Civic Intelligence

Rushford Peterson Booster Club

EIN 41-1725503 • 501(c)3 • Rushford, MN

Profile

Provide support to rushford-peterson school extra curricular activites through fundraisers and charitable gambling events

PO Box 124Rushford, MN 55971
Siviq Scores

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

Liabilities / Assets

19th percentile

0.00x

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

501(c)3 • $1M-$5M nonprofits • Source year 2025

Liabilities / Revenue

20th percentile

0.00x

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

501(c)3 • $1M-$5M nonprofits • Source year 2025

Net Margin

42nd percentile

1.2%

Higher net margin than 42% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2025

Top Officer Pay

40th percentile

$0

Higher top officer pay than 40% of similar nonprofits.

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

501(c)3 • $1M-$5M nonprofits • Source year 2025

Asset Growth

37th percentile

-0.7%

Faster asset growth than 37% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Annualized from 2024 to 2025

Revenue Growth

25th percentile

-8.1%

Faster revenue growth than 25% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Annualized from 2024 to 2025

Assets

Down

$102,592

Down $675 (-0.7%) from 2024

Liabilities

Down

$0

Down $965 (-100%) from 2024

Net Assets

Up

$102,592

Up $290 (+0.3%) from 2024

Revenue

Down

$212,675

Down $18,742 (-8.1%) from 2024

Expenses

Down

$210,215

Down $20,216 (-8.8%) from 2024

Net Income

Up

$2,460

Up $1,474 (+149%) from 2024

Trend Graphs

Balance Sheet Trend

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

$150K$100K$50K$0Assets 2011: $66,871Liabilities 2011: $0Net Assets 2011: $66,8712011Assets 2012: $69,950Liabilities 2012: $0Net Assets 2012: $69,9502012Assets 2013: $87,570Liabilities 2013: $0Net Assets 2013: $87,5702013Assets 2014: $88,999Liabilities 2014: $0Net Assets 2014: $88,9992014Assets 2015: $49,647Liabilities 2015: $0Net Assets 2015: $49,6472015Assets 2016: $48,567Liabilities 2016: $0Net Assets 2016: $48,5672016Assets 2017: $50,129Liabilities 2017: $0Net Assets 2017: $50,1292017Assets 2018: $48,387Liabilities 2018: $0Net Assets 2018: $48,3872018Assets 2019: $55,002Liabilities 2019: $0Net Assets 2019: $55,0022019Assets 2020: $89,818Liabilities 2020: $0Net Assets 2020: $89,8182020Assets 2021: $87,801Liabilities 2021: $0Net Assets 2021: $87,8012021Assets 2022: $106,831Liabilities 2022: $540Net Assets 2022: $106,2912022Assets 2023: $101,184Liabilities 2023: $917Net Assets 2023: $100,2672023Assets 2024: $103,267Liabilities 2024: $965Net Assets 2024: $102,3022024Assets 2025: $102,592Liabilities 2025: $0Net Assets 2025: $102,5922025

Highlighted filing

2025

Assets$102,592
Liabilities$0
Net Assets$102,592

Operations Trend

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

$300K$200K$100K$0-$100KRevenue 2011: $35,947Expenses 2011: $40,939Net Income 2011: -$4,9922011Revenue 2012: $44,967Expenses 2012: $41,888Net Income 2012: $3,0792012Revenue 2013: $74,676Expenses 2013: $57,056Net Income 2013: $17,6202013Revenue 2014: $80,146Expenses 2014: $78,717Net Income 2014: $1,4292014Revenue 2015: $81,800Expenses 2015: $121,152Net Income 2015: -$39,3522015Revenue 2016: $75,316Expenses 2016: $76,396Net Income 2016: -$1,0802016Revenue 2017: $83,822Expenses 2017: $82,260Net Income 2017: $1,5622017Revenue 2018: $83,012Expenses 2018: $84,754Net Income 2018: -$1,7422018Revenue 2019: $93,174Expenses 2019: $86,559Net Income 2019: $6,6152019Revenue 2020: $97,178Expenses 2020: $74,160Net Income 2020: $23,0182020Revenue 2021: $155,017Expenses 2021: $153,439Net Income 2021: $1,5782021Revenue 2022: $247,165Expenses 2022: $229,451Net Income 2022: $17,7142022Revenue 2023: $234,305Expenses 2023: $235,110Net Income 2023: -$8052023Revenue 2024: $231,417Expenses 2024: $230,431Net Income 2024: $9862024Revenue 2025: $212,675Expenses 2025: $210,215Net Income 2025: $2,4602025

