Civic Intelligence

Champlin Park Traveling Basketball Assoc

EIN 41-1736343 • 501(c)3 • Champlin, MN

Profile

Dedicated to enhancing the development, delivery, and competitiveness of its youth basketball programs and serves the youth grades 4 through 8, parents/legal guardians and coaches within the attendance area of champlin park high school.

PO Box 170Champlin, MN 55316

www.cptba.com

Siviq Scores

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

Liabilities / Assets

60th percentile

0.00x

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

501(c)3 • <$500k nonprofits • Source year 2025

Liabilities / Revenue

62nd percentile

0.00x

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

501(c)3 • <$500k nonprofits • Source year 2025

Net Margin

58th percentile

6.2%

Higher net margin than 58% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2025

Top Officer Pay

81st percentile

$0

Higher top officer pay than 81% of similar nonprofits.

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

501(c)3 • <$500k nonprofits • Source year 2025

Asset Growth

73rd percentile

16%

Faster asset growth than 73% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2024 to 2025

Revenue Growth

57th percentile

3.7%

Faster revenue growth than 57% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2024 to 2025

Assets

Up

$83,773

Up $11,513 (+16%) from 2024

Liabilities

Flat

$0

Flat from 2024

Net Assets

Up

$83,773

Up $11,513 (+16%) from 2024

Revenue

Up

$185,214

Up $6,593 (+3.7%) from 2024

Expenses

Up

$173,701

Up $20,585 (+13%) from 2024

Net Income

Down

$11,513

Down $13,992 (-55%) from 2024

Trend Graphs

Balance Sheet Trend

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

$100K$50K$0Assets 2012: $25,096Liabilities 2012: $02012Assets 2013: $37,546Liabilities 2013: $02013Assets 2014: $47,582Liabilities 2014: $02014Assets 2015: $40,593Liabilities 2015: $02015Assets 2016: $48,928Liabilities 2016: $02016Assets 2017: $63,359Liabilities 2017: $02017Assets 2018: $77,877Liabilities 2018: $02018Assets 2019: $86,693Liabilities 2019: $02019Assets 2020: $83,047Liabilities 2020: $02020Assets 2021: $67,485Liabilities 2021: $02021Assets 2022: $74,583Liabilities 2022: $0Net Assets 2022: $74,5832022Assets 2023: $46,755Liabilities 2023: $0Net Assets 2023: $46,7552023Assets 2024: $72,260Liabilities 2024: $0Net Assets 2024: $72,2602024Assets 2025: $83,773Liabilities 2025: $0Net Assets 2025: $83,7732025

Highlighted filing

2025

Assets$83,773
Liabilities$0
Net Assets$83,773

Operations Trend

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

$200K$100K$0-$100KRevenue 2012: $76,679Expenses 2012: $79,057Net Income 2012: -$2,3782012Revenue 2013: $93,143Expenses 2013: $80,684Net Income 2013: $12,4592013Revenue 2014: $105,748Expenses 2014: $95,712Net Income 2014: $10,0362014Revenue 2015: $113,368Expenses 2015: $120,357Net Income 2015: -$6,9892015Revenue 2016: $126,772Expenses 2016: $118,437Net Income 2016: $8,3352016Revenue 2017: $132,349Expenses 2017: $117,918Net Income 2017: $14,4312017Revenue 2018: $139,176Expenses 2018: $124,658Net Income 2018: $14,5182018Revenue 2019: $132,584Expenses 2019: $123,768Net Income 2019: $8,8162019Revenue 2020: $123,989Expenses 2020: $127,635Net Income 2020: -$3,6462020Revenue 2021: $83,746Expenses 2021: $99,308Net Income 2021: -$15,5622021Revenue 2022: $159,592Expenses 2022: $152,494Net Income 2022: $7,0982022Revenue 2023: $166,724Expenses 2023: $194,552Net Income 2023: -$27,8282023Revenue 2024: $178,621Expenses 2024: $153,116Net Income 2024: $25,5052024Revenue 2025: $185,214Expenses 2025: $173,701Net Income 2025: $11,5132025

