Civic Intelligence

City of Bloomington Welfare Benefit

EIN 36-4585838 • 501(c)9 • Bloomington, MN

Profile

To fund reimbursement of medical expenses under a health reimbursement arrangement

1800 West Old Shakopee RoadBloomington, MN 55431

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 2022

Liabilities / Revenue

80th percentile

0.00x

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

501(c)9 • <$500k nonprofits • Source year 2022

Net Margin

79th percentile

24%

Higher net margin than 79% of similar nonprofits.

501(c)9 • <$500k nonprofits • Source year 2022

Top Officer Pay

75th percentile

$0

Higher top officer pay than 75% of similar nonprofits.

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

501(c)9 • <$500k nonprofits • Source year 2022

Asset Growth

46th percentile

-100%

Faster asset growth than 46% of similar nonprofits.

501(c)9 • <$500k nonprofits • Annualized from 2021 to 2022

Revenue Growth

45th percentile

-44%

Faster revenue growth than 45% of similar nonprofits.

501(c)9 • <$500k nonprofits • Annualized from 2021 to 2022

Balance Sheet
Liabilities / AssetsScore unavailable

Assets

Down

$0

Down $1,056,099 (-100%) from 2021

Liabilities

Flat

$0

Flat from 2021

Net Assets

Down

$0

Down $1,056,099 (-100%) from 2021

Operations
Liabilities / Revenue80th percentileNet Margin79th percentile

Revenue

Down

$195,573

Down $153,617 (-44%) from 2021

Expenses

Down

$147,797

Down $221,489 (-60%) from 2021

Net Income

Up

$47,776

Up $67,872 (+338%) from 2021

Trend Graphs

Balance Sheet Trend

Asset Growth46th percentile

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

$1.5M$1.0M$500K$0Assets 2019: $1,043,964Liabilities 2019: $0Net Assets 2019: $1,043,9642019Assets 2020: $1,074,791Liabilities 2020: $0Net Assets 2020: $1,074,7912020Assets 2021: $1,056,099Liabilities 2021: $0Net Assets 2021: $1,056,0992021Assets 2022: $0Liabilities 2022: $0Net Assets 2022: $02022

Highlighted filing

2022

Assets$0
Liabilities$0
Net Assets$0
Open 2022 Filing

Operations Trend

Revenue Growth45th percentile

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

$600K$400K$200K$0-$200KRevenue 2019: $575,770Expenses 2019: $534,178Net Income 2019: $41,5922019Revenue 2020: $287,451Expenses 2020: $256,624Net Income 2020: $30,8272020Revenue 2021: $349,190Expenses 2021: $369,286Net Income 2021: -$20,0962021Revenue 2022: $195,573Expenses 2022: $147,797Net Income 2022: $47,7762022

Highlighted filing

2022

Revenue$195,573
Expenses$147,797
Net Income$47,776
Open 2022 Filing

Filings

Most recent year

2022 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$0
Liabilities
$0
Net assets
$0
Revenue
$195,573
Expenses
$147,797
Net income
$47,776
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2022Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.20$0.15$0.05
2021Detailed filing. Detailed filing data is available for this year.$1.06$0.00$1.06$0.35$0.37$0.02
2020Detailed filing. Detailed filing data is available for this year.$1.07$0.00$1.07$0.29$0.26$0.03
2019Detailed filing. Detailed filing data is available for this year.$1.04$0.00$1.04$0.58$0.53$0.04
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2022 to Dec 31, 2022
Signed
Apr 19, 2023
Return Version
2022v5.0
Gross Receipts
$195,573
Mission and Program Overview

Mission

To fund reimbursement of medical expenses under a health reimbursement arrangement

To fund reimbursement of medical expenses under a health reimbursement arrangement.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cap Stk Tr Prin Current Funds$1,056,099--
Savings and Temporary Cash Investments$969,211--
Investments in Publicly Traded Securities$86,888--
Total Assets$1,056,099$0▼ $1,056,099
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Total Net Assets Fund Balance$1,056,099$0▼ $1,056,099
Total Liabilities and Net Assets / Fund Balance$1,056,099$0▼ $1,056,099
Compensation and Service Providers
Top Officer Pay75th percentile