Highlighted filing

2025

Revenue$212,675
Expenses$210,215
Net Income$2,460

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2025Detailed filing. Detailed filing data is available for this year.$1.03$0.00$1.03$2.13$2.10$0.02
2024Detailed filing. Detailed filing data is available for this year.$1.03$0.01$1.02$2.31$2.30$0.01
2023Detailed filing. Detailed filing data is available for this year.$1.01$0.01$1.00$2.34$2.35$0.01
2022Detailed filing. Detailed filing data is available for this year.$1.07$0.01$1.06$2.47$2.29$0.18
2021Detailed filing. Detailed filing data is available for this year.$0.88$0.00$0.88$1.55$1.53$0.02
2020Detailed filing. Detailed filing data is available for this year.$0.90$0.00$0.90$0.97$0.74$0.23
2019Detailed filing. Detailed filing data is available for this year.$0.55$0.00$0.55$0.93$0.87$0.07
2018Detailed filing. Detailed filing data is available for this year.$0.48$0.00$0.48$0.83$0.85$0.02
2017Detailed filing. Detailed filing data is available for this year.$0.50$0.00$0.50$0.84$0.82$0.02
2016Summary only. Only limited summary data is available for this year.$0.49$0.00$0.49$0.75$0.76$0.01
2015Summary only. Only limited summary data is available for this year.$0.50$0.00$0.50$0.82$1.21$0.39
2014Summary only. Only limited summary data is available for this year.$0.89$0.00$0.89$0.80$0.79$0.01
2013Summary only. Only limited summary data is available for this year.$0.88$0.00$0.88$0.75$0.57$0.18
2012Summary only. Only limited summary data is available for this year.$0.70$0.00$0.70$0.45$0.42$0.03
2011Summary only. Only limited summary data is available for this year.$0.67$0.00$0.67$0.36$0.41$0.05
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jul 1, 2024 to Jun 30, 2025
Signed
Nov 21, 2025
Return Version
2024v5.2
Gross Receipts
$1,811,620
Mission and Program Overview

Mission

Provide support to rushford-peterson school extra curricular activites through fundraisers and charitable gambling events

Balance Sheet Detail
LineBeginningEndChange
Assets
Rtn Earn Endowment Incm Other Fnds$102,302$102,592▲ $290
Savings and Temporary Cash Investments$63,851$66,381▲ $2,530
Cash and Non-Interest-Bearing Accounts$39,416$36,211▼ $3,205
Total Assets$103,267$102,592▼ $675
Liabilities
Deferred Revenue$965--
Total Liabilities$965$0▼ $965
Net Assets / Fund Balance
Total Net Assets Fund Balance$102,302$102,592▲ $290
Total Liabilities and Net Assets / Fund Balance$103,267$102,592▼ $675
Compensation and Service Providers

Board Members and Trustees

NameTitle
Kyle ColbensonPresident
Kendra EideVice President
Kayla VolkmanDirector
Kellie ChaffeeDirector
Tim HoheiselDirector
David HinzGambling Manager
Jennifer ServaisSecretary
Michelle JohansonTreasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$5,020
Program Service Revenue
$5,115
Investment Income
$2,925
Other Revenue
$199,615
All Other Contributions
$915
Change in Net Assets
$2,460
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$112,911
Grants and Similar Amounts Paid$75,947
Salaries, Compensation, and Employee Benefits$21,357
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Grants to Domestic Orgs$75,947--$75,947
Other Expenses$59,311--$59,311
Occupancy$40,862--$40,862
Other Salaries and Wages$18,300--$18,300
Fees for Services Accounting$8,030--$8,030
Payroll Taxes$3,057--$3,057
Office Expenses$50$909-$959
Advertising-$730-$730
Total Functional Expenses$208,576$1,639$0$210,215
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Rushford Peterson School DistrictRushford, MN-Support School Activities$64,212
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
Yes
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Gaming Gross Income$1,795,797
Gaming Direct Expenses$1,597,196
Fundraising Gross Income$2,763
Fundraising Direct Expenses$1,749
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
Backup withholding compliance
Yes
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
No
Management duties delegated
No

Governance Explanations

Members or stockholder classes and rights Part VI line 6

A volunteer board of directors governs the organization and meets monthly. A membership drive is held each year.

Form 990 governing body review Part VI line 11

A copy of form 990 is made available for review to all board members.

CEO executive director top management comp Part VI line 15A

Officers and directors are not compensated.

Other officer or key employee compensation Part VI line 15B

Officers and directors are not compensated.

Governing documents etc available to public Part VI line 19

The organizations governing document, financial statements, and form 990 are available for public inspection upon written request to the board.

