Civic Intelligence

Indiana Self-Insurer'S Inc

EIN 35-1420875 • 501(c)6 • Syracuse, IN

Profile

To educate its members, to maintain an equitable worker's compensation law and assure that the administration of the workers compensation act meets the needs of injured employees and their employers

PO Box 160Syracuse, IN 46567-1060

www.indianaselfinsurers.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 2020

Liabilities / Revenue

Score unavailable

No value available

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

Source year 2020

Net Margin

65th percentile

8.3%

Higher net margin than 65% of similar nonprofits.

501(c)6 • <$500k nonprofits • Source year 2020

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 2020

Asset Growth

8th percentile

-100%

Faster asset growth than 8% of similar nonprofits.

501(c)6 • <$500k nonprofits • Annualized from 2019 to 2020

Revenue Growth

48th percentile

-1.4%

Faster revenue growth than 48% of similar nonprofits.

501(c)6 • <$500k nonprofits • Annualized from 2019 to 2020

Balance Sheet
Liabilities / AssetsScore unavailable

Assets

Down

$0

Down $3,844 (-100%) from 2019

Liabilities

-

No earlier filing loaded for comparison.

Net Assets

Down

$0

Down $3,844 (-100%) from 2019

Operations
Liabilities / RevenueScore unavailableNet Margin65th percentile

Revenue

Down

$8,500

Down $125 (-1.4%) from 2019

Expenses

Down

$7,793

Down $8,173 (-51%) from 2019

Net Income

Up

$707

Up $8,048 (+110%) from 2019

Trend Graphs

Balance Sheet Trend

Asset Growth8th percentile

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

$15K$10K$5.0K$0Assets 2010: $9,926Net Assets 2010: $9,9262010Assets 2011: $2,142Net Assets 2011: $2,1422011Assets 2012: $2,947Net Assets 2012: $2,9472012Assets 2013: $2,463Net Assets 2013: $2,4632013Assets 2014: $6,320Net Assets 2014: $6,3202014Assets 2015: $8,070Net Assets 2015: $8,0702015Assets 2016: $6,549Net Assets 2016: $6,5492016Assets 2017: $8,758Net Assets 2017: $8,7582017Assets 2018: $11,185Net Assets 2018: $11,1852018Assets 2019: $3,844Net Assets 2019: $3,8442019Assets 2020: $0Net Assets 2020: $02020

Highlighted filing

2020

Assets$0
Liabilities-
Net Assets$0
Open 2020 Filing

Operations Trend

Revenue Growth48th percentile

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

$40K$30K$20K$10K$0-$10KRevenue 2010: $30,260Expenses 2010: $25,425Net Income 2010: $4,8352010Revenue 2011: $20,620Expenses 2011: $28,404Net Income 2011: -$7,7842011Revenue 2012: $17,275Expenses 2012: $16,470Net Income 2012: $8052012Revenue 2013: $15,825Expenses 2013: $16,309Net Income 2013: -$4842013Revenue 2014: $17,555Expenses 2014: $13,698Net Income 2014: $3,8572014Revenue 2015: $18,950Expenses 2015: $17,200Net Income 2015: $1,7502015Revenue 2016: $13,210Expenses 2016: $14,731Net Income 2016: -$1,5212016Revenue 2017: $15,400Expenses 2017: $13,191Net Income 2017: $2,2092017Revenue 2018: $16,145Expenses 2018: $13,718Net Income 2018: $2,4272018Revenue 2019: $8,625Expenses 2019: $15,966Net Income 2019: -$7,3412019Revenue 2020: $8,500Expenses 2020: $7,793Net Income 2020: $7072020

Highlighted filing

2020

Revenue$8,500
Expenses$7,793
Net Income$707
Open 2020 Filing

Filings

Most recent year

2020 • Form 990EZDetailed filing. Detailed filing data is available for this year.

