Civic Intelligence

Southeastern Regional Physician Services

990 • Fiscal year 2016 • EIN 26-4762805

Oct 01, 2015 to Sep 30, 2016 • Filed on Aug 15, 2017

PO Box 1408 300 W 27th StreetLumberton, NC 28359-1408

(910) 671-5000

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

22nd percentile

0.04x

Higher debt load relative to assets than 22% of similar nonprofits.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2016

Liabilities / Revenue

11th percentile

0.03x

Higher debt load relative to revenue than 11% of similar nonprofits.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2016

Net Margin

6th percentile

-45%

Higher net margin than 6% of similar nonprofits.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2016

Top Officer Pay

94th percentile

$757,076

Higher top officer pay than 94% of similar nonprofits.

Top officer pay equals 3.4% of source-year revenue.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2016

Asset Growth

20th percentile

-4.3%

Faster asset growth than 20% of similar nonprofits.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Annualized from 2015 to 2016

Revenue Growth

36th percentile

-1.2%

Faster revenue growth than 36% of similar nonprofits.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Annualized from 2015 to 2016

Assets

Down

$15,105,231

Down $680,576 (-4.3%) from 2015

Net Assets

Down

$14,542,446

Down $95,096 (-0.6%) from 2015

Liabilities

Down

$562,785

Down $585,480 (-51%) from 2015

Revenue

Down

$22,361,432

Down $280,666 (-1.2%) from 2015

Expenses

Up

$32,417,466

Up $897,702 (+2.8%) from 2015

Net Income

Down

-$10,056,034

Down $1,178,368 (-13%) from 2015

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$40M$20M$0-$20MAssets 2012: $19,870,367Liabilities 2012: $621,174Net Assets 2012: $19,249,1932012Assets 2013: $18,518,214Liabilities 2013: $767,649Net Assets 2013: $17,750,5652013Assets 2014: $17,091,377Liabilities 2014: $884,113Net Assets 2014: $16,207,2642014Assets 2015: $15,785,807Liabilities 2015: $1,148,265Net Assets 2015: $14,637,5422015Assets 2016: $15,105,231Liabilities 2016: $562,785Net Assets 2016: $14,542,4462016Assets 2017: $15,241,303Liabilities 2017: $503,161Net Assets 2017: $14,738,1422017Assets 2018: $13,434,814Liabilities 2018: $732,873Net Assets 2018: $12,701,9412018Assets 2019: $13,390,234Liabilities 2019: $649,881Net Assets 2019: $12,740,3532019Assets 2020: $22,363,102Liabilities 2020: $2,075,761Net Assets 2020: $20,287,3412020Assets 2021: $38,282,293Liabilities 2021: $661,648Net Assets 2021: $37,620,6452021Assets 2022: $9,907,191Liabilities 2022: $446,609Net Assets 2022: $9,460,5822022Assets 2023: $8,193,476Liabilities 2023: $16,276,327Net Assets 2023: -$8,082,8512023Assets 2024: $6,771,907Liabilities 2024: $2,223,488Net Assets 2024: $4,548,4192024

Highlighted filing

2016

Assets$15,105,231
Liabilities$562,785
Net Assets$14,542,446

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$60M$40M$20M$0-$20M-$40MExpenses 2012: $26,845,1982012Expenses 2013: $28,458,9622013Revenue 2014: $22,067,778Expenses 2014: $29,972,218Net Income 2014: -$7,904,4402014Revenue 2015: $22,642,098Expenses 2015: $31,519,764Net Income 2015: -$8,877,6662015Revenue 2016: $22,361,432Expenses 2016: $32,417,466Net Income 2016: -$10,056,0342016Revenue 2017: $21,099,533Expenses 2017: $30,179,999Net Income 2017: -$9,080,4662017Revenue 2018: $23,181,194Expenses 2018: $36,537,962Net Income 2018: -$13,356,7682018Revenue 2019: $27,510,777Expenses 2019: $44,702,116Net Income 2019: -$17,191,3392019Revenue 2020: $28,788,737Expenses 2020: $44,286,090Net Income 2020: -$15,497,3532020Revenue 2021: $24,618,776Expenses 2021: $32,938,854Net Income 2021: -$8,320,0782021Revenue 2022: $29,597,764Expenses 2022: $44,566,580Net Income 2022: -$14,968,8162022Revenue 2023: $9,281,058Expenses 2023: $33,063,035Net Income 2023: -$23,781,9772023Revenue 2024: $7,071,542Expenses 2024: $26,083,341Net Income 2024: -$19,011,7992024

Highlighted filing

2016

Revenue$22,361,432
Expenses$32,417,466
Net Income-$10,056,034
Jump To
Filing Snapshot
Filing Period
Oct 1, 2015 to Sep 30, 2016
Signed
Aug 15, 2017
Return Version
2015v3.0
Gross Receipts
$22,361,432
Mission and Program Overview

Mission

Physician services operates more than 30 primary care, specialty and urgent care clinics throughout robeson, bladen, cumberland and scotland counties, specializing in providing quality family or internal medicine services.