Filing and Contact Details

Filer

Filer Name
Rushford Peterson Booster Club
EIN
41-1725503
In Care Of
% KYLE COLBENSON
Address
PO BOX 124, RUSHFORD, MN 55971

Signing Officer

Name
Kyle Colbenson
Title
President
Signed
2025-11-21
Discuss with paid preparer
Yes

Organization Details

Formed
1996
Legal Domicile
Mn
Voting Board Members
7
Independent Board Members
0
Employees
0

Preparer

Firm
Engelson & Associates Ltd
Address
501 Empire St, Holmen, WI 54636
Preparer
Bradley Peterson CPA
Phone
6085263437
Supplemental Narrative

Additional Explanations

Explanation of other changes in net assets or fund balances Part XI line 9

Miscellaneous adjustment (2,170)

Raw XML AppendixShowing 400 of 409 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/Form990PartVIISectionAGrp/TitleTxt0DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt1GAMBLING MANAGER
IRS990/Form990PartVIISectionAGrp/TitleTxt2DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt3DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt4PRESIDENT
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IRS990/Form990PartVIISectionAGrp/TitleTxt6SECRETARY
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IRS990/RtnEarnEndowmentIncmOthFndsGrp/EOYAmt0102592
IRS990/SavingsAndTempCashInvstGrp/BOYAmt063851
IRS990/SavingsAndTempCashInvstGrp/EOYAmt066381
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearAmt05020
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus1YearAmt05136
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus2YearsAmt04864
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus3YearsAmt05548
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus4YearsAmt04181
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/TotalAmt024749
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearAmt02925
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus1YearAmt0378
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus2YearsAmt0216
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus3YearsAmt0187
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus4YearsAmt0230
IRS990ScheduleA/GrossInvestmentIncome170Grp/TotalAmt03936
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearAmt01471
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus1YearAmt0-1482
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus2YearsAmt0-702
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus3YearsAmt0-3736
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus4YearsAmt0-3301
IRS990ScheduleA/OtherIncome170Grp/TotalAmt0-7750
IRS990ScheduleA/PublicOrganization170Ind0X
IRS990ScheduleA/PublicSupportCY170Pct00.46560
IRS990ScheduleA/PublicSupportPY170Pct00.36240
IRS990ScheduleA/PublicSupportTotal170Amt024749
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY170Ind0X
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearAmt05020
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus1YearAmt05136
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus2YearsAmt04864
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus3YearsAmt05548
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus4YearsAmt04181
IRS990ScheduleA/TotalCalendarYear170Grp/TotalAmt024749
IRS990ScheduleA/TotalSupportAmt053158
IRS990ScheduleA/UnrelatedBusinessNetIncm170Grp/CurrentTaxYearAmt03153
IRS990ScheduleA/UnrelatedBusinessNetIncm170Grp/CurrentTaxYearMinus1YearAmt0947
IRS990ScheduleA/UnrelatedBusinessNetIncm170Grp/CurrentTaxYearMinus2YearsAmt08407
IRS990ScheduleA/UnrelatedBusinessNetIncm170Grp/CurrentTaxYearMinus3YearsAmt017373
IRS990ScheduleA/UnrelatedBusinessNetIncm170Grp/CurrentTaxYearMinus4YearsAmt02343
IRS990ScheduleA/UnrelatedBusinessNetIncm170Grp/TotalAmt032223
IRS990/ScheduleBRequiredInd0false
IRS990ScheduleG/CharitableDistributionRqrInd0true
IRS990ScheduleG/CntrctWith3rdPrtyForGameRevInd0false
IRS990ScheduleG/DistributedAmt059580
IRS990ScheduleG/GamingInformationGrp/CashPrizesPullTabsAmt01597196
IRS990ScheduleG/GamingInformationGrp/CashPrizesTotalGamingAmt01597196
IRS990ScheduleG/GamingInformationGrp/DirectExpenseSummaryGamingAmt01597196
IRS990ScheduleG/GamingInformationGrp/GrossRevenuePullTabsAmt01795797
IRS990ScheduleG/GamingInformationGrp/GrossRevenueTotalGamingAmt01795797
IRS990ScheduleG/GamingInformationGrp/NetGamingIncomeSummaryAmt0198601
IRS990ScheduleG/GamingInformationGrp/VolunteerLaborPullTabsInd0false
IRS990ScheduleG/GamingManagerCompensationAmt018300
IRS990ScheduleG/GamingManagerIsEmployeeInd0X
IRS990ScheduleG/GamingManagerPersonNm0DAVID HINZ
IRS990ScheduleG/GamingManagerServicesProvTxt0GAMING MANAGER
IRS990ScheduleG/GamingOtherFacilityPct01.000
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IRS990ScheduleG/IndividualWithBooksNm0DAVID HINZ
IRS990ScheduleG/LicensedInd0true
IRS990ScheduleG/LicenseSuspendedEtcInd0false
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IRS990ScheduleG/StatesWhereGamingConductedCd0MN
