Civic Intelligence

Community Improvement Corp of Vw

EIN 34-1521028 • 501(c)6 • Van Wert, OH

Profile

ECONOMIC DEVELOPMENT

515 East Main StreetVan Wert, OH 45891
Siviq Scores

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

Liabilities / Assets

49th percentile

0.00x

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

501(c)6 • <$500k nonprofits • Source year 2016

Liabilities / Revenue

51st percentile

0.00x

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

501(c)6 • <$500k nonprofits • Source year 2016

Net Margin

11th percentile

-52%

Higher net margin than 11% of similar nonprofits.

501(c)6 • <$500k nonprofits • Source year 2016

Top Officer Pay

77th percentile

$0

Higher top officer pay than 77% of similar nonprofits.

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

501(c)6 • <$500k nonprofits • Source year 2016

Asset Growth

48th percentile

-2.5%

Faster asset growth than 48% of similar nonprofits.

501(c)6 • <$500k nonprofits • Annualized from 2015 to 2016

Revenue Growth

15th percentile

-39%

Faster revenue growth than 15% of similar nonprofits.

501(c)6 • <$500k nonprofits • Annualized from 2015 to 2016

Balance Sheet
Liabilities / Assets49th percentile

Assets

Down

$452,970

Down $11,788 (-2.5%) from 2015

Liabilities

Down

$0

Down $3,829 (-100%) from 2015

Net Assets

Down

$452,970

Down $7,959 (-1.7%) from 2015

Operations
Liabilities / Revenue51st percentileNet Margin11th percentile

Revenue

Down

$15,309

Down $9,691 (-39%) from 2015

Expenses

Up

$23,268

Up $5,772 (+33%) from 2015

Net Income

Down

-$7,959

Down $15,463 (-206%) from 2015

Trend Graphs

Balance Sheet Trend

Asset Growth48th percentile

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

$1.0M$500K$0Assets 2012: $937,016Liabilities 2012: $457,776Net Assets 2012: $479,2402012Assets 2013: $472,884Liabilities 2013: $93,074Net Assets 2013: $379,8102013Assets 2014: $462,017Liabilities 2014: $8,592Net Assets 2014: $453,4252014Assets 2015: $464,758Liabilities 2015: $3,829Net Assets 2015: $460,9292015Assets 2016: $452,970Liabilities 2016: $0Net Assets 2016: $452,9702016

Highlighted filing

2016

Assets$452,970
Liabilities$0
Net Assets$452,970
Open 2016 Filing

Operations Trend

Revenue Growth15th percentile

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

$400K$300K$200K$100K$0-$100KExpenses 2012: $346,2112012Revenue 2013: $66,596Expenses 2013: $55,210Net Income 2013: $11,3862013Revenue 2014: $84,780Expenses 2014: $11,165Net Income 2014: $73,6152014Revenue 2015: $25,000Expenses 2015: $17,496Net Income 2015: $7,5042015Revenue 2016: $15,309Expenses 2016: $23,268Net Income 2016: -$7,9592016

Highlighted filing

2016

Revenue$15,309
Expenses$23,268
Net Income-$7,959
Open 2016 Filing

Filings

Most recent year

2016 • Form 990XML pending. An XML filing is linked for this year, but detailed extraction is still pending.

Open filing
Assets
$452,970
Liabilities
$0
Net assets
$452,970
Revenue
$15,309
Expenses
$23,268
Net income
-$7,959
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$4.53$0.00$4.53$0.15$0.23$0.08
2015Detailed filing. Detailed filing data is available for this year.$4.65$0.04$4.61$0.25$0.17$0.08
2014Detailed filing. Detailed filing data is available for this year.$4.62$0.09$4.53$0.85$0.11$0.74
2013XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$4.73$0.93$3.80$0.67$0.55$0.11
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$9.37$4.58$4.79$3.46
Latest Detailed Filing

The latest 2016 filing currently has linked XML that has not been fully parsed yet. Showing the latest detailed filing from 2015 below.

Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
May 2, 2016
Return Version
2015v2.1
Gross Receipts
$25,000
Mission and Program Overview

Mission

ECONOMIC DEVELOPMENT

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$264,995$264,995→ $0
Cash and Non-Interest-Bearing Accounts$33,898$36,639▲ $2,741
Savings and Temporary Cash Investments$25,120$25,120→ $0
Total Assets$462,017$464,758▲ $2,741
Other Assets Total$138,004$138,004→ $0
Liabilities
Grants Payable$7,342$2,500▼ $4,842
Other Liabilities$1,250$1,329▲ $79
Total Liabilities$8,592$3,829▼ $4,763
Net Assets / Fund Balance
Unrestricted Net Assets$453,425$460,929▲ $7,504
Total Net Assets Fund Balance$453,425$460,929▲ $7,504
Total Liabilities and Net Assets / Fund Balance$462,017$464,758▲ $2,741

Asset Categories

AssetBook ValueDepreciationBasis
Land$264,995-$264,995
Other Assets Org$138,004--
Compensation and Service Providers
Top Officer Pay77th percentile

Board Members and Trustees

NameTitle
Jon RhoadesPresident
Bev FuerstTrustee
Bill EvansTrustee
Edd BuhlTrustee
Greg BerquistTrustee
Todd WolfrumTrustee
Tom AlexanderTrustee
Cynthia LeisAdvisor
Caitlin JonesSecretary
Steven S SamplesTreasurer
Don FarmerVice Preside
Revenue and Support

Revenue Composition

Contributions and Grants
$25,000
Program Service Revenue
$0
Investment Income
$0
Other Revenue
$0
All Other Contributions
$20,000
Change in Net Assets
$7,504
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$17,496
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
Advertising$2,358--$2,358
Insurance$1,576--$1,576
Fees for Services Legal-$1,493-$1,493
Conferences and Meetings-$1,222-$1,222
Other Expenses$3,296$36-$36
Office Expenses-$27-$27
Occupancy-$-623-$-623
Total Functional Expenses$12,630$4,866$0$17,496
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
Subject to proxy tax
No
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Entrepreneur Fair/business Plan$1,329
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Backup withholding compliance
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
No

Governance Explanations

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

“The treasurer is signing as the paid preparer and he is the process by which the return is review by the organization.”

Form 990, Page 6, Part VI, Line 19

“Available for inspection at van wert city hall”

Filing and Contact Details

Filer

Filer Name
Community Improvement Corp of Vw
EIN
34-1521028
Phone
4192382000
Address
515 EAST MAIN STREET, VAN WERT, OH 45891

Signing Officer

Name
Steven S Samples
Title
Treasurer
Phone
4192382999
Signed
2016-05-02
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Steven S Samples
Formed
1992
Legal Domicile
Oh
Voting Board Members
11
Independent Board Members
11
Employees
0
Volunteers
15

