Civic Intelligence

Foundation for Adult Living Inc

EIN 20-4168841 • 501(c)3 • Atlanta, GA

View Organization Page

Profile

To own, operate and provide management services to all foundation for adult living nursing homes and to make contributions to worthy charitable causes.

3330 Cumberland Blvd Ste 1000Atlanta, GA 30339

n/A

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 2018

Liabilities / Revenue

62nd percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • <$500k nonprofits • Source year 2018

Net Margin

9th percentile

-111%

Higher net margin than 9% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2018

Top Officer Pay

81st percentile

$0

Higher top officer pay than 81% of similar nonprofits.

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

501(c)3 • <$500k nonprofits • Source year 2018

Asset Growth

10th percentile

-100%

Faster asset growth than 10% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2017 to 2018

Revenue Growth

Score unavailable

No value available

A valid growth rate could not be computed from the available filing history.

Annualized from 2017 to 2018

Balance Sheet
Liabilities / AssetsScore unavailable

Assets

Down

$0

Down $141,332 (-100%) from 2017

Liabilities

Down

$0

Down $63,412 (-100%) from 2017

Net Assets

Down

$0

Down $77,920 (-100%) from 2017

Operations
Liabilities / Revenue62nd percentileNet Margin9th percentile

Revenue

Up

$70,200

Up $70,200 from 2017

Expenses

Up

$148,120

Up $129,304 (+687%) from 2017

Net Income

Down

-$77,920

Down $59,104 (-314%) from 2017

Trend Graphs

Balance Sheet Trend

Asset Growth10th percentile

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

$4.0M$2.0M$0-$2.0MAssets 2010: $1,403,886Liabilities 2010: $3,066,702Net Assets 2010: -$1,662,8162010Assets 2011: $1,199,615Liabilities 2011: $2,950,658Net Assets 2011: -$1,751,0432011Assets 2012: $1,983,026Liabilities 2012: $1,863Net Assets 2012: $1,981,1632012Assets 2013: $1,821,332Liabilities 2013: $399,921Net Assets 2013: $1,421,4112013Assets 2014: $223,165Liabilities 2014: $1,909Net Assets 2014: $221,2562014Assets 2015: $143,664Liabilities 2015: $11,938Net Assets 2015: $131,7262015Assets 2016: $137,926Liabilities 2016: $41,190Net Assets 2016: $96,7362016Assets 2017: $141,332Liabilities 2017: $63,412Net Assets 2017: $77,9202017Assets 2018: $0Liabilities 2018: $0Net Assets 2018: $02018

Highlighted filing

2018

Assets$0
Liabilities$0
Net Assets$0
Open 2018 Filing

Operations Trend

Revenue GrowthScore unavailable

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

$6.0M$4.0M$2.0M$0-$2.0MExpenses 2010: $1,787,9052010Revenue 2011: $925,000Expenses 2011: $1,013,227Net Income 2011: -$88,2272011Expenses 2012: $5,763,5272012Revenue 2013: $415,395Expenses 2013: $975,147Net Income 2013: -$559,7522013Revenue 2014: $967,432Expenses 2014: $2,167,587Net Income 2014: -$1,200,1552014Revenue 2015: $575,466Expenses 2015: $664,996Net Income 2015: -$89,5302015Revenue 2016: $8Expenses 2016: $34,998Net Income 2016: -$34,9902016Revenue 2017: $0Expenses 2017: $18,816Net Income 2017: -$18,8162017Revenue 2018: $70,200Expenses 2018: $148,120Net Income 2018: -$77,9202018

Highlighted filing

2018

Revenue$70,200
Expenses$148,120
Net Income-$77,920
Open 2018 Filing

Filings

Most recent year

2018 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$0
Liabilities
$0
Net assets
$0
Revenue
$70,200
Expenses
$148,120
Net income
-$77,920
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2018Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.07$0.15$0.08
2017Detailed filing. Detailed filing data is available for this year.$0.14$0.06$0.08$0.00$0.02$0.02
2016Detailed filing. Detailed filing data is available for this year.$0.14$0.04$0.10$0.00$0.03$0.03
2015Detailed filing. Detailed filing data is available for this year.$0.14$0.01$0.13$0.58$0.66$0.09
2014Detailed filing. Detailed filing data is available for this year.$0.22$0.00$0.22$0.97$2.17$1.20
2013Detailed filing. Detailed filing data is available for this year.$1.82$0.40$1.42$0.42$0.98$0.56
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.98$0.00$1.98$5.76
2011Summary only. Only limited summary data is available for this year.$1.20$2.95$1.75$0.93$1.01$0.09
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.40$3.07$1.66$1.79
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2018 to Dec 31, 2018
Signed
Sep 17, 2019
Return Version
2018v3.1
Gross Receipts
$70,200
Mission and Program Overview

Mission

To own, operate and provide management services to all foundation for adult living nursing homes and to make contributions to worthy charitable causes.