Open filing
Assets
$0
Liabilities
-
Net assets
$0
Revenue
$8,500
Expenses
$7,793
Net income
$707
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2020Detailed filing. Detailed filing data is available for this year.$0.00$0.00$8.50$7.79$0.71
2019Detailed filing. Detailed filing data is available for this year.$3.84$3.84$8.63$16.0$7.34
2018Detailed filing. Detailed filing data is available for this year.$11.2$11.2$16.1$13.7$2.43
2017Detailed filing. Detailed filing data is available for this year.$8.76$8.76$15.4$13.2$2.21
2016Detailed filing. Detailed filing data is available for this year.$6.55$6.55$13.2$14.7$1.52
2015Detailed filing. Detailed filing data is available for this year.$8.07$8.07$19.0$17.2$1.75
2014Detailed filing. Detailed filing data is available for this year.$6.32$6.32$17.6$13.7$3.86
2013Detailed filing. Detailed filing data is available for this year.$2.46$2.46$15.8$16.3$0.48
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$2.95$2.95$17.3$16.5$0.81
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$2.14$2.14$20.6$28.4$7.78
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$9.93$9.93$30.3$25.4$4.84
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2020 to Dec 31, 2020
Signed
Feb 22, 2021
Return Version
2020v4.0
Gross Receipts
$8,500
Mission and Program Overview

Mission

To educate its members, to maintain an equitable worker's compensation law and assure that the administration of the workers compensation act meets the needs of injured employees and their employers

Program Services

DescriptionGrantsExpenses
ISIA PROVIDES A FORUM FOR EDUCATION AND ACTION TO ITS MEMBERS THROUGH INSTRUCTIONAL SEMINARS--
TO PROVIDE EDUCATION TO EMPLOYERS THROUGH INSTRUCTIONAL SEMINARS--
Compensation and Service Providers
Top Officer Pay77th percentile

Employees

NameTitleFull / Part TimeBaseOtherTotal
ROBERT FANNINGExec Directo-$0--
JERRY WILLIAMSPresident/Di-$0--
JESSICA AMOSVice-Preside-$0--
JESSICA AMOSSec/Treas/Di-$0--
SANDY FRALICHDirector-$0--
GARY GONTHIERDirector-$0--
MICHAEL HOUGHDirector-$0--
Filing and Contact Details

Filer

Filer Name
INDIANA SELF-INSURER'S INC
EIN
35-1420875
Phone
5744577600
Address
PO BOX 160, SYRACUSE, IN 46567-1060

Signing Officer

Name
Robert Fanning
Title
Exec Director
Phone
5744577600
Signed
2021-02-22
Discuss with paid preparer
Yes

Preparer

Firm
R Steven Perry CPA Pc
Address
3960 NAPLES DRIVE, COLUMBUS, IN 47203-8356
Preparer
R Steven Perry
Phone
8123481040
Supplemental Narrative

Additional Explanations

Form 990-ez, Part I, Line 16

“Expenses administrative fees 6,000 office expense 1,143 miscellaneous fees 30 dues 120 total 7,293”

Form 990-ez, Part I, Line 20

“ACCOUNTS PAYABLE -4,551”

Form 990-ez, Part III

“To educate its members, to maintain an equitable worker's compensation law and assure that the administration of the workers compensation act meets the needs of injured employees and their employers”

Form 990-ez, Part III, Line 31

“To provide education to employers through instructional seminars”