Preparer

Firm
Shultz Huber & Associates Inc
Address
595 FOX RD, VAN WERT, OH 45891-2457
Preparer
Steven S Samples
Phone
4192382000
Raw XML Appendix328 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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IRS990/ActivitiesConductedPrtshpInd0false
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IRS990/AdvertisingGrp/TotalAmt02358
IRS990/AllOtherContributionsAmt020000
IRS990/BackupWthldComplianceInd0false
IRS990/BooksInCareOfDetail/PersonNm0STEVEN S SAMPLES
IRS990/BooksInCareOfDetail/PhoneNum04192382000
IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt0595 FOX ROAD
IRS990/BooksInCareOfDetail/USAddress/CityNm0VAN WERT
IRS990/BooksInCareOfDetail/USAddress/StateAbbreviationCd0OH
IRS990/BooksInCareOfDetail/USAddress/ZIPCd045891
IRS990/BusinessRlnWithFamMemInd0false
IRS990/BusinessRlnWithOfficerEntInd0false
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IRS990/CashNonInterestBearingGrp/BOYAmt033898
IRS990/CashNonInterestBearingGrp/EOYAmt036639
IRS990/ChangeToOrgDocumentsInd0false
IRS990/CollectionsOfArtInd0false
IRS990/CompensationFromOtherSrcsInd0false
IRS990/CompensationProcessCEOInd0false
IRS990/CompensationProcessOtherInd0false
IRS990/ConferencesMeetingsGrp/ManagementAndGeneralAmt01222
IRS990/ConferencesMeetingsGrp/TotalAmt01222
IRS990/ConflictOfInterestPolicyInd0false
IRS990/ConservationEasementsInd0false
IRS990/ConsolidatedAuditFinclStmtInd0false
IRS990/CreditCounselingInd0false
IRS990/CYBenefitsPaidToMembersAmt00
IRS990/CYContributionsGrantsAmt025000
IRS990/CYGrantsAndSimilarPaidAmt00
IRS990/CYInvestmentIncomeAmt00
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IRS990/CYOtherRevenueAmt00
IRS990/CYProgramServiceRevenueAmt00
IRS990/CYRevenuesLessExpensesAmt07504
IRS990/CYSalariesCompEmpBnftPaidAmt00
IRS990/CYTotalExpensesAmt017496
IRS990/CYTotalFundraisingExpenseAmt00
IRS990/CYTotalProfFndrsngExpnsAmt00
IRS990/CYTotalRevenueAmt025000
IRS990/DecisionsSubjectToApprovaInd0false
IRS990/DeductibleArtContributionInd0false
IRS990/DeductibleNonCashContriInd0false
IRS990/DelegationOfMgmtDutiesInd0false
IRS990/Desc0ECONOMIC DEVELOPMENT OTHER IS WORKING TO DEVELOP A 1600 ACRE SUPER SITE TO
IRS990/DescribedInSection501c3Ind0false
IRS990/DisregardedEntityInd0false
IRS990/DocumentRetentionPolicyInd0false
IRS990/DonorAdvisedFundInd0false
IRS990/ElectionOfBoardMembersInd0false
IRS990/EmployeeCnt00
IRS990/ExpenseAmt08696
IRS990/FamilyOrBusinessRlnInd0false
IRS990/FederalGrantAuditRequiredInd0false
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IRS990/FeesForServicesLegalGrp/TotalAmt01493
IRS990/ForeignActivitiesInd0false
IRS990/ForeignFinancialAccountInd0false
IRS990/ForeignOfficeInd0false
IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt01.00
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IRS990/Form990PartVIISectionAGrp/OfficerInd0X
IRS990/Form990PartVIISectionAGrp/OfficerInd1X
IRS990/Form990PartVIISectionAGrp/OfficerInd2X
IRS990/Form990PartVIISectionAGrp/OfficerInd3X
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt00
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt10
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt20
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt30
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IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt100
IRS990/Form990PartVIISectionAGrp/PersonNm0STEVEN S SAMPLES
IRS990/Form990PartVIISectionAGrp/PersonNm1JON RHOADES
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IRS990/Form990PartVIISectionAGrp/PersonNm3TOM ALEXANDER
IRS990/Form990PartVIISectionAGrp/PersonNm4CAITLIN JONES
IRS990/Form990PartVIISectionAGrp/PersonNm5BEV FUERST
IRS990/Form990PartVIISectionAGrp/PersonNm6TODD WOLFRUM
IRS990/Form990PartVIISectionAGrp/PersonNm7GREG BERQUIST
IRS990/Form990PartVIISectionAGrp/PersonNm8BILL EVANS
IRS990/Form990PartVIISectionAGrp/PersonNm9CYNTHIA LEIS
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IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt00