Board Members and Trustees

NameTitle
Matrix Trust CompanyTrustee
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$186,314
Investment Income
$9,259
Other Revenue
$0
Change in Net Assets
$47,776
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$3,179
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
Benefits to Members---$144,618
Fees for Services Other---$3,179
Total Functional Expenses$0$0$0$147,797
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
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Backup withholding compliance
No
Business relationship with 35% controlled entity
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
Yes
Management duties delegated
No

Governance Explanations

Form 990, Page 6, Part VI, Line 7B

“The trustee, which is the governing body of the trust, is a directed trustee who takes certain direction regarding the trust from the plan administrator (or its designee) and the members.”

Form 990, Page 6, Part VI, Line 9

“Matrix trust company 717 17th street, suite 1300 denver, co 80202”

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

“The trustee reviews the form 990 based upon the financial records for the organization and executes it.”

Form 990, Page 6, Part VI, Line 19

“The organization makes governing documents and financial statements available to the public upon written request to the organiztion. The information is then mailed to the requesting party.”

Filing and Contact Details

Filer

Filer Name
City of Bloomington Welfare Benefit
EIN
36-4585838
Phone
9525634899
Address
1800 WEST OLD SHAKOPEE ROAD, BLOOMINGTON, MN 55431

Signing Officer

Name
Tim Busse
Title
Mayor
Phone
9525634899
Signed
2023-04-19
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Matrix Trust Company
Voting Board Members
1
Independent Board Members
1
Employees
0

Preparer

Firm
Lewis Kisch & Associates Ltd
Address
1125 SOUTH FRONTAGE ROAD SUITE 1, HASTINGS, MN 55033-2489
Preparer
Samantha R Mulvihill
Phone
6514373356
Supplemental Narrative

Additional Explanations

Form 990, Part XI, Line 9

“Transfer to new benefit plan trust -1,094,659”