To own and operate all foundation for adult living nursing homes.

Balance Sheet Detail
LineBeginningEndChange
Assets
Pd in Cap Srpls Land Bldg Eqp Fund$3,426,149$3,426,149→ $0
Accounts Receivable$113,933$0▼ $113,933
Cash and Non-Interest-Bearing Accounts$5,305$0▼ $5,305
Savings and Temporary Cash Investments-$0-
Other Notes and Loans Receivable, Net-$0-
Pledges and Grants Receivable-$0-
Receivable From Disqualified Prsn-$0-
Receivables From Officers Etc-$0-
Investments Other Securities-$0-
Investments Program Related-$0-
Investments in Publicly Traded Securities-$0-
Land, Buildings, and Equipment, Net-$0-
Cap Stk Tr Prin Current Funds$0$0→ $0
Intangible Assets-$0-
Inventories for Sale or Use-$0-
Prepaid Expenses and Deferred Charges-$0-
Rtn Earn Endowment Incm Other Fnds$-3,348,229$-3,426,149▼ $77,920
Total Assets$141,332$0▼ $141,332
Other Assets Total$22,094$0▼ $22,094
Liabilities
Other Liabilities$62,756$0▼ $62,756
Accounts Payable and Accrued Expenses$656$0▼ $656
Total Liabilities$63,412$0▼ $63,412
Net Assets / Fund Balance
Total Net Assets Fund Balance$77,920$0▼ $77,920
Total Liabilities and Net Assets / Fund Balance$141,332$0▼ $141,332
Compensation and Service Providers
Top Officer Pay81st percentile

Board Members and Trustees

NameTitle
Elaine BolickPresident
James JarosikDirector
Jason SchreiberDirector
Karen AustinDirector
R Craig StricklandDirector
Terence SchwartzDirector
Revenue and Support

Revenue Composition

Contributions and Grants
$70,200
Program Service Revenue
$0
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$-77,920
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$148,120
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
Other Expenses$2,091--$2,091
Fees for Services Accounting$1,500--$1,500
All Other Expenses$391--$391
Total Functional Expenses$148,120$0$0$148,120
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
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Receivables from Disqualified Persons-$0-
Receivables from Officers, Directors, Trustees, and Key Employees-$0-
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
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

Governance Explanations

Form 990, Part VI, Section A, Line 3

“Management duties were delegated to greystone healthcare management.”

Form 990, Part VI, Section B, Line 11B

“Form 990 is prepared by hlb gross collins, p.c., an independent certified public accounting firm. Form 990 is then provided to management for their review, approval, and signature. Form 990 is typically electronically filed after management reviews and provides an electronic filing signature document to tax preparer.”

Form 990, Part VI, Section B, Line 12

“Management regularly monitors compliance with the conflict of interest policy.”

Form 990, Part VI, Section C, Line 19

“The organization will provide its governing documents, conflict of interest policy, and financial statements available to persons upon request.”

Form 990, Part VI, Section A, Line 9

“Elaine bolick - 603 delphinium boulevard, acworth, ga 30102 terence schwartz - 35 montrose road, scarsdale, ny 10583 r. Craig strickland- c/o hope presbyterian church 8500 walnut grove rd, cordova, tn 38018 karen austin - c/o deaconess hospital, 311 straight st, cincinnati, oh 45219 jason schreiber - 2135 n. Clifton ave., chicago, il 60614 james jarosik - 344 highland avenue, upper montclair, nj 07043”

Form 990, Part VII Contact Addresses for Officers, Directors, Etc

“Terence schwartz - 35 montrose road, scarsdale, ny 10583. Karen austin - c/o deaconess hospital, 311 straight st, cincinnati, oh 45219. Jason schreiber - 2135 n. Clifton ave, chicago, il 60614. James jarosik - 344 highland avenue, upper montclair, nj 07043. Elaine bolick - 603 delphinium boulevard, acworth, ga 30102. R. Craig strickland - c/o hope presbyterian church, 8500 walnut grove rd, cordova, tn 38018.”