IRS990ScheduleG/SupplementalInformationDetail/ExplanationTxt0GAMBLING GROSS PROFIT 198,601 * 30% = 59,580 REQUIRED DISTRIBUTIONS
IRS990ScheduleG/SupplementalInformationDetail/FormAndLineReferenceDesc0Mandatory distributions (Part III, line 17b)
IRS990ScheduleI/GrantRecordsMaintainedInd0true
IRS990ScheduleI/RecipientTable/CashGrantAmt064212
IRS990ScheduleI/RecipientTable/PurposeOfGrantTxt0SUPPORT SCHOOL ACTIVITIES
IRS990ScheduleI/RecipientTable/RecipientBusinessName/BusinessNameLine1Txt0RUSHFORD PETERSON SCHOOL DISTRICT
IRS990ScheduleI/RecipientTable/RecipientEIN0411655958
IRS990ScheduleI/RecipientTable/USAddress/AddressLine1Txt01000 PINE MEADOWS LANE
IRS990ScheduleI/RecipientTable/USAddress/CityNm0RUSHFORD
IRS990ScheduleI/RecipientTable/USAddress/StateAbbreviationCd0MN
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IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0A VOLUNTEER BOARD OF DIRECTORS GOVERNS THE ORGANIZATION AND MEETS MONTHLY. A MEMBERSHIP DRIVE IS HELD EACH YEAR.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1A COPY OF FORM 990 IS MADE AVAILABLE FOR REVIEW TO ALL BOARD MEMBERS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2OFFICERS AND DIRECTORS ARE NOT COMPENSATED.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3OFFICERS AND DIRECTORS ARE NOT COMPENSATED.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4THE ORGANIZATIONS GOVERNING DOCUMENT, FINANCIAL STATEMENTS, AND FORM 990 ARE AVAILABLE FOR PUBLIC INSPECTION UPON WRITTEN REQUEST TO THE BOARD.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5MISCELLANEOUS ADJUSTMENT (2,170)
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Members or stockholder classes and rights Part VI line 6
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Form 990 governing body review Part VI line 11
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2CEO executive director top management comp Part VI line 15a
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3Other officer or key employee compensation Part VI line 15b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4Governing documents etc available to public Part VI line 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5Explanation of other changes in net assets or fund balances Part XI line 9
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IRS990/TaxableDistributionsInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt0103267
IRS990/TotalAssetsEOYAmt0102592
IRS990/TotalAssetsGrp/BOYAmt0103267
IRS990/TotalAssetsGrp/EOYAmt0102592
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt05020
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt01639
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0208576
IRS990/TotalFunctionalExpensesGrp/TotalAmt0210215
IRS990/TotalGrossUBIAmt0192800
IRS990/TotalLiabilitiesBOYAmt0965
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt0965
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0102302
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0102592
IRS990/TotalOtherCompensationAmt00
IRS990/TotalProgramServiceExpensesAmt0208576
IRS990/TotalProgramServiceRevenueAmt05115
IRS990/TotalReportableCompFromOrgAmt00
IRS990/TotalRevenueGrp/ExclusionAmt09740
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt05115
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0212675
IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt0192800
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0103267
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt0102592
IRS990/TotReportableCompRltdOrgAmt00
IRS990/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0true
IRS990/UponRequestInd0X
IRS990/VotingMembersGoverningBodyCnt07
IRS990/VotingMembersIndependentCnt00
IRS990/WhistleblowerPolicyInd0false
ReturnHeader/BuildTS02025-03-06 01:10:19Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0KYLE COLBENSON
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0PRESIDENT
ReturnHeader/BusinessOfficerGrp/SignatureDt02025-11-21
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0RUSHFORD PETERSON BOOSTER CLUB
ReturnHeader/Filer/BusinessNameControlTxt0RUSH
ReturnHeader/Filer/EIN0411725503
ReturnHeader/Filer/InCareOfNm0% KYLE COLBENSON
ReturnHeader/Filer/USAddress/AddressLine1Txt0PO BOX 124
ReturnHeader/Filer/USAddress/CityNm0RUSHFORD
ReturnHeader/Filer/USAddress/StateAbbreviationCd0MN
ReturnHeader/Filer/USAddress/ZIPCd055971
ReturnHeader/IRSResponsiblePrtyInfoCurrInd0true
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0391625814
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0Engelson & Associates Ltd
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0501 Empire St
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0Holmen
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0WI

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