Civic Intelligence

Physicians Medical Forum

990 • Fiscal year 2014 • EIN 30-0086728

Jul 01, 2013 to Jun 30, 2014 • Filed on Nov 13, 2014

2201 Broadway94612

(510) 562-5560

Siviq Scores

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

Liabilities / Assets

55th percentile

0.00x

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

2014 filings • 501(c)3 • <$500k nonprofits • Source year 2014

Liabilities / Revenue

55th percentile

0.00x

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

2014 filings • 501(c)3 • <$500k nonprofits • Source year 2014

Net Margin

12th percentile

-27%

Higher net margin than 12% of similar nonprofits.

2014 filings • 501(c)3 • <$500k nonprofits • Source year 2014

Top Officer Pay

93rd percentile

$54,000

Higher top officer pay than 93% of similar nonprofits.

Top officer pay equals 14.6% of source-year revenue.

2014 filings • 501(c)3 • <$500k nonprofits • Source year 2014

Asset Growth

11th percentile

-40%

Faster asset growth than 11% of similar nonprofits.

2014 filings • 501(c)3 • <$500k nonprofits • Annualized from 2013 to 2014

Revenue Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2014

Assets

Down

$279,339

Down $188,184 (-40%) from 2013

Net Assets

Down

$279,339

Down $188,184 (-40%) from 2013

Liabilities

Flat

$0

Flat from 2013

Revenue

$370,450

No earlier filing loaded for comparison.

Expenses

Up

$472,152

Up $142,303 (+43%) from 2013

Net Income

-$101,702

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

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

$1.5M$1.0M$500K$0-$500K-$1.0MAssets 2013: $467,523Liabilities 2013: $0Net Assets 2013: $467,5232013Assets 2014: $279,339Liabilities 2014: $0Net Assets 2014: $279,3392014Assets 2015: $0Liabilities 2015: $0Net Assets 2015: $02015Assets 2016: $0Liabilities 2016: $0Net Assets 2016: $02016Assets 2017: $0Liabilities 2017: $0Net Assets 2017: $02017Assets 2018: $0Liabilities 2018: $0Net Assets 2018: $02018Assets 2019: $0Liabilities 2019: $0Net Assets 2019: $02019Assets 2020: $152,732Liabilities 2020: $0Net Assets 2020: $152,7322020Assets 2021: $234,282Liabilities 2021: $0Net Assets 2021: $234,2822021Assets 2022: $144,909Liabilities 2022: $0Net Assets 2022: $144,9092022Assets 2023: $438,110Liabilities 2023: -$612,925Net Assets 2023: $1,051,0352023Assets 2024: $379,254Liabilities 2024: $18,320Net Assets 2024: $360,9342024

Highlighted filing

2014

Assets$279,339
Liabilities$0
Net Assets$279,339

Operations Trend

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

$600K$400K$200K$0-$200KExpenses 2013: $329,8492013Revenue 2014: $370,450Expenses 2014: $472,152Net Income 2014: -$101,7022014Revenue 2015: $115,500Expenses 2015: $189,798Net Income 2015: -$74,2982015Revenue 2016: $273,600Expenses 2016: $275,846Net Income 2016: -$2,2462016Revenue 2017: $233,176Expenses 2017: $248,924Net Income 2017: -$15,7482017Revenue 2018: $114,551Expenses 2018: $250,941Net Income 2018: -$136,3902018Revenue 2019: $310,000Expenses 2019: $277,934Net Income 2019: $32,0662019Revenue 2020: $0Expenses 2020: $180,455Net Income 2020: -$180,4552020Revenue 2021: $115,350Expenses 2021: $146,807Net Income 2021: -$31,4572021Revenue 2022: $368,662Expenses 2022: $346,476Net Income 2022: $22,1862022Revenue 2023: $313,192Expenses 2023: $202,154Net Income 2023: $111,0382023Revenue 2024: $205,067Expenses 2024: $254,158Net Income 2024: -$49,0912024

Highlighted filing

2014

Revenue$370,450
Expenses$472,152
Net Income-$101,702
Jump To
Filing Snapshot
Filing Period
Jul 1, 2013 to Jun 30, 2014
Signed
Nov 13, 2014
Return Version
2013v3.1
Gross Receipts
$370,450
Mission and Program Overview