Highlighted filing

2025

Revenue$185,214
Expenses$173,701
Net Income$11,513

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2025Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.84$0.00$0.84$1.85$1.74$0.12
2024XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.72$0.00$0.72$1.79$1.53$0.26
2023XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.47$0.00$0.47$1.67$1.95$0.28
2022XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.75$0.00$0.75$1.60$1.52$0.07
2021Summary only. Only limited summary data is available for this year.$0.67$0.00$0.84$0.99$0.16
2020Summary only. Only limited summary data is available for this year.$0.83$0.00$1.24$1.28$0.04
2019Summary only. Only limited summary data is available for this year.$0.87$0.00$1.33$1.24$0.09
2018Summary only. Only limited summary data is available for this year.$0.78$0.00$1.39$1.25$0.15
2017Summary only. Only limited summary data is available for this year.$0.63$0.00$1.32$1.18$0.14
2016Summary only. Only limited summary data is available for this year.$0.49$0.00$1.27$1.18$0.08
2015Summary only. Only limited summary data is available for this year.$0.41$0.00$1.13$1.20$0.07
2014Summary only. Only limited summary data is available for this year.$0.48$0.00$1.06$0.96$0.10
2013Summary only. Only limited summary data is available for this year.$0.38$0.00$0.93$0.81$0.12
2012Summary only. Only limited summary data is available for this year.$0.25$0.00$0.77$0.79$0.02
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jul 1, 2024 to Jun 30, 2025
Signed
Nov 13, 2025
Return Version
2024v5.0
Gross Receipts
$257,817
Mission and Program Overview

Mission

Dedicated to enhancing the development, delivery, and competitiveness of its youth basketball programs and serves the youth grades 4 through 8, parents/legal guardians and coaches within the attendance area of champlin park high school.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$72,260$83,773▲ $11,513
Total Assets$72,260$83,773▲ $11,513
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$72,260$83,773▲ $11,513
Total Net Assets Fund Balance$72,260$83,773▲ $11,513
Total Liabilities and Net Assets / Fund Balance$72,260$83,773▲ $11,513
Compensation and Service Providers

Board Members and Trustees

NameTitle
Carter RomoPresident
Chad BucherDirector of
Jackie WickmanDirector of
Matt WestlundDirector Web
Matt LoganAssistant Co
Andy PfeifferAssistant Tr
Ken BakerAsst Boys to
Brian BelongiaAt Large
Tim StueweBoys Tournam
Jen WagnerCoaching Dev
Alece HendersonConcession C
Courtney HoffmanGirls Tourna
Mike BueckersScheduler
Nicole GedatusSectretary
Anne SoashTournament O
Jared BaileyTreasurer
Kristin GowVice Preside
Lindsay DahmerVolunteer Co
Revenue and Support

Revenue Composition

Contributions and Grants
$3,095
Program Service Revenue
$99,485
Investment Income
$44
Other Revenue
$82,590
All Other Contributions
$3,095
Change in Net Assets
$11,513
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$173,701
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
Occupancy$42,273--$42,273
Other Expenses$2,826--$2,826
All Other Expenses$2,500--$2,500
Insurance$2,306--$2,306
Fees for Services Accounting-$1,750-$1,750
Office Expenses-$879-$879
Information Technology-$835-$835
Advertising$600--$600
Total Functional Expenses$170,237$3,464$0$173,701
Fundraising, Events, and Gaming
Fundraising activities
Yes
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Gross Income$154,618
Fundraising Direct Expenses$72,167
Gaming Gross Income$575
Gaming Direct Expenses$436
Professional Fundraising Fees$0

Fundraising Events

EventGross ReceiptsGross RevenueDirect ExpensesNet Income
Tournament Fund$148,803$148,803$61,623$87,180
Golf Tournament$5,815$5,815$1,167$4,648
Total Events$154,618$154,618$72,167$82,451
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
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

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

Board is allowed to see a copy of the return upon their request. Board approval and treasurer does review and sign the tax return.

Form 990, Page 6, Part VI, Line 19

BY REQUEST

Filing and Contact Details

Filer

Filer Name
Champlin Park Traveling Basketball
EIN
41-1736343
Phone
3362870899
Address
PO BOX 170, CHAMPLIN, MN 55316

Signing Officer

Name
Jared Bailey
Title
Treasurer
Phone
3362870899
Signed
2025-11-13
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Jared Bailey
Formed
1993
Legal Domicile
Mn
Voting Board Members
18
Independent Board Members
18
Employees
0
Volunteers
150

Preparer

Firm
Patricia a Maus CPA
Address
11117 ZEALAND AVE N, CHAMPLIN, MN 55316-3595
Preparer
Patricia a Maus
Phone
7632088123
Supplemental Narrative

Additional Explanations

FORM 990 - ORGANIZATION'S MISSION

Dedicated to enhancing the development, delivery, and competitiveness of its youth basketball programs and serves the youth grades 4 through 8, parents/legal guardians and coaches within the attendance area of champlin park high school.