Filing and Contact Details

Filer

Filer Name
Foundation for Adult Living Inc
EIN
20-4168841
Phone
7704331711
Address
3330 CUMBERLAND BLVD STE 1000, ATLANTA, GA 30339

Signing Officer

Name
Elaine Bolick
Title
President
Phone
7704331711
Signed
2019-09-17
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Elaine Bolick
Formed
2006
Legal Domicile
De
Voting Board Members
6
Independent Board Members
6
Employees
0
Volunteers
0

Preparer

Firm
Hlb Gross Collins Pc
Address
3330 CUMBERLAND BOULEVARD 1000, ATLANTA, GA 30339
Preparer
Cynthia Gibbs
Phone
7704331711
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IRS990ScheduleI/SupplementalInformationDetail/ExplanationTxt0THE ORGANIZATION HAS ENTERED INTO AN AGREEMENT WITH THE MURRAY AND SYDELL ROSENBERG FOUNDATION, INC. (MSRF) TO COOPERATE IN ACHIEVING COMMON CHARITABLE AND HUMANITARIAN GOALS. MSRF IDENTIFIES AND RECOMMENDS GRANT RECIPIENTS BASED ON PRETEDERMINED CRITERIA AND RESEARCH. THE BOARD OF THE ORGANIZATION APPROVES ALL GRANT REQUESTS.
IRS990ScheduleI/SupplementalInformationDetail/FormAndLineReferenceDesc0PART I, LINE 2:
IRS990/ScheduleJRequiredInd00
IRS990ScheduleN/AssetsDistributedInd00
IRS990ScheduleN/AttorneyGeneralNotifiedInd00
IRS990ScheduleN/BondsOutstandingInd00
IRS990ScheduleN/DirectorOfSuccessorInd00
IRS990ScheduleN/EmployeeOfSuccessorInd00
IRS990ScheduleN/LiabilitiesPaidInd00
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc0THERE WERE NO ASSETS AT THE TIME OF DISSOLUTION. THERE WERE NO ASSETS DISTRIBUTED OR TRANSACTION EXPENSES PAID.
IRS990ScheduleN/OwnerOfSuccessorInd00
IRS990ScheduleN/ReceiveCompensationInd00
IRS990ScheduleN/RequiredToNotifyAGInd00
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0MANAGEMENT DUTIES WERE DELEGATED TO GREYSTONE HEALTHCARE MANAGEMENT.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1FORM 990 IS PREPARED BY HLB GROSS COLLINS, P.C., AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTING FIRM. FORM 990 IS THEN PROVIDED TO MANAGEMENT FOR THEIR REVIEW, APPROVAL, AND SIGNATURE. FORM 990 IS TYPICALLY ELECTRONICALLY FILED AFTER MANAGEMENT REVIEWS AND PROVIDES AN ELECTRONIC FILING SIGNATURE DOCUMENT TO TAX PREPARER.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2MANAGEMENT REGULARLY MONITORS COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3THE ORGANIZATION WILL PROVIDE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO PERSONS UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4ELAINE BOLICK - 603 DELPHINIUM BOULEVARD, ACWORTH, GA 30102 TERENCE SCHWARTZ - 35 MONTROSE ROAD, SCARSDALE, NY 10583 R. CRAIG STRICKLAND- C/O HOPE PRESBYTERIAN CHURCH 8500 WALNUT GROVE RD, CORDOVA, TN 38018 KAREN AUSTIN - C/O DEACONESS HOSPITAL, 311 STRAIGHT ST, CINCINNATI, OH 45219 JASON SCHREIBER - 2135 N. CLIFTON AVE., CHICAGO, IL 60614 JAMES JAROSIK - 344 HIGHLAND AVENUE, UPPER MONTCLAIR, NJ 07043
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5TERENCE SCHWARTZ - 35 MONTROSE ROAD, SCARSDALE, NY 10583. KAREN AUSTIN - C/O DEACONESS HOSPITAL, 311 STRAIGHT ST, CINCINNATI, OH 45219. JASON SCHREIBER - 2135 N. CLIFTON AVE, CHICAGO, IL 60614. JAMES JAROSIK - 344 HIGHLAND AVENUE, UPPER MONTCLAIR, NJ 07043. ELAINE BOLICK - 603 DELPHINIUM BOULEVARD, ACWORTH, GA 30102. R. CRAIG STRICKLAND - C/O HOPE PRESBYTERIAN CHURCH, 8500 WALNUT GROVE RD, CORDOVA, TN 38018.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION A, LINE 3
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION B, LINE 12
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PART VI, SECTION A, LINE 9
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC
IRS990ScheduleR/AssetExchangeInd00
IRS990ScheduleR/AssetPurchaseFromOtherOrgInd00
IRS990ScheduleR/AssetSaleToOtherOrgInd00
IRS990ScheduleR/DivRelatedOrganizationInd00
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd01
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd00
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd00
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingNACd0N/A
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt0FAL MOUNTAIN CREST
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN0204137987
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt0501(C)(3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd0DE
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt0TO OWN & OPERATE NURSING HOMES
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PublicCharityStatusTxt0509(A)(2)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt03330 CUMBERLAND BLVD SUITE 1000
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm0ATLANTA
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd0GA
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd030339
IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd00
IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd00
IRS990ScheduleR/PaidEmployeesSharingInd00
IRS990ScheduleR/PerformOfServicesByOtherOrgInd00
IRS990ScheduleR/PerformOfServicesForOthOrgInd00
IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd00
IRS990ScheduleR/ReimbursementPaidByOtherOrgInd00
IRS990ScheduleR/ReimbursementPaidToOtherOrgInd00
IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd00
IRS990ScheduleR/RentalOfFcltsFromOthOrgInd00
IRS990ScheduleR/SharingOfFacilitiesInd00
IRS990ScheduleR/TransactionsRelatedOrgGrp/InvolvedAmt070200
IRS990ScheduleR/TransactionsRelatedOrgGrp/MethodOfAmountDeterminationTxt0FMV
IRS990ScheduleR/TransactionsRelatedOrgGrp/OtherOrganizationName/BusinessNameLine1Txt0FAL MT CREST
IRS990ScheduleR/TransactionsRelatedOrgGrp/TransactionTypeTxt0C
IRS990ScheduleR/TransferFromOtherOrgInd00
IRS990ScheduleR/TransferToOtherOrgInd00
IRS990/SchoolOperatingInd00
IRS990/SignificantChangeInd00
IRS990/SignificantNewProgramSrvcInd00
IRS990/SubjectToExcsTaxNetInvstIncInd00
IRS990/SubjectToProxyTaxInd00
IRS990/SubjToTaxRmnrtnExPrchtPymtInd00
IRS990/TaxablePartyNotificationInd00
IRS990/TaxExemptBondsInd00
IRS990/TempOrPermanentEndowmentsInd00
IRS990/TerminateOperationsInd01
IRS990/TotalAssetsBOYAmt0141332
IRS990/TotalAssetsEOYAmt00
IRS990/TotalAssetsGrp/BOYAmt0141332
IRS990/TotalAssetsGrp/EOYAmt00
IRS990/TotalCompGreaterThan150KInd00
IRS990/TotalContributionsAmt070200
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt00
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0148120
IRS990/TotalFunctionalExpensesGrp/TotalAmt0148120
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt063412
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt063412
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt077920
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt00
IRS990/TotalOtherCompensationAmt00
IRS990/TotalProgramServiceExpensesAmt0148120
IRS990/TotalReportableCompFromOrgAmt00
IRS990/TotalRevenueGrp/ExclusionAmt00
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt00
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt070200
IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt00
IRS990/TotalVolunteersCnt00
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0141332
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt00
IRS990/TotReportableCompRltdOrgAmt00
IRS990/TrnsfrExmptNonChrtblRltdOrgInd00
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd00
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt03330 CUMBERLAND BLVD STE 1000
IRS990/USAddress/CityNm0ATLANTA
IRS990/USAddress/StateAbbreviationCd0GA
IRS990/USAddress/ZIPCd030339
IRS990/VotingMembersGoverningBodyCnt06
IRS990/VotingMembersIndependentCnt06
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd00
ReturnHeader/BuildTS02019-02-21 02:37:17Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0ELAINE BOLICK
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0PRESIDENT
ReturnHeader/BusinessOfficerGrp/PhoneNum07704331711
ReturnHeader/BusinessOfficerGrp/SignatureDt02019-09-17
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0FOUNDATION FOR ADULT LIVING INC
ReturnHeader/Filer/BusinessName/BusinessNameLine2Txt0C/O HLB GROSS COLLINS PC
ReturnHeader/Filer/BusinessNameControlTxt0FOUN
ReturnHeader/Filer/EIN0204168841
ReturnHeader/Filer/PhoneNum07704331711
ReturnHeader/Filer/USAddress/AddressLine1Txt03330 CUMBERLAND BLVD STE 1000
ReturnHeader/Filer/USAddress/CityNm0ATLANTA
ReturnHeader/Filer/USAddress/StateAbbreviationCd0GA
ReturnHeader/Filer/USAddress/ZIPCd030339
ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId043FBCCFA4AABCA6AC485C0E703FF9FA047501FA5
ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId0AA51BE414A518B64744863E0F3C57802506E5DCC
ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd0P
ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt066.77.128.118
ReturnHeader/FilingSecurityInformation/IPDt02019-09-17
ReturnHeader/FilingSecurityInformation/IPTimezoneCd0ED
ReturnHeader/FilingSecurityInformation/IPTm014:11:44
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0581367012
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0HLB GROSS COLLINS PC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt03330 CUMBERLAND BOULEVARD 1000
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0ATLANTA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0GA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd030339
ReturnHeader/PreparerPersonGrp/PhoneNum07704331711
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0CYNTHIA GIBBS
ReturnHeader/ReturnTs02019-09-24T10:35:33-05:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02018-01-01

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