Mission

Encourage the recruitment and

Encourage the recruitment and retention of African American physicians, and thereby help to eliminate health disparities, imporve access to care and improve the quality of life and medical care for citizens in the SF/Bay Area

Balance Sheet Detail
LineBeginningEndChange
Assets
Rtn Earn Endowment Incm Other Fnds$467,523$279,339▼ $188,184
Savings and Temporary Cash Investments$464,928$276,744▼ $188,184
Prepaid Expenses and Deferred Charges$2,595$2,595→ $0
Total Assets$467,523$279,339▼ $188,184
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Total Net Assets Fund Balance$467,523$279,339▼ $188,184
Total Liabilities and Net Assets / Fund Balance$467,523$279,339▼ $188,184
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseTotal
Stalfana Bello BroadheadExecutive DirectorFT$54,000$54,000

Board Members and Trustees

NameTitle
Albert L Brooks MdPresident
Carol Miller MdDirector
Kathryn Malone MdDirector
Renee Navarro MdDirector
Thurman Hunt MdDirector
Tiffany WilliamsDirector
Warren J Strudwick MdChief financial Officer
Michelle Shute MdSecretary
Revenue and Support

Revenue Composition

Contributions and Grants
$370,450
Program Service Revenue
$0
Investment Income
$0
Other Revenue
$0
All Other Contributions
$370,450
Change in Net Assets
$-101,702

Noncash Contribution Practices

Property subject to holding requirements
No
Reviewed unusual noncash gifts
Yes
Third parties used for noncash contributions
No

Noncash Contributions

Contribution TypeReported Amount
Other Non Cash Contri Table$280,000
Total Noncash Contributions$280,000
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$410,747
Salaries, Compensation, and Employee Benefits$61,405
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
All Other Expenses$275,386$90,185$0$365,571
Current Officers, Directors, Trustees, and Key Employees$43,200$10,800$0$54,000
Occupancy$18,866$12,577$0$31,443
Payroll Taxes$5,051$1,263$0$6,314
Fees for Services Accounting$0$4,624$0$4,624
Insurance$0$3,167$0$3,167
Information Technology$0$1,765$0$1,765
Depreciation Depletion$0$1,301$0$1,301
Office Expenses$0$1,161$0$1,161
Other Employee Benefits$0$1,091$0$1,091
Conferences and Meetings$0$800$0$800
Total Functional Expenses$342,503$129,649$0$472,152
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
Yes
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
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
No
Key decisions subject to board approval
No
Management duties delegated
No
Filing and Contact Details

Filer

EIN
30-0086728
Phone
5105625560

Signing Officer

Name
Warren Strudwick Md
Title
Board Officer
Phone
5105625560
Signed
2014-11-13
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Stalfana Bello
Formed
2002
Legal Domicile
CA
Voting Board Members
9
Independent Board Members
0
Employees
1
Volunteers
25

Preparer

Preparer
Mittie Grigsby
Phone
5106384878
Supplemental Narrative

Additional Explanations

Pt VI, Line 11B

Accountants prepares return,Exec Dir & Pres &CFo review nad approve

Pt VI, Line 12C

Annual reviews are done with legal review

Pt VI, Line 15A

Yes, business attorney recommendation based on non-profit model

Pt VI, Line 19

Interested parties contact org. and appt is set for review

Pt V, Line 14B

Organization does not provide this service

Pt V, Line 3B

Organization does not have this type of income

Pt VI, Line 15B

Review performed by board members

Pt XI

Net change in investment accounts

Form 990, Part III, Line 4D

Branding development & other program costs 265568. 0. 0.