Raw XML Appendix174 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
CompensationExplanation/CompensationExplanationGrp/PersonNm0ROBERT FANNING
CompensationExplanation/CompensationExplanationGrp/PersonNm1JERRY WILLIAMS
CompensationExplanation/CompensationExplanationGrp/PersonNm2JESSICA AMOS
CompensationExplanation/CompensationExplanationGrp/PersonNm3JESSICA AMOS
CompensationExplanation/CompensationExplanationGrp/PersonNm4SANDY FRALICH
CompensationExplanation/CompensationExplanationGrp/PersonNm5GARY GONTHIER
CompensationExplanation/CompensationExplanationGrp/PersonNm6MICHAEL HOUGH
IRS990EZ/ActivitiesNotPreviouslyRptInd0false
IRS990EZ/BooksInCareOfDetail/PersonNm0ROBERT FANNING
IRS990EZ/BooksInCareOfDetail/PhoneNum05744577600
IRS990EZ/BooksInCareOfDetail/USAddress/AddressLine1Txt0PO BOX 160
IRS990EZ/BooksInCareOfDetail/USAddress/CityNm0SYRACUSE
IRS990EZ/BooksInCareOfDetail/USAddress/StateAbbreviationCd0IN
IRS990EZ/BooksInCareOfDetail/USAddress/ZIPCd0465671060
IRS990EZ/CashSavingsAndInvestmentsGrp/BOYAmt03844
IRS990EZ/ChgMadeToOrgnzngDocNotRptInd0false
IRS990EZ/DonorAdvisedFndsInd0false
IRS990EZ/ExcessOrDeficitForYearAmt0707
IRS990EZ/FeesAndOtherPymtToIndCntrctAmt0500
IRS990EZ/FinalReturnInd0X
IRS990EZ/ForeignFinancialAccountInd0false
IRS990EZ/ForeignOfficeInd0false
IRS990EZ/Form1120PolFiledInd0false
IRS990EZ/Form990TotalAssetsGrp/BOYAmt03844
IRS990EZ/Form990TotalAssetsGrp/EOYAmt00
IRS990EZ/GrossReceiptsAmt08500
IRS990EZ/InfoInScheduleOPartIIIInd0X
IRS990EZ/InfoInScheduleOPartIInd0X
IRS990EZ/MadeLoansToFromOfficersInd0false
IRS990EZ/MembershipDuesAmt08500
IRS990EZ/MethodOfAccountingCashInd0X
IRS990EZ/NetAssetsOrFundBalancesBOYAmt03844
IRS990EZ/NetAssetsOrFundBalancesGrp/BOYAmt03844
IRS990EZ/NetAssetsOrFundBalancesGrp/EOYAmt00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt0000.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt1000.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt2000.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt3000.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt4000.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt5000.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt6000.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt10
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt20
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt30
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt40
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt50
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt60
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm0ROBERT FANNING
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm1JERRY WILLIAMS
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm2JESSICA AMOS
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm3JESSICA AMOS
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm4SANDY FRALICH
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm5GARY GONTHIER
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm6MICHAEL HOUGH
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt0EXEC DIRECTO
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt1PRESIDENT/DI
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt2VICE-PRESIDE
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt3SEC/TREAS/DI
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt4DIRECTOR
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt5DIRECTOR
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt6DIRECTOR
IRS990EZ/OperateHospitalInd0false
IRS990EZ/Organization501cInd0X
IRS990EZ/OrganizationDissolvedEtcInd0true
IRS990EZ/OrganizationHadUBIInd0false
IRS990EZ/OtherChangesInNetAssetsAmt0-4551
IRS990EZ/OtherExpensesTotalAmt07293
IRS990EZ/PoliticalCampaignActyInd0false
IRS990EZ/PrimaryExemptPurposeTxt0TO EDUCATE ITS MEMBERS, TO MAINTAIN AN EQUITABLE WORKER'S COMPENSATION LAW AND ASSURE THAT THE ADMINISTRATION OF THE WORKERS COMPENSATION ACT MEETS THE NEEDS OF INJURED EMPLOYEES AND THEIR EMPLOYERS
IRS990EZ/ProgramSrvcAccomplishmentGrp/DescriptionProgramSrvcAccomTxt0ISIA PROVIDES A FORUM FOR EDUCATION AND ACTION TO ITS MEMBERS THROUGH INSTRUCTIONAL SEMINARS
IRS990EZ/ProgramSrvcAccomplishmentGrp/DescriptionProgramSrvcAccomTxt1TO PROVIDE EDUCATION TO EMPLOYERS THROUGH INSTRUCTIONAL SEMINARS
IRS990EZ/ProhibitedTaxShelterTransInd0false
IRS990EZ/RelatedOrganizationCtrlEntInd0false
IRS990EZ/ScheduleBNotRequiredInd0X
IRS990EZ/StatesWhereCopyOfReturnIsFldCd0IN
IRS990EZ/SubjectToProxyTaxInd0false
IRS990EZ/TanningServicesProvidedInd0false
IRS990EZ/TotalExpensesAmt07793
IRS990EZ/TotalRevenueAmt08500
IRS990EZ/TransactionWithControlEntInd0false
IRS990EZ/TypeOfOrganizationCorpInd0X
IRS990EZ/WebsiteAddressTxt0WWW.INDIANASELFINSURERS.ORG
IRS990ScheduleN/AssetsDistributedInd0true
IRS990ScheduleN/BondsOutstandingInd0false
IRS990ScheduleN/DirectorOfSuccessorInd0false
IRS990ScheduleN/EmployeeOfSuccessorInd0false
IRS990ScheduleN/LiabilitiesPaidInd0true
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc0ADMIN FEES
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc1ACCTG FEES
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc2WEBSITE FEES
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc3BANK SERVICE CHARGES
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine1Txt0DUE DOYLE FANNING & ALDERFER LLP
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine1Txt1R STEVEN PERRY CPA PC
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine1Txt2VELOCITY CONCEPTS LLC