Raw XML Appendix251 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
IRS990/ActivityOrMissionDesc0TO FUND REIMBURSEMENT OF MEDICAL EXPENSES UNDER A HEALTH REIMBURSEMENT ARRANGEMENT.
IRS990/BackupWthldComplianceInd0false
IRS990/BenefitsToMembersGrp/TotalAmt0144618
IRS990/BooksInCareOfDetail/BusinessName/BusinessNameLine1Txt0HEALTHEQUITY
IRS990/BooksInCareOfDetail/PhoneNum06516625065
IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt01750 YANKEE DOODLE RD S140
IRS990/BooksInCareOfDetail/USAddress/CityNm0EAGAN
IRS990/BooksInCareOfDetail/USAddress/StateAbbreviationCd0MN
IRS990/BooksInCareOfDetail/USAddress/ZIPCd055121
IRS990/BusinessRlnWith35CtrlEntInd0false
IRS990/BusinessRlnWithFamMemInd0false
IRS990/BusinessRlnWithOrgMemInd0false
IRS990/CapStkTrPrinCurrentFundsGrp/BOYAmt01056099
IRS990/ChangeToOrgDocumentsInd0false
IRS990/CollectionsOfArtInd0false
IRS990/CompensationFromOtherSrcsInd0false
IRS990/CompensationProcessCEOInd0false
IRS990/CompensationProcessOtherInd0false
IRS990/ConflictOfInterestPolicyInd0false
IRS990/ConservationEasementsInd0false
IRS990/ConsolidatedAuditFinclStmtInd0false
IRS990/ContractTerminationInd0X
IRS990/CreditCounselingInd0false
IRS990/CYBenefitsPaidToMembersAmt0144618
IRS990/CYContributionsGrantsAmt00
IRS990/CYGrantsAndSimilarPaidAmt00
IRS990/CYInvestmentIncomeAmt09259
IRS990/CYOtherExpensesAmt03179
IRS990/CYOtherRevenueAmt00
IRS990/CYProgramServiceRevenueAmt0186314
IRS990/CYRevenuesLessExpensesAmt047776
IRS990/CYSalariesCompEmpBnftPaidAmt00
IRS990/CYTotalExpensesAmt0147797
IRS990/CYTotalFundraisingExpenseAmt00
IRS990/CYTotalProfFndrsngExpnsAmt00
IRS990/CYTotalRevenueAmt0195573
IRS990/DecisionsSubjectToApprovaInd0true
IRS990/DeductibleArtContributionInd0false
IRS990/DeductibleNonCashContriInd0false
IRS990/DelegationOfMgmtDutiesInd0false
IRS990/Desc0HEALTH REIMBURSEMENT ARRANGEMENT BY ORGANIZTION WHOSE PARTICIPANTS RECEIVED MEDICAL CARE IN THE AMOUNT OF 365,501.
IRS990/DescribedInSection501c3Ind0false
IRS990/DisregardedEntityInd0false
IRS990/DocumentRetentionPolicyInd0true
IRS990/DonorAdvisedFundInd0false
IRS990/DonorRstrOrQuasiEndowmentsInd0false
IRS990/ElectionOfBoardMembersInd0false
IRS990/EmployeeCnt00
IRS990/FamilyOrBusinessRlnInd0false
IRS990/FeesForServicesOtherGrp/TotalAmt03179
IRS990/FinalReturnInd0X
IRS990/ForeignActivitiesInd0false
IRS990/ForeignFinancialAccountInd0false
IRS990/ForeignOfficeInd0false
IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt01.00
IRS990/Form990PartVIISectionAGrp/InstitutionalTrusteeInd0X
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt00
IRS990/Form990PartVIISectionAGrp/PersonNm0MATRIX TRUST COMPANY
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt00
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt00
IRS990/Form990PartVIISectionAGrp/TitleTxt0TRUSTEE
IRS990/Form990ProvidedToGvrnBodyInd0true
IRS990/FormerOfcrEmployeesListedInd0false
IRS990/FSAuditedInd0false
IRS990/FundraisingActivitiesInd0false
IRS990/GamingActivitiesInd0false
IRS990/GoverningBodyVotingMembersCnt01
IRS990/GrantsToIndividualsInd0false
IRS990/GrantsToOrganizationsInd0false
IRS990/GrantToRelatedPersonInd0false
IRS990/GrossReceiptsAmt0195573
IRS990/GroupReturnForAffiliatesInd0false
IRS990/IncludeFIN48FootnoteInd0false
IRS990/IndependentAuditFinclStmtInd0false
IRS990/IndependentVotingMemberCnt01
IRS990/IndoorTanningServicesInd0false
IRS990/InfoInScheduleOPartVIInd0X
IRS990/InfoInScheduleOPartXIInd0X
IRS990/InvestmentIncomeGrp/ExclusionAmt09259
IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt09259
IRS990/InvestmentInJointVentureInd0false
IRS990/InvestmentsPubTradedSecGrp/BOYAmt086888
IRS990/IRPDocumentCnt00
IRS990/IRPDocumentW2GCnt00
IRS990/LoanOutstandingInd0false
IRS990/LocalChaptersInd0false
IRS990/MaterialDiversionOrMisuseInd0false
IRS990/MembersOrStockholdersInd0false
IRS990/MethodOfAccountingAccrualInd0X
IRS990/MinutesOfCommitteesInd0true
IRS990/MinutesOfGoverningBodyInd0true