Raw XML Appendix393 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/Desc0THE PMF "DOCTOR ON BOARD" PROGRAM (DOB)AND COMMUNITY HEALTH AMBASSADOR PROGRAM (CHA) ARE PIPELINE PROGRAMS TO ENCOURAGE YOUNG, AFRICAN AMERICAN PRE-MED, COLLEGE/UNIVERSITY, COMMUNITY COLLEGE, POST-BACCALAUREATE STUDENTS AND HIGH SCHOOL JUNIORS AND SENIORS WHO WANT TO BECOME PHYSICIANS TO ATTEND AN INNOVATIVE ALL DAY CONFERENCE. STUDENTS RECEIVE INFORMATION ON APPLYING FOR MEDICAL SCHOOLS, MCAT, FINANCIAL AID, NETWORK WITH FACULTY, MEDICAL SCHOOL ADMINISTRATORS, PHYSICIANS IN THE COMMUNITY, ATTEND MOCK MEDICAL CLINICS AND MOCK KNOT TYING/SUTURING CLINICS, AND RECEIVE MATERIAL ON BECOMING PHYSICIANS.
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IRS990/Form990PartVIISectionAGrp/PersonNm5THURMAN HUNT MD
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IRS990/Form990PartVIISectionAGrp/PersonNm7TIFFANY WILLIAMS
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IRS990/Form990PartVIISectionAGrp/TitleTxt0Executive Director
IRS990/Form990PartVIISectionAGrp/TitleTxt1President
IRS990/Form990PartVIISectionAGrp/TitleTxt2Chief financial Officer
IRS990/Form990PartVIISectionAGrp/TitleTxt3Secretary
IRS990/Form990PartVIISectionAGrp/TitleTxt4Director
IRS990/Form990PartVIISectionAGrp/TitleTxt5Director
IRS990/Form990PartVIISectionAGrp/TitleTxt6Director
IRS990/Form990PartVIISectionAGrp/TitleTxt7Director
IRS990/Form990PartVIISectionAGrp/TitleTxt8Director
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IRS990/ProgSrvcAccomActy2Grp/Desc0RECRUITMENT OF AFRICAN AMERICAN RESIDENTS AND MEDICAL STUDENTS THAT UPON THEIR COMPLETION OF THEIR ENDUCATION AND TRAINING, TO PURSE CAREERS AS PHYSICIANS AND REMAIN IN OR COME TO ALAMEDA, CONTRA COSTA OR SAN FRANCISCO COUNTIES TO PRACTICE MEDICINE.
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IRS990/ProgSrvcAccomActy3Grp/Desc0TO MAINTAIN STRATEGIC OPERATONS, OUTREACH, EDUCATION AND FUND DEVELOPMENT TO SUPPORT THE ORGANIZATIONS' VISION, MISSION, GOALS AND OBJECTIVES OF AFRICAN AMERICANS PHYSICIANS, RESIDENTS, MEDICAL STUDENTS AND PIPELINE PROGRAMS PURSING CAREERS AS PHYSICIANS IN ALAMEDA, CONTRA COSTA AND SAN FRANCISCO COUNTIES
IRS990/ProgSrvcAccomActy3Grp/ExpenseAmt024793
IRS990/ProgSrvcAccomActyOtherGrp/Desc0Branding Development & Other Program Costs To strive to provide a sustainable network and To strive to provide a sustainable network and To strive to provide a sustainable network and To strive to provide a sustainable network and To strive to provide a sustainable network and To strive to provide a sustainable network and
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IRS990ScheduleA/GrossInvestmentIncome509Grp/TotalAmt09071
IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearMinus4YearsAmt09071
IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/TotalAmt09071
IRS990ScheduleA/InvestmentIncomeCYPct00.00500
IRS990ScheduleA/InvestmentIncomePYPct00.01200
IRS990ScheduleA/PubliclySupportedOrg509a2Ind0X
IRS990ScheduleA/PublicSupportCY170Pct00
IRS990ScheduleA/PublicSupportCY509Pct00.99500
IRS990ScheduleA/PublicSupportPY509Pct00.98800
IRS990ScheduleA/PublicSupportTotal170Amt00
IRS990ScheduleA/PublicSupportTotal509Amt01800171
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY509Ind0X
IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt0480450
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt0275500
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt0387600
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt0329050
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt0327571
IRS990ScheduleA/Total509Grp/TotalAmt01800171
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt01809242
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
IRS990/ScheduleBRequiredInd0true
IRS990/ScheduleJRequiredInd0false
IRS990ScheduleM/AnyPropertyThatMustBeHeldInd0false
IRS990ScheduleM/OtherNonCashContriTableGrp/Desc0In-Kind contributions
IRS990ScheduleM/OtherNonCashContriTableGrp/NoncashContributionsRptF990Amt0280000
IRS990ScheduleM/ReviewProcessUnusualNCGiftsInd0true
IRS990ScheduleM/ThirdPartiesUsedInd0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0Accountants prepares return,Exec Dir & Pres &CFo review nad approve
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1Annual reviews are done with legal review
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2Yes, business attorney recommendation based on non-profit model
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3Interested parties contact org. and appt is set for review
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4Organization does not provide this service
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5Organization does not have this type of income