Raw XML AppendixShowing 400 of 417 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/Form990PartVIISectionAGrp/TitleTxt1VICE PRESIDE
IRS990/Form990PartVIISectionAGrp/TitleTxt2SECTRETARY
IRS990/Form990PartVIISectionAGrp/TitleTxt3TREASURER
IRS990/Form990PartVIISectionAGrp/TitleTxt4ASSISTANT TR
IRS990/Form990PartVIISectionAGrp/TitleTxt5SCHEDULER
IRS990/Form990PartVIISectionAGrp/TitleTxt6DIRECTOR OF
IRS990/Form990PartVIISectionAGrp/TitleTxt7DIRECTOR OF
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IRS990/OfficeExpensesGrp/TotalAmt0879
IRS990/OfficerMailingAddressInd0false
IRS990/OperateHospitalInd0false
IRS990/Organization501c3Ind0X
IRS990/OrganizationFollowsFASB117Ind0X
IRS990/OtherExpensesGrp/Desc0TOURNAMENT FEES
IRS990/OtherExpensesGrp/Desc1UNIFORMS, SUPPLIES, OTHER
IRS990/OtherExpensesGrp/Desc2TRAINING
IRS990/OtherExpensesGrp/Desc3EQUIPMENT & PROGRAM EXP
IRS990/OtherExpensesGrp/ProgramServicesAmt088406
IRS990/OtherExpensesGrp/ProgramServicesAmt123485
IRS990/OtherExpensesGrp/ProgramServicesAmt27841
IRS990/OtherExpensesGrp/ProgramServicesAmt32826
IRS990/OtherExpensesGrp/TotalAmt088406
IRS990/OtherExpensesGrp/TotalAmt123485
IRS990/OtherExpensesGrp/TotalAmt27841
IRS990/OtherExpensesGrp/TotalAmt32826
IRS990/PartialLiquidationInd0false
IRS990/PayPremiumsPrsnlBnftCntrctInd0false
IRS990/PoliticalCampaignActyInd0false
IRS990/PrincipalOfficerNm0JARED BAILEY
IRS990/ProfessionalFundraisingInd0false
IRS990/ProgramServiceRevenueGrp/Desc0MEMBERSHIP DUES
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt099485
IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt099485
IRS990/ProhibitedTaxShelterTransInd0false
IRS990/PYContributionsGrantsAmt04100
IRS990/PYExcessBenefitTransInd0false
IRS990/PYInvestmentIncomeAmt028
IRS990/PYOtherExpensesAmt0153116
IRS990/PYOtherRevenueAmt080307
IRS990/PYProgramServiceRevenueAmt094186
IRS990/PYRevenuesLessExpensesAmt025505
IRS990/PYTotalExpensesAmt0153116
IRS990/PYTotalRevenueAmt0178621
IRS990/QuidProQuoContributionsInd0false
IRS990/RcvFndsToPayPrsnlBnftCntrctInd0false
IRS990/ReconcilationRevenueExpnssAmt011513
IRS990/RelatedEntityInd0false
IRS990/RelatedOrganizationCtrlEntInd0false
IRS990/ReportInvestmentsOtherSecInd0false
IRS990/ReportLandBuildingEquipmentInd0false
IRS990/ReportOtherAssetsInd0false
IRS990/ReportOtherLiabilitiesInd0false
IRS990/ReportProgramRelatedInvstInd0false
IRS990/RevenueAmt099485
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearAmt03095
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus1YearAmt04100
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus2YearsAmt03000
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/TotalAmt010195
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearAmt099529
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus1YearAmt094214
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus2YearsAmt0105224
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus3YearsAmt099815
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus4YearsAmt072514
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/TotalAmt0471296
IRS990ScheduleA/GrossReceiptsNonUnrltBusGrp/CurrentTaxYearAmt0155193
IRS990ScheduleA/GrossReceiptsNonUnrltBusGrp/CurrentTaxYearMinus1YearAmt0149608
IRS990ScheduleA/GrossReceiptsNonUnrltBusGrp/CurrentTaxYearMinus2YearsAmt0117640
IRS990ScheduleA/GrossReceiptsNonUnrltBusGrp/CurrentTaxYearMinus3YearsAmt093756
IRS990ScheduleA/GrossReceiptsNonUnrltBusGrp/CurrentTaxYearMinus4YearsAmt017096
IRS990ScheduleA/GrossReceiptsNonUnrltBusGrp/TotalAmt0533293
IRS990ScheduleA/InvestmentIncomeCYPct00.00000
IRS990ScheduleA/InvestmentIncomePYPct00.00000
IRS990ScheduleA/PubliclySupportedOrg509a2Ind0X
IRS990ScheduleA/PublicSupportCY509Pct01.00000
IRS990ScheduleA/PublicSupportPY509Pct01.00000
IRS990ScheduleA/PublicSupportTotal509Amt01014784
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY509Ind0X
IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt0257817
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt0247922
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt0225864
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt0193571
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt089610
IRS990ScheduleA/Total509Grp/TotalAmt01014784
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt0257817
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt0247922
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt0225864