IRS990/MissionDesc0TO FUND REIMBURSEMENT OF MEDICAL EXPENSES UNDER A HEALTH REIMBURSEMENT ARRANGEMENT.
IRS990/MoreThan5000KToIndividualsInd0false
IRS990/MoreThan5000KToOrgInd0false
IRS990/NetAssetsOrFundBalancesBOYAmt01056099
IRS990/NetAssetsOrFundBalancesEOYAmt00
IRS990/NetUnrlzdGainsLossesInvstAmt0-9216
IRS990/NoListedPersonsCompensatedInd0X
IRS990/NondeductibleContributionsInd0false
IRS990/OfficerMailingAddressInd0true
IRS990/OperateHospitalInd0false
IRS990/Organization501cInd0X
IRS990/OrgDoesNotFollowFASB117Ind0X
IRS990/OtherChangesInNetAssetsAmt0-1094659
IRS990/PartialLiquidationInd0true
IRS990/PoliticalCampaignActyInd0false
IRS990/PrincipalOfficerNm0MATRIX TRUST COMPANY
IRS990/ProfessionalFundraisingInd0false
IRS990/ProgramServiceRevenueGrp/BusinessCd0525100
IRS990/ProgramServiceRevenueGrp/Desc0EMPLOYER CONTRIBUTION
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt0186314
IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt0186314
IRS990/ProhibitedTaxShelterTransInd0false
IRS990/PYBenefitsPaidToMembersAmt0365502
IRS990/PYInvestmentIncomeAmt030742
IRS990/PYOtherExpensesAmt03784
IRS990/PYProgramServiceRevenueAmt0318448
IRS990/PYRevenuesLessExpensesAmt0-20096
IRS990/PYTotalExpensesAmt0369286
IRS990/PYTotalRevenueAmt0349190
IRS990/ReconcilationRevenueExpnssAmt047776
IRS990/RelatedEntityInd0true
IRS990/RelatedOrganizationCtrlEntInd0false
IRS990/ReportInvestmentsOtherSecInd0false
IRS990/ReportLandBuildingEquipmentInd0false
IRS990/ReportOtherAssetsInd0false
IRS990/ReportOtherLiabilitiesInd0false
IRS990/ReportProgramRelatedInvstInd0false
IRS990/SavingsAndTempCashInvstGrp/BOYAmt0969211
IRS990/ScheduleBRequiredInd0false
IRS990/ScheduleJRequiredInd0false
IRS990ScheduleN/DirectorOfSuccessor2Ind0false
IRS990ScheduleN/EmployeeOfSuccessor2Ind0false
IRS990ScheduleN/OwnerOfSuccessor2Ind0false
IRS990ScheduleN/ReceiveCompensation2Ind0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0THE TRUSTEE, WHICH IS THE GOVERNING BODY OF THE TRUST, IS A DIRECTED TRUSTEE WHO TAKES CERTAIN DIRECTION REGARDING THE TRUST FROM THE PLAN ADMINISTRATOR (OR ITS DESIGNEE) AND THE MEMBERS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1MATRIX TRUST COMPANY 717 17TH STREET, SUITE 1300 DENVER, CO 80202
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2THE TRUSTEE REVIEWS THE FORM 990 BASED UPON THE FINANCIAL RECORDS FOR THE ORGANIZATION AND EXECUTES IT.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3THE ORGANIZATION MAKES GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST TO THE ORGANIZTION. THE INFORMATION IS THEN MAILED TO THE REQUESTING PARTY.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4TRANSFER TO NEW BENEFIT PLAN TRUST -1,094,659
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PAGE 6, PART VI, LINE 7B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PAGE 6, PART VI, LINE 9
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PAGE 6, PART VI, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PAGE 6, PART VI, LINE 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PART XI, LINE 9
IRS990ScheduleR/AssetExchangeInd0false
IRS990ScheduleR/AssetPurchaseFromOtherOrgInd0false
IRS990ScheduleR/AssetSaleToOtherOrgInd0false
IRS990ScheduleR/DivRelatedOrganizationInd0false
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd0false
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd0false
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd0false
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingNACd0N/A
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt0CITY OF BLOOMINGTON
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN0416004990
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt0GOV
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd0MN
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt0GOVERNMENT
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt01800 W OLD SHOKOPEE ROAD
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm0BLOOMINGTON