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IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt30
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IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt100
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt00
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IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt50
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IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt100
IRS990/Form990PartVIISectionAGrp/TitleTxt0TREASURER
IRS990/Form990PartVIISectionAGrp/TitleTxt1PRESIDENT
IRS990/Form990PartVIISectionAGrp/TitleTxt2VICE PRESIDE
IRS990/Form990PartVIISectionAGrp/TitleTxt3TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt4SECRETARY
IRS990/Form990PartVIISectionAGrp/TitleTxt5TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt6TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt7TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt8TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt9ADVISOR
IRS990/Form990PartVIISectionAGrp/TitleTxt10TRUSTEE
IRS990/Form990ProvidedToGvrnBodyInd0false
IRS990/FormationYr01992
IRS990/FormerOfcrEmployeesListedInd0false
IRS990/FSAuditedInd0false
IRS990/FundraisingActivitiesInd0false
IRS990/GamingActivitiesInd0false
IRS990/GoverningBodyVotingMembersCnt011
IRS990/GovernmentGrantsAmt05000
IRS990/GrantsPayableGrp/BOYAmt07342
IRS990/GrantsPayableGrp/EOYAmt02500
IRS990/GrantsToIndividualsInd0false
IRS990/GrantsToOrganizationsInd0false
IRS990/GrantToRelatedPersonInd0false
IRS990/GrossReceiptsAmt025000
IRS990/GroupReturnForAffiliatesInd0false
IRS990/IncludeFIN48FootnoteInd0false
IRS990/IndependentAuditFinclStmtInd0false
IRS990/IndependentVotingMemberCnt011
IRS990/IndoorTanningServicesInd0false
IRS990/InfoInScheduleOPartVIInd0X
IRS990/InsuranceGrp/ProgramServicesAmt01576
IRS990/InsuranceGrp/TotalAmt01576
IRS990/InvestmentInJointVentureInd0false
IRS990/IRPDocumentCnt00
IRS990/IRPDocumentW2GCnt00
IRS990/LandBldgEquipBasisNetGrp/BOYAmt0264995
IRS990/LandBldgEquipBasisNetGrp/EOYAmt0264995
IRS990/LandBldgEquipCostOrOtherBssAmt0264995
IRS990/LegalDomicileStateCd0OH
IRS990/LoanOutstandingInd0false
IRS990/LocalChaptersInd0false
IRS990/MaterialDiversionOrMisuseInd0false
IRS990/MembersOrStockholdersInd0false
IRS990/MethodOfAccountingCashInd0X
IRS990/MinutesOfCommitteesInd0true
IRS990/MinutesOfGoverningBodyInd0true
IRS990/MissionDesc0ECONOMIC DEVELOPMENT
IRS990/MoreThan5000KToIndividualsInd0false
IRS990/MoreThan5000KToOrgInd0false
IRS990/NetAssetsOrFundBalancesBOYAmt0453425
IRS990/NetAssetsOrFundBalancesEOYAmt0460929
IRS990/NoListedPersonsCompensatedInd0X
IRS990/NondeductibleContributionsInd0false
IRS990/OccupancyGrp/ManagementAndGeneralAmt0-623
IRS990/OccupancyGrp/TotalAmt0-623
IRS990/OfficeExpensesGrp/ManagementAndGeneralAmt027
IRS990/OfficeExpensesGrp/TotalAmt027
IRS990/OfficerMailingAddressInd0false
IRS990/OperateHospitalInd0false
IRS990/Organization501cInd0X
IRS990/OrganizationFollowsSFAS117Ind0X
IRS990/OtherAssetsTotalGrp/BOYAmt0138004
IRS990/OtherAssetsTotalGrp/EOYAmt0138004
IRS990/OtherExpensesGrp/Desc0MEGASITE SURVEY COSTS
IRS990/OtherExpensesGrp/Desc1DUES
IRS990/OtherExpensesGrp/Desc2TRAINING
IRS990/OtherExpensesGrp/Desc3BWC EXPENSE
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IRS990/OtherExpensesGrp/TotalAmt336
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IRS990/PartialLiquidationInd0false
IRS990/PoliticalCampaignActyInd0false
IRS990/PrincipalOfficerNm0STEVEN S SAMPLES
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IRS990/ProgSrvcAccomActy2Grp/ExpenseAmt03934
IRS990/ProhibitedTaxShelterTransInd0false
IRS990/PYContributionsGrantsAmt010340
IRS990/PYOtherExpensesAmt011165
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IRS990/ReportOtherAssetsInd0true
IRS990/ReportOtherLiabilitiesInd0true
IRS990/ReportProgramRelatedInvstInd0false
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IRS990ScheduleB/ContributorInformationGrp/ContributorBusinessName/BusinessNameLine10RESTRICTED
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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