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt0193571
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus4YearsAmt089610
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt01014784
IRS990/ScheduleBRequiredInd0false
IRS990ScheduleG/FundraisingEventInformationGrp/DirectExpenseSummaryEventsAmt072167
IRS990ScheduleG/FundraisingEventInformationGrp/Event1Nm0TOURNAMENT FUND
IRS990ScheduleG/FundraisingEventInformationGrp/Event2Nm0GOLF TOURNAMENT
IRS990ScheduleG/FundraisingEventInformationGrp/GrossReceiptsEvent1Amt0148803
IRS990ScheduleG/FundraisingEventInformationGrp/GrossReceiptsEvent2Amt05815
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IRS990ScheduleG/FundraisingEventInformationGrp/GrossRevenueEvent1Amt0148803
IRS990ScheduleG/FundraisingEventInformationGrp/GrossRevenueEvent2Amt05815
IRS990ScheduleG/FundraisingEventInformationGrp/GrossRevenueTotalEventsAmt0154618
IRS990ScheduleG/FundraisingEventInformationGrp/NetIncomeSummaryAmt082451
IRS990ScheduleG/FundraisingEventInformationGrp/OthDirectExpnssTotalEventsAmt062790
IRS990ScheduleG/FundraisingEventInformationGrp/OtherDirectExpensesEvent1Amt061623
IRS990ScheduleG/FundraisingEventInformationGrp/OtherDirectExpensesEvent2Amt01167
IRS990ScheduleG/FundraisingEventInformationGrp/RentFacilityCostsEvent1Amt09377
IRS990ScheduleG/FundraisingEventInformationGrp/RentFcltyCostsTotalEventsAmt09377
IRS990/ScheduleJRequiredInd0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0DEDICATED TO ENHANCING THE DEVELOPMENT, DELIVERY, AND COMPETITIVENESS OF ITS YOUTH BASKETBALL PROGRAMS AND SERVES THE YOUTH GRADES 4 THROUGH 8, PARENTS/LEGAL GUARDIANS AND COACHES WITHIN THE ATTENDANCE AREA OF CHAMPLIN PARK HIGH SCHOOL.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1BOARD IS ALLOWED TO SEE A COPY OF THE RETURN UPON THEIR REQUEST. BOARD APPROVAL AND TREASURER DOES REVIEW AND SIGN THE TAX RETURN.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2BY REQUEST
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990 - ORGANIZATION'S MISSION
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PAGE 6, PART VI, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PAGE 6, PART VI, LINE 19
IRS990/SchoolOperatingInd0false
IRS990/SignificantChangeInd0false
IRS990/SignificantNewProgramSrvcInd0false
IRS990/StatesWhereCopyOfReturnIsFldCd0MN
IRS990/SubjectToExcsTaxNetInvstIncInd0false
IRS990/SubjectToProxyTaxInd0false
IRS990/SubjToTaxRmnrtnExPrchtPymtInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt072260
IRS990/TotalAssetsEOYAmt083773
IRS990/TotalAssetsGrp/BOYAmt072260
IRS990/TotalAssetsGrp/EOYAmt083773
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt03095
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt03464
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0170237
IRS990/TotalFunctionalExpensesGrp/TotalAmt0173701
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt00
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt072260
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt083773
IRS990/TotalProgramServiceExpensesAmt0170237
IRS990/TotalProgramServiceRevenueAmt099485
IRS990/TotalRevenueGrp/ExclusionAmt082590
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt099529
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0185214
IRS990/TotalVolunteersCnt0150
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt072260
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt083773
IRS990/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0PO BOX 88
IRS990/USAddress/CityNm0CHAMPLIN
IRS990/USAddress/StateAbbreviationCd0MN
IRS990/USAddress/ZIPCd055316
IRS990/VotingMembersGoverningBodyCnt018
IRS990/VotingMembersIndependentCnt018
IRS990/WebsiteAddressTxt0WWW.CPTBA.COM
IRS990/WhistleblowerPolicyInd0false
ReturnHeader/BuildTS02025-03-06 01:10:19Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0JARED BAILEY
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0TREASURER
ReturnHeader/BusinessOfficerGrp/PhoneNum03362870899
ReturnHeader/BusinessOfficerGrp/SignatureDt02025-11-13
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0CHAMPLIN PARK TRAVELING BASKETBALL
ReturnHeader/Filer/BusinessNameControlTxt0CHAM
ReturnHeader/Filer/EIN0411736343
ReturnHeader/Filer/PhoneNum03362870899
ReturnHeader/Filer/USAddress/AddressLine1Txt0PO BOX 170
ReturnHeader/Filer/USAddress/CityNm0CHAMPLIN

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