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd0MN
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd055431
IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd0false
IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd0false
IRS990ScheduleR/PaidEmployeesSharingInd0false
IRS990ScheduleR/PerformOfServicesByOtherOrgInd0false
IRS990ScheduleR/PerformOfServicesForOthOrgInd0false
IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd0false
IRS990ScheduleR/ReimbursementPaidByOtherOrgInd0false
IRS990ScheduleR/ReimbursementPaidToOtherOrgInd0false
IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd0false
IRS990ScheduleR/RentalOfFcltsFromOthOrgInd0false
IRS990ScheduleR/SharingOfFacilitiesInd0false
IRS990ScheduleR/TransferFromOtherOrgInd0true
IRS990ScheduleR/TransferToOtherOrgInd0false
IRS990/SchoolOperatingInd0false
IRS990/SignificantChangeInd0false
IRS990/SignificantNewProgramSrvcInd0false
IRS990/SubjectToExcsTaxNetInvstIncInd0false
IRS990/SubjectToProxyTaxInd0false
IRS990/SubjToTaxRmnrtnExPrchtPymtInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt01056099
IRS990/TotalAssetsEOYAmt00
IRS990/TotalAssetsGrp/BOYAmt01056099
IRS990/TotalAssetsGrp/EOYAmt00
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt00
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt00
IRS990/TotalFunctionalExpensesGrp/TotalAmt0147797
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt00
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt01056099
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt00
IRS990/TotalProgramServiceRevenueAmt0186314
IRS990/TotalRevenueGrp/ExclusionAmt09259
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt0186314
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0195573
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt01056099
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt00
IRS990/TypeOfOrganizationTrustInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0717 17TH STREET SUITE 1300
IRS990/USAddress/CityNm0DENVER
IRS990/USAddress/StateAbbreviationCd0CO
IRS990/USAddress/ZIPCd080202
IRS990/VotingMembersGoverningBodyCnt01
IRS990/VotingMembersIndependentCnt01
IRS990/WhistleblowerPolicyInd0false
ReturnHeader/BuildTS02023-04-26 12:10:37Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0TIM BUSSE
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0MAYOR
ReturnHeader/BusinessOfficerGrp/PhoneNum09525634899
ReturnHeader/BusinessOfficerGrp/SignatureDt02023-04-19
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0CITY OF BLOOMINGTON WELFARE BENEFIT
ReturnHeader/Filer/BusinessName/BusinessNameLine2Txt0PLAN TRUST
ReturnHeader/Filer/BusinessNameControlTxt0CITY
ReturnHeader/Filer/EIN0364585838
ReturnHeader/Filer/PhoneNum09525634899
ReturnHeader/Filer/USAddress/AddressLine1Txt01800 WEST OLD SHAKOPEE ROAD
ReturnHeader/Filer/USAddress/CityNm0BLOOMINGTON
ReturnHeader/Filer/USAddress/StateAbbreviationCd0MN
ReturnHeader/Filer/USAddress/ZIPCd055431
ReturnHeader/IRSResponsiblePrtyInfoCurrInd0false
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0411620961
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0LEWIS KISCH & ASSOCIATES LTD
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt01125 SOUTH FRONTAGE ROAD SUITE 1
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0HASTINGS
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0MN
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0550332489
ReturnHeader/PreparerPersonGrp/PhoneNum06514373356
ReturnHeader/PreparerPersonGrp/PreparationDt02023-04-21
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0SAMANTHA R MULVIHILL
ReturnHeader/ReturnTs02023-04-21T11:50:04-04:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/SigningOfficerGrp/PersonFullName/PersonFirstNm0LYNNE
ReturnHeader/SigningOfficerGrp/PersonFullName/PersonLastNm0TARABOI
ReturnHeader/TaxPeriodBeginDt02022-01-01
ReturnHeader/TaxPeriodEndDt02022-12-31
ReturnHeader/TaxYr02022

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