Physician services operates more than 40 primary care, specialty and urgent care clinics throughout robeson, bladen, cumberland and scotland counties, specializing in providing quality family or internal medicine services.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$13,176,915$13,281,652▲ $104,737
Accounts Receivable$1,554,802$1,147,787▼ $407,015
Cash and Non-Interest-Bearing Accounts$1,054,090$675,792▼ $378,298
Total Assets$15,785,807$15,105,231▼ $680,576
Liabilities
Accounts Payable and Accrued Expenses$1,148,265$562,785▼ $585,480
Total Liabilities$1,148,265$562,785▼ $585,480
Net Assets / Fund Balance
Unrestricted Net Assets$14,637,542$14,542,446▼ $95,096
Total Net Assets Fund Balance$14,637,542$14,542,446▼ $95,096
Total Liabilities and Net Assets / Fund Balance$15,785,807$15,105,231▼ $680,576

Asset Categories

AssetBook ValueDepreciationBasis
Other Land Buildings$13,281,652$9,567,060$22,848,712
Compensation and Service Providers

Employees

NameTitleBaseOtherTotal
Virgilio MatheusPhysician$707,076$50,000$757,076
Riyaz H JinnahPhysician$654,927$41,667$696,594
David DalsimerPhysician$625,239$64,573$625,239
Harvey H AllenPhysician$426,113$50,000$490,686
Sadanand HegdePhysician$426,774-$476,774

Board Members and Trustees

NameTitle
Michael Bo StoneChairman
Joann AndersonPresident
Jerry L JohnsonVice Chair &
W C WashingtonTrustee
Faye C CatonImmediate Pa
Lynn WietiesSecretary
C Thomas Johnson IiiTreasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$22,361,432
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$-10,056,034
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$27,408,942
Other Expenses$5,008,524
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$22,140,045$368,756-$22,508,801
Other Employee Benefits$4,805,123$95,018-$4,900,141
Fees for Services Other$715,231$499,384-$1,214,615
Depreciation Depletion$509,798$549,652-$1,059,450
Occupancy$465,633$80,692-$546,325
Conferences and Meetings$138,621$9,841-$148,462
Office Expenses$107,324$15,394-$122,718
Other Expenses$88,968$11,356-$88,968
Travel$19,916$3,003-$22,919
Insurance$10,289--$10,289
Total Functional Expenses$30,784,370$1,633,096$0$32,417,466
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
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
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
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Page 6, Part VI, Line 11B

Corporate officers review form 990 before filing

Form 990, Page 6, Part VI, Line 12C

A copy of southeastern regional medical center's (center) conflict of interest policy along with a statement of conflict of interest is given to the center's officers, directors, trustees and key employees annually to review and sign. If any disclosures are made, discussions with the interested person occur and then he or she leaves the meeting, at which time the remaining board or committee members decide if a conflict of interest exists. If a conflict of interest is determined to exist, the board determines whether the center can obtain a more advantageous transaction or arrangement with reasonable efforts from a person or entity that would not give rise to a conflict of interest. If that is not reasonably attainable, the board or committee, by a majority vote of disinterested directors, shall determine whether the transaction or arrangement is in the center's best interest, for its own benefit, and whether the transaction is fair and reasonable to the center.

Form 990, Page 6, Part VI, Line 15A

The ceo and vice president positions were evaluated by a separate compensation committee and an independent consulting firm. The executive compensation philosophy was updated. Information was gathered on competitive practices and a reasonable compensation plan was determined. Actions of the committee are approved regularly and are based on the organization's rebuttable presumption policy that requires the committee to exercise the diligence needed to meet the requirements for the presumption of reasonableness.

Form 990, Page 6, Part VI, Line 15B

SAME AS ABOVE

Form 990, Page 6, Part VI, Line 19

Various governing documents are made available to the general public using srmc's website, other website, and providing copies upon request.

