Bank service charges 158.”

Form 990EZ, Part I, Line 16

“WEBSITE 636.”

Form 990EZ, Part I, Line 16

“PAYROLL TAXES 2490.”

Form 990EZ, Part I, Line 16

“Merger transfer to foundation for laughter 83444.”

Form 990EZ, Part I, Line 16

“MISCELLANEOUS 22.”

Form 990EZ, Part II, Line 24

“PREPAID EXPENSES”

Form 990EZ, Part II, Line 26

“PAYROLL LIABILITIES”

Raw XML Appendix204 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.

Path#Value
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IRS990EZ/BooksInCareOfDetail/PersonNm0SYLVIA KEALY
IRS990EZ/BooksInCareOfDetail/PhoneNum04252187737
IRS990EZ/BooksInCareOfDetail/USAddress/AddressLine1Txt017922 TALBOT RD
IRS990EZ/BooksInCareOfDetail/USAddress/CityNm0EDMONDS
IRS990EZ/BooksInCareOfDetail/USAddress/StateAbbreviationCd0WA
IRS990EZ/BooksInCareOfDetail/USAddress/ZIPCd098026
IRS990EZ/CashSavingsAndInvestmentsGrp/BOYAmt033437
IRS990EZ/CashSavingsAndInvestmentsGrp/EOYAmt00
IRS990EZ/ChgMadeToOrgnzngDocNotRptInd0false
IRS990EZ/ContributionsGiftsGrantsEtcAmt082095
IRS990EZ/CostOfGoodsSoldAmt00
IRS990EZ/CostOrOtherBasisExpenseSaleAmt00
IRS990EZ/DonorAdvisedFndsInd0false
IRS990EZ/EngagedInExcessBenefitTransInd0false
IRS990EZ/ExcessOrDeficitForYearAmt0-33275
IRS990EZ/FeesAndOtherPymtToIndCntrctAmt05277
IRS990EZ/FiledScheduleAInd0true
IRS990EZ/FinalReturnInd0X
IRS990EZ/ForeignFinancialAccountInd0false
IRS990EZ/ForeignOfficeInd0false
IRS990EZ/Form1120PolFiledInd0false
IRS990EZ/Form990TotalAssetsGrp/BOYAmt033443
IRS990EZ/Form990TotalAssetsGrp/EOYAmt00
IRS990EZ/FundraisingGrossIncomeAmt00
IRS990EZ/GainOrLossFromSaleOfAssetsAmt00
IRS990EZ/GrossProfitLossSlsOfInvntryAmt00
IRS990EZ/GrossReceiptsAmt082095
IRS990EZ/GrossReceiptsForPublicUseAmt00
IRS990EZ/InfoInScheduleOPartIInd0X
IRS990EZ/InitiationFeesAndCapContriAmt00
IRS990EZ/InvestmentIncomeAmt00
IRS990EZ/LobbyingActivitiesInd0false
IRS990EZ/MadeLoansToFromOfficersInd0false
IRS990EZ/MembershipDuesAmt00
IRS990EZ/MethodOfAccountingCashInd0X
IRS990EZ/NetAssetsOrFundBalancesBOYAmt033275
IRS990EZ/NetAssetsOrFundBalancesEOYAmt00
IRS990EZ/NetAssetsOrFundBalancesGrp/BOYAmt033275
IRS990EZ/NetAssetsOrFundBalancesGrp/EOYAmt00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt01.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt11.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt21.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt314.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt10
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt20
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt314708
IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt10
IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt20
IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt30
IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt10
IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt20
IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt30
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm0AMANDA SMITH
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm1NANCY WEIR-WEYNA
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm2RUBAB AZEEM
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm3LINDA SEVERT
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt0PRESIDENT
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt1TREASURER
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt2SECRETARY
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt3DIRECTOR/VICE PRESIDENT
IRS990EZ/OperateHospitalInd0false
IRS990EZ/Organization501c3Ind0X
IRS990EZ/OrganizationDissolvedEtcInd0true
IRS990EZ/OrganizationHadUBIInd0false
IRS990EZ/OtherAssetsTotalDetail/BOYAmt06
IRS990EZ/OtherAssetsTotalDetail/EOYAmt00
IRS990EZ/OtherExpensesTotalAmt089368
IRS990EZ/PartVIHghstPdCntrctProfSrvcTxt0NONE
IRS990EZ/PartVIOfCompOfHghstPdEmplTxt0NONE
IRS990EZ/PoliticalCampaignActyInd0false
IRS990EZ/PrimaryExemptPurposeTxt0OUR MISSION IS TO ENHANCE HEALTH AND WELL-BEING THROUGH LAUGHTER AND JOY.
IRS990EZ/ProgramServiceRevenueAmt00
IRS990EZ/ProgramSrvcAccomplishmentGrp/DescriptionProgramSrvcAccomTxt0SEE ATTACHED STATEMENT
IRS990EZ/ProgramSrvcAccomplishmentGrp/GrantsAndAllocationsAmt00
IRS990EZ/ProgramSrvcAccomplishmentGrp/ProgramServiceExpensesAmt0115370
IRS990EZ/ProhibitedTaxShelterTransInd0false
IRS990EZ/RelatedOrganizationCtrlEntInd0false
IRS990EZ/SalariesOtherCompEmplBnftAmt020725
IRS990EZ/SchoolOperatingInd0false
IRS990EZ/SpecialEventsDirectExpensesAmt00
IRS990EZ/SpecialEventsNetIncomeLossAmt00
IRS990EZ/SubjectToProxyTaxInd0false
IRS990EZ/SumOfTotalLiabilitiesGrp/BOYAmt0168
IRS990EZ/TanningServicesProvidedInd0false
IRS990EZ/TotalExpensesAmt0115370
IRS990EZ/TotalProgramServiceExpensesAmt0115370
IRS990EZ/TotalRevenueAmt082095
IRS990EZ/TransactionWithControlEntInd0false
IRS990EZ/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990EZ/TypeOfOrganizationCorpInd0X
IRS990EZ/WebsiteAddressTxt0WWW.ROOMCIRCUS.ORG
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearAmt082095
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus1YearAmt037563
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus2YearsAmt033998
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus3YearsAmt048636
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus4YearsAmt056461
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/TotalAmt0258753
IRS990ScheduleA/GovtFurnSrvcFcltsVl170Grp/TotalAmt00
IRS990ScheduleA/GrossInvestmentIncome170Grp/TotalAmt00
IRS990ScheduleA/InvestmentIncomeCYPct00
IRS990ScheduleA/OtherIncome170Grp/TotalAmt00
IRS990ScheduleA/OtherSupportSumAmt00
IRS990ScheduleA/PublicOrganization170Ind0X
IRS990ScheduleA/PublicSupportCY170Pct01.00000
IRS990ScheduleA/PublicSupportCY509Pct00
IRS990ScheduleA/PublicSupportPY170Pct01.00000
IRS990ScheduleA/PublicSupportTotal170Amt0258753
IRS990ScheduleA/PublicSupportTotal509Amt00
IRS990ScheduleA/SubstantialContributorsTotAmt00