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6Review performed by board members
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7Net change in investment accounts
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt8BRANDING DEVELOPMENT & OTHER PROGRAM COSTS 265568. 0. 0.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Pt VI, Line 11b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Pt VI, Line 12c
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2Pt VI, Line 15a
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3Pt VI, Line 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4Pt V, Line 14b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5Pt V, Line 3b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6Pt VI, Line 15b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7Pt XI
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc8Form 990, Part III, Line 4d
IRS990/SchoolOperatingInd0false
IRS990/SignificantChangeInd0false
IRS990/SignificantNewProgramSrvcInd0false
IRS990/StatesWhereCopyOfReturnIsFldCd0CA
IRS990/SubjectToProxyTaxInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TempOrPermanentEndowmentsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt0467523
IRS990/TotalAssetsEOYAmt0279339
IRS990/TotalAssetsGrp/BOYAmt0467523
IRS990/TotalAssetsGrp/EOYAmt0279339
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt0370450
IRS990/TotalEmployeeCnt01
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt0129649
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0342503
IRS990/TotalFunctionalExpensesGrp/TotalAmt0472152
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt00
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0467523
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0279339
IRS990/TotalOtherProgSrvcExpenseAmt0265568
IRS990/TotalProgramServiceExpensesAmt0342503
IRS990/TotalReportableCompFromOrgAmt054000
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0370450
IRS990/TotalVolunteersCnt025
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0467523
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt0279339
IRS990/TransactionWithControlEntInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine102201 Broadway 212
IRS990/USAddress/City0Oakland
IRS990/USAddress/State0CA
IRS990/USAddress/ZIPCode094612
IRS990/VotingMembersGoverningBodyCnt09
IRS990/VotingMembersIndependentCnt00
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd0true
ReturnHeader/BuildTS02015-11-30 17:44:51Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0WARREN STRUDWICK MD
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0BOARD OFFICER
ReturnHeader/BusinessOfficerGrp/PhoneNum05105625560
ReturnHeader/BusinessOfficerGrp/SignatureDt02014-11-13
ReturnHeader/Filer/BusinessName/BusinessNameLine10Physicians Medical Forum
ReturnHeader/Filer/BusinessNameControlTxt0PHYS
ReturnHeader/Filer/EIN0300086728
ReturnHeader/Filer/PhoneNum05105625560
ReturnHeader/Filer/USAddress/AddressLine102201 Broadway
ReturnHeader/Filer/USAddress/City0Oakland
ReturnHeader/Filer/USAddress/State0CA
ReturnHeader/Filer/USAddress/ZIPCode094612
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine10Grigsby Finance and Tax Services
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine108050 Hansom Drive
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/City0Oakland
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/State0CA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCode094605
ReturnHeader/PreparerPersonGrp/PhoneNum05106384878
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0MITTIE GRIGSBY
ReturnHeader/PreparerPersonGrp/SelfEmployedInd0X
ReturnHeader/ReturnTs02014-11-13T15:39:28-08:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02013-07-01
ReturnHeader/TaxPeriodEndDt02014-06-30
ReturnHeader/TaxYr02013

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.38$0.02$0.36$0.21$0.25$0.05
2023XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.44$0.61$1.05$0.31$0.20$0.11
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.14$0.00$0.14$0.37$0.35$0.02
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.23$0.00$0.23$0.12$0.15$0.03
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.15$0.00$0.15$0.00$0.18$0.18
2019Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.00$0.00$0.00$0.31$0.28$0.03
2018XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.00$0.00$0.00$0.11$0.25$0.14
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.00$0.00$0.00$0.23$0.25$0.02
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.00$0.00$0.00$0.27$0.28$0.00
2015Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.12$0.19$0.07
2014Detailed filing. Detailed filing data is available for this year.$0.28$0.00$0.28$0.37$0.47$0.10
2013Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.47$0.00$0.47$0.33