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IRS990ScheduleD/OtherAssetsOrgGrp/Desc0OPTIONS
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt01329
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc0ENTREPRENEUR FAIR/BUSINESS PLAN
IRS990ScheduleD/TotalBookValueLandBuildingsAmt0264995
IRS990ScheduleD/TotalBookValueOtherAssetsAmt0138004
IRS990ScheduleD/TotalLiabilityAmt01329
IRS990/ScheduleJRequiredInd0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0THE TREASURER IS SIGNING AS THE PAID PREPARER AND HE IS THE PROCESS BY WHICH THE RETURN IS REVIEW BY THE ORGANIZATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1AVAILABLE FOR INSPECTION AT VAN WERT CITY HALL
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PAGE 6, PART VI, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PAGE 6, PART VI, LINE 19
IRS990/SchoolOperatingInd0false
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IRS990/SubjectToProxyTaxInd0false
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IRS990/TaxExemptBondsInd0false
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IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt0462017
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IRS990/TotalAssetsGrp/BOYAmt0462017
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IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt025000
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt04866
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt012630
IRS990/TotalFunctionalExpensesGrp/TotalAmt017496
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt08592
IRS990/TotalLiabilitiesEOYAmt03829
IRS990/TotalLiabilitiesGrp/BOYAmt08592
IRS990/TotalLiabilitiesGrp/EOYAmt03829
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0453425
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0460929
IRS990/TotalProgramServiceExpensesAmt012630
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt025000
IRS990/TotalVolunteersCnt015
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0462017
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt0464758
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UnrestrictedNetAssetsGrp/BOYAmt0453425
IRS990/UnrestrictedNetAssetsGrp/EOYAmt0460929
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0595 FOX RD
IRS990/USAddress/CityNm0VAN WERT
IRS990/USAddress/StateAbbreviationCd0OH
IRS990/USAddress/ZIPCd045891
IRS990/VotingMembersGoverningBodyCnt011
IRS990/VotingMembersIndependentCnt011
IRS990/WhistleblowerPolicyInd0false
ReturnHeader/BuildTS02016-09-27 15:27:22Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0STEVEN S SAMPLES
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0TREASURER
ReturnHeader/BusinessOfficerGrp/PhoneNum04192382999
ReturnHeader/BusinessOfficerGrp/SignatureDt02016-05-02
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0COMMUNITY IMPROVEMENT CORP OF VW
ReturnHeader/Filer/BusinessNameControlTxt0COMM
ReturnHeader/Filer/EIN0341521028
ReturnHeader/Filer/PhoneNum04192382000
ReturnHeader/Filer/USAddress/AddressLine1Txt0515 EAST MAIN STREET
ReturnHeader/Filer/USAddress/CityNm0VAN WERT
ReturnHeader/Filer/USAddress/StateAbbreviationCd0OH
ReturnHeader/Filer/USAddress/ZIPCd045891
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0341769212
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0SHULTZ HUBER & ASSOCIATES INC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0595 FOX RD
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0VAN WERT
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0OH
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0458912457
ReturnHeader/PreparerPersonGrp/PhoneNum04192382000
ReturnHeader/PreparerPersonGrp/PreparationDt02016-05-04
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0STEVEN S SAMPLES
ReturnHeader/ReturnTs02016-05-05T12:05:30-05:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02015-01-01
ReturnHeader/TaxPeriodEndDt02015-12-31
ReturnHeader/TaxYr02015

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