IRS990ScheduleA/TaxRevLeviedOrgnztnlBnft170Grp/TotalAmt00
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY170Ind0X
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearAmt082095
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus1YearAmt037563
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus2YearsAmt033998
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus3YearsAmt048636
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus4YearsAmt056461
IRS990ScheduleA/TotalCalendarYear170Grp/TotalAmt0258753
IRS990ScheduleA/TotalSupportAmt0258753
IRS990ScheduleA/UnrelatedBusinessNetIncm170Grp/TotalAmt00
IRS990ScheduleB/ContributorInformationGrp/ContributorBusinessName/BusinessNameLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorNum0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine20RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/City0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/ZIPCode0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt0RESTRICTED
IRS990ScheduleN/AssetsDistributedInd0true
IRS990ScheduleN/AttorneyGeneralNotifiedInd0true
IRS990ScheduleN/BondsOutstandingInd0false
IRS990ScheduleN/LiabilitiesPaidInd0true
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc0CASH
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine1Txt0SLAPPY AND MONDAY'S FOUNDATION FOR
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt02021-09-21
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/EIN0260598220
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt083444
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/IRCSectionTxt0501(C)3
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/MethodOfFMVDeterminationTxt0CASH
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine1Txt02801 WINGREN RD
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/CityNm0IRVING
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/StateAbbreviationCd0TX
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/ZIPCd075062
IRS990ScheduleN/RequiredToNotifyAGInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0EDUCATION AND DEVELOPMENT 250.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1COSTUMES AND PROPS 565.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2DUES AND SUBSCRIPTIONS 209.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3FLOWERS 536.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4INSURANCE 1058.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5BANK SERVICE CHARGES 158.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6WEBSITE 636.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7PAYROLL TAXES 2490.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt8MERGER TRANSFER TO FOUNDATION FOR LAUGHTER 83444.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt9MISCELLANEOUS 22.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt10PREPAID EXPENSES
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt11PAYROLL LIABILITIES
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Form 990EZ, Part I, Line 16
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Form 990EZ, Part I, Line 16
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2Form 990EZ, Part I, Line 16
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3Form 990EZ, Part I, Line 16
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4Form 990EZ, Part I, Line 16
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5Form 990EZ, Part I, Line 16
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6Form 990EZ, Part I, Line 16
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7Form 990EZ, Part I, Line 16
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc8Form 990EZ, Part I, Line 16
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc9Form 990EZ, Part I, Line 16
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc10Form 990EZ, Part II, Line 24
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc11Form 990EZ, Part II, Line 26
ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/AuthenticationAssuranceLevelCd0AAL1
ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/FederatedAssuranceLevelCd0FAL1
ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/IdentityAssuranceLevelCd0IAL1
ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/TrustedCustomerCd03
ReturnHeader/BuildTS02022-09-23 18:48:47Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0LINDA SEVERT
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0DIRECTOR
ReturnHeader/BusinessOfficerGrp/PhoneNum02064466522
ReturnHeader/BusinessOfficerGrp/SignatureDt02002-11-18
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0ROOM CIRCUS MEDICAL CLOWING
ReturnHeader/Filer/BusinessNameControlTxt0ROOM
ReturnHeader/Filer/EIN0203534374
ReturnHeader/Filer/PhoneNum02064466522
ReturnHeader/Filer/USAddress/AddressLine1Txt0PO BOX 15434
ReturnHeader/Filer/USAddress/CityNm0Seattle
ReturnHeader/Filer/USAddress/StateAbbreviationCd0WA
ReturnHeader/Filer/USAddress/ZIPCd098115
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0SYLVIA KEALY EA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt017922 TALBOT RD
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0EDMONDS
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0WA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd098026
ReturnHeader/PreparerPersonGrp/PhoneNum04252187737
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0Sylvia Kealy EA
ReturnHeader/PreparerPersonGrp/SelfEmployedInd0X
ReturnHeader/ReturnTs02021-11-18T16:19:49-08:00
ReturnHeader/ReturnTypeCd0990EZ
ReturnHeader/SigningOfficerGrp/PersonFullName/PersonFirstNm0LINDA
ReturnHeader/SigningOfficerGrp/PersonFullName/PersonLastNm0SEVERT
ReturnHeader/TaxPeriodBeginDt02020-10-01
ReturnHeader/TaxPeriodEndDt02021-09-30
ReturnHeader/TaxYr02020

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