Filing and Contact Details

Filer

Filer Name
Southeastern Regional Physician
EIN
26-4762805
Phone
9106715000
Address
PO BOX 1408 300 W 27TH STREET, LUMBERTON, NC 28359-1408

Signing Officer

Name
C Thomas Johnson Iii
Title
Treasurer
Phone
9106715090
Signed
2017-08-15
Discuss with paid preparer
Yes

Organization Details

Principal Officer
C Thomas Johnson Iii
Formed
2009
Legal Domicile
Nc
Voting Board Members
5
Independent Board Members
4
Employees
345
Volunteers
2

Preparer

Firm
S Preston Douglas & Associates Llp
Address
PO BOX 2339, LUMBERTON, NC 28359-2339
Preparer
John L Grissom Jr
Phone
9107397523
Supplemental Narrative

Additional Explanations

Form 990, Part XI, Line 9

Transfers from tax exmpt related org 9,960,938 total 9,960,938

Raw XML Appendix381 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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IRS990/RegularMonitoringEnfrcInd0true
IRS990/RelatedEntityInd0false
IRS990/RelatedOrganizationCtrlEntInd0false
IRS990/ReportInvestmentsOtherSecInd0false
IRS990/ReportLandBuildingEquipmentInd0true
IRS990/ReportOtherAssetsInd0false
IRS990/ReportOtherLiabilitiesInd0false
IRS990/ReportProgramRelatedInvstInd0false
IRS990/RevenueAmt022361432
IRS990ScheduleA/HospitalInd0X
IRS990/ScheduleBRequiredInd0false
IRS990ScheduleD/OtherLandBuildingsGrp/BookValueAmt013281652
IRS990ScheduleD/OtherLandBuildingsGrp/DepreciationAmt09567060
IRS990ScheduleD/OtherLandBuildingsGrp/OtherCostOrOtherBasisAmt022848712
IRS990ScheduleD/TotalBookValueLandBuildingsAmt013281652
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IRS990ScheduleJ/CompBasedOnRevenueOfFlngOrgInd0false
IRS990ScheduleJ/CompBsdNetEarnsFlngOrgInd0false
IRS990ScheduleJ/CompBsdNetEarnsRltdOrgsInd0false
IRS990ScheduleJ/CompBsdOnRevRelatedOrgsInd0false
IRS990ScheduleJ/EquityBasedCompArrngmInd0false
IRS990ScheduleJ/InitialContractExceptionInd0false
IRS990/ScheduleJRequiredInd0true
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt0707076
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt1654927
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt2625239
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt3426113
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt4426774
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount050000
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount141667
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount264573
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount350000
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm0VIRGILIO MATHEUS
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm1RIYAZ H JINNAH
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm2DAVID DALSIMER
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm3HARVEY H ALLEN
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm4SADANAND HEGDE
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt0PHYSICIAN
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt1PHYSICIAN
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt2PHYSICIAN
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt3PHYSICIAN
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt4PHYSICIAN
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt0757076
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt1696594
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt2625239
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt3490686
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt4476774
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IRS990ScheduleJ/SupplementalNonqualRtrPlanInd0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0CORPORATE OFFICERS REVIEW FORM 990 BEFORE FILING
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1A COPY OF SOUTHEASTERN REGIONAL MEDICAL CENTER'S (CENTER) CONFLICT OF INTEREST POLICY ALONG WITH A STATEMENT OF CONFLICT OF INTEREST IS GIVEN TO THE CENTER'S OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ANNUALLY TO REVIEW AND SIGN. IF ANY DISCLOSURES ARE MADE, DISCUSSIONS WITH THE INTERESTED PERSON OCCUR AND THEN HE OR SHE LEAVES THE MEETING, AT WHICH TIME THE REMAINING BOARD OR COMMITTEE MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE BOARD DETERMINES WHETHER THE CENTER CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF THAT IS NOT REASONABLY ATTAINABLE, THE BOARD OR COMMITTEE, BY A MAJORITY VOTE OF DISINTERESTED DIRECTORS, SHALL DETERMINE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CENTER'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CENTER.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2THE CEO AND VICE PRESIDENT POSITIONS WERE EVALUATED BY A SEPARATE COMPENSATION COMMITTEE AND AN INDEPENDENT CONSULTING FIRM. THE EXECUTIVE COMPENSATION PHILOSOPHY WAS UPDATED. INFORMATION WAS GATHERED ON COMPETITIVE PRACTICES AND A REASONABLE COMPENSATION PLAN WAS DETERMINED. ACTIONS OF THE COMMITTEE ARE APPROVED REGULARLY AND ARE BASED ON THE ORGANIZATION'S REBUTTABLE PRESUMPTION POLICY THAT REQUIRES THE COMMITTEE TO EXERCISE THE DILIGENCE NEEDED TO MEET THE REQUIREMENTS FOR THE PRESUMPTION OF REASONABLENESS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3SAME AS ABOVE