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine1Txt3CHASE BANK
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine2Txt0DUE DOYLE FANNING & ALDERFER
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine2Txt1R STEVEN PERRY CPA PC
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine2Txt2VELOCITY CONCEPTS LLC
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine2Txt3JP MORGAN CHASE BANK NA
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt02021-02-28
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt12021-02-28
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt22021-02-28
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt32021-02-28
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/EIN0351870079
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt03659
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt1500
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt2329
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt363
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/MethodOfFMVDeterminationTxt0CASH
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/MethodOfFMVDeterminationTxt1CASH
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/MethodOfFMVDeterminationTxt2CASH
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/MethodOfFMVDeterminationTxt3CASH
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine1Txt08440 ALLISON POINTE STE 350
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine1Txt13960 NAPLES DR
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine1Txt24341 N 700 E
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine1Txt3PO BOX 182051
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine2Txt08440 ALLISON POINTE BLVD STE 350
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine2Txt13960 NAPLES DR
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine2Txt24341 N 700 E
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine2Txt3PO BOX 182051
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/CityNm0INDIANAPOLIS
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/CityNm1COLUMBUS
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/CityNm2LEESBURG
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/CityNm3COLUMBUS
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/StateAbbreviationCd0IN
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/StateAbbreviationCd1IN
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/StateAbbreviationCd2IN
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/StateAbbreviationCd3OH
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/ZIPCd046250
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/ZIPCd147203
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/ZIPCd246538
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/ZIPCd343218
IRS990ScheduleN/OwnerOfSuccessorInd0false
IRS990ScheduleN/ReceiveCompensationInd0false
IRS990ScheduleN/RequiredToNotifyAGInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0EXPENSES ADMINISTRATIVE FEES 6,000 OFFICE EXPENSE 1,143 MISCELLANEOUS FEES 30 DUES 120 TOTAL 7,293
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1ACCOUNTS PAYABLE -4,551
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2TO EDUCATE ITS MEMBERS, TO MAINTAIN AN EQUITABLE WORKER'S COMPENSATION LAW AND ASSURE THAT THE ADMINISTRATION OF THE WORKERS COMPENSATION ACT MEETS THE NEEDS OF INJURED EMPLOYEES AND THEIR EMPLOYERS
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3TO PROVIDE EDUCATION TO EMPLOYERS THROUGH INSTRUCTIONAL SEMINARS
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990-EZ, PART I, LINE 16
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990-EZ, PART I, LINE 20
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990-EZ, PART III
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990-EZ, PART III, LINE 31
ReturnHeader/BuildTS02022-09-23 18:48:47Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0ROBERT FANNING
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0EXEC DIRECTOR
ReturnHeader/BusinessOfficerGrp/PhoneNum05744577600
ReturnHeader/BusinessOfficerGrp/SignatureDt02021-02-22
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0INDIANA SELF-INSURER'S INC
ReturnHeader/Filer/BusinessNameControlTxt0INDI
ReturnHeader/Filer/EIN0351420875
ReturnHeader/Filer/PhoneNum05744577600
ReturnHeader/Filer/USAddress/AddressLine1Txt0PO BOX 160
ReturnHeader/Filer/USAddress/CityNm0SYRACUSE
ReturnHeader/Filer/USAddress/StateAbbreviationCd0IN
ReturnHeader/Filer/USAddress/ZIPCd0465671060
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0351870079
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0R STEVEN PERRY CPA PC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt03960 NAPLES DRIVE
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0COLUMBUS
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0IN
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0472038356
ReturnHeader/PreparerPersonGrp/PhoneNum08123481040
ReturnHeader/PreparerPersonGrp/PreparationDt02021-02-22
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0R STEVEN PERRY
ReturnHeader/ReturnTs02021-02-25T08:37:02-06:00
ReturnHeader/ReturnTypeCd0990EZ
ReturnHeader/SigningOfficerGrp/PersonFullName/PersonFirstNm0ROBERT
ReturnHeader/SigningOfficerGrp/PersonFullName/PersonLastNm0FANNING
ReturnHeader/TaxPeriodBeginDt02020-01-01
ReturnHeader/TaxPeriodEndDt02020-12-31
ReturnHeader/TaxYr02020

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