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4VARIOUS GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE GENERAL PUBLIC USING SRMC'S WEBSITE, OTHER WEBSITE, AND PROVIDING COPIES UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5TRANSFERS FROM TAX EXMPT RELATED ORG 9,960,938 TOTAL 9,960,938
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PAGE 6, PART VI, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PAGE 6, PART VI, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PAGE 6, PART VI, LINE 15A
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PAGE 6, PART VI, LINE 15B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PAGE 6, PART VI, LINE 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5FORM 990, PART XI, LINE 9
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IRS990/SignificantChangeInd0false
IRS990/SignificantNewProgramSrvcInd0false
IRS990/SubjectToProxyTaxInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TempOrPermanentEndowmentsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt015785807
IRS990/TotalAssetsEOYAmt015105231
IRS990/TotalAssetsGrp/BOYAmt015785807
IRS990/TotalAssetsGrp/EOYAmt015105231
IRS990/TotalCompGreaterThan150KInd0true
IRS990/TotalEmployeeCnt0345
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt01633096
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt030784370
IRS990/TotalFunctionalExpensesGrp/TotalAmt032417466
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt01148265
IRS990/TotalLiabilitiesEOYAmt0562785
IRS990/TotalLiabilitiesGrp/BOYAmt01148265
IRS990/TotalLiabilitiesGrp/EOYAmt0562785
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt014637542
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt014542446
IRS990/TotalProgramServiceExpensesAmt030784370
IRS990/TotalProgramServiceRevenueAmt022361432
IRS990/TotalReportableCompFromOrgAmt03046369
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt022361432
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt022361432
IRS990/TotalVolunteersCnt02
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt015785807
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt015105231
IRS990/TravelGrp/ManagementAndGeneralAmt03003
IRS990/TravelGrp/ProgramServicesAmt019916
IRS990/TravelGrp/TotalAmt022919
IRS990/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UnrestrictedNetAssetsGrp/BOYAmt014637542
IRS990/UnrestrictedNetAssetsGrp/EOYAmt014542446
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0PO BOX 1408
IRS990/USAddress/CityNm0LUMBERTON
IRS990/USAddress/StateAbbreviationCd0NC
IRS990/USAddress/ZIPCd028359
IRS990/VotingMembersGoverningBodyCnt05
IRS990/VotingMembersIndependentCnt04
IRS990/WebsiteAddressTxt0WWW.SRMC.ORG
IRS990/WhistleblowerPolicyInd0true
ReturnHeader/BuildTS02017-02-10 21:41:12Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0C THOMAS JOHNSON III
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0TREASURER
ReturnHeader/BusinessOfficerGrp/PhoneNum09106715090
ReturnHeader/BusinessOfficerGrp/SignatureDt02017-08-15
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0SOUTHEASTERN REGIONAL PHYSICIAN
ReturnHeader/Filer/BusinessName/BusinessNameLine2Txt0SERVICES
ReturnHeader/Filer/BusinessNameControlTxt0SOUT
ReturnHeader/Filer/EIN0264762805
ReturnHeader/Filer/PhoneNum09106715000
ReturnHeader/Filer/USAddress/AddressLine1Txt0PO BOX 1408 300 W 27TH STREET
ReturnHeader/Filer/USAddress/CityNm0LUMBERTON
ReturnHeader/Filer/USAddress/StateAbbreviationCd0NC
ReturnHeader/Filer/USAddress/ZIPCd0283591408
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0560731535
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0S PRESTON DOUGLAS & ASSOCIATES LLP
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0PO BOX 2339
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0LUMBERTON
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0NC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0283592339
ReturnHeader/PreparerPersonGrp/PhoneNum09107397523
ReturnHeader/PreparerPersonGrp/PreparationDt02017-08-15
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0JOHN L GRISSOM JR
ReturnHeader/ReturnTs02017-08-15T11:37:34-04:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02015-10-01
ReturnHeader/TaxPeriodEndDt02016-09-30
ReturnHeader/TaxYr02015

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