Siviq Scores
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Balance Sheet
Assets
Flat$123,414
Flat from 2013
Net Assets
Flat$123,414
Flat from 2013
Liabilities
Flat$0
Flat from 2013
Revenue And Expenses
Revenue
-
No earlier filing loaded for comparison.
Expenses
Flat$1,305,290
Flat from 2013
Net Income
-
No earlier filing loaded for comparison.
Historical Trend
Jump To
Filing Snapshot
- Filing Period
- Nov 1, 2012 to Oct 31, 2013
- Signed
- Jul 25, 2014
- Return Version
- 2012v2.1
- Gross Receipts
- $1,395,999
Mission and Program Overview
Mission
Voluntary employees' beneficiary association to provide health and short term disability benefits
Filing and Contact Details
Filer
- EIN
- 42-1210714
Raw XML Appendix273 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 |
|---|---|---|
| IRS990/AccountantCompileOrReview | 0 | 0 |
| IRS990/ActivitiesConductedPartnership | 0 | 0 |
| IRS990/ActivityOrMissionDescription | 0 | VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION TO PROVIDE HEALTH AND SHORT TERM DISABILITY BENEFITS |
| IRS990/AddressPrincipalOfficerUS/AddressLine1 | 0 | PO BOX 50 |
| IRS990/AddressPrincipalOfficerUS/City | 0 | OSKALOOSA |
| IRS990/AddressPrincipalOfficerUS/State | 0 | IA |
| IRS990/AddressPrincipalOfficerUS/ZIPCode | 0 | 52577 |
| IRS990/AuditCommittee | 0 | 1 |
| IRS990/BenefitsPaidToMembersCY | 0 | 974158 |
| IRS990/BenefitsPaidToMembersPriorYear | 0 | 1124110 |
| IRS990/BenefitsToMembers/ProgramServices | 0 | 974158 |
| IRS990/BenefitsToMembers/Total | 0 | 974158 |
| IRS990/BsnssRltnshpThruFamilyMember | 0 | 0 |
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| IRS990/CapStckTrstPrinCurrentFunds/BOY | 0 | 0 |
| IRS990/CapStckTrstPrinCurrentFunds/EOY | 0 | 0 |
| IRS990/CashNonInterestBearing/BOY | 0 | 33462 |
| IRS990/CashNonInterestBearing/EOY | 0 | 33462 |
| IRS990/ChangesToOrganizingDocs | 0 | 0 |
| IRS990/CollectionsOfArt | 0 | 0 |
| IRS990/CompensationFromOtherSources | 0 | 0 |
| IRS990/CompensationProcessCEO | 0 | 0 |
| IRS990/CompensationProcessOther | 0 | 0 |
| IRS990/ConflictOfInterestPolicy | 0 | 0 |
| IRS990/ConservationEasements | 0 | 0 |
| IRS990/ConsolidatedAuditFinancialStmt | 0 | 0 |
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| IRS990/ContributionsGrantsPriorYear | 0 | 0 |
| IRS990/CreditCounseling | 0 | 0 |
| IRS990/DecisionsSubjectToApproval | 0 | 0 |
| IRS990/DeductibleContributionsOfArt | 0 | 0 |
| IRS990/DeductibleNonCashContributions | 0 | 0 |
| IRS990/DelegationOfManagementDuties | 0 | 0 |
| IRS990/DescribedIn501C3 | 0 | 0 |
| IRS990/Description | 0 | PROVIDES SHORT TERM DISABILITY AND HEALTH CARE BENEFITS TO AN AVERAGE OF 153 COVERED EMPLOYEES AND THEIR DEPENDENTS |
| IRS990/DisregardedEntity | 0 | 0 |
| IRS990/DocumentRetentionPolicy | 0 | 0 |
| IRS990/DonorAdvisedFunds | 0 | 0 |
| IRS990/DoNotFollowSFAS117 | 0 | X |
| IRS990/ElectionOfBoardMembers | 0 | 0 |
| IRS990/EmploymentTaxReturnsFiled | 0 | 1 |
| IRS990/Expense | 0 | 1305290 |
| IRS990/FamilyOrBusinessRelationship | 0 | 0 |
| IRS990/FederalGrantAuditRequired | 0 | 0 |
| IRS990/ForeignActivities | 0 | 0 |
| IRS990/ForeignFinancialAccount | 0 | 0 |
| IRS990/ForeignOffice | 0 | 0 |
| IRS990/Form1098CFiled | 0 | 0 |
| IRS990/Form8282PropertyDisposedOf | 0 | 0 |
| IRS990/Form8899Filed | 0 | 0 |
| IRS990/Form990PartVIISectionA/AverageHoursPerWeek | 0 | 0.10 |
| IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector | 0 | X |
| IRS990/Form990PartVIISectionA/NamePerson | 0 | BRADLEY MUHL |
| IRS990/Form990PartVIISectionA/OtherCompensation | 0 | 0 |
| IRS990/Form990PartVIISectionA/ReportableCompFromOrganization | 0 | 0 |
| IRS990/Form990PartVIISectionA/ReportableCompFromRelatedOrgs | 0 | 0 |
| IRS990/Form990PartVIISectionA/Title | 0 | TRUSTEE |
| IRS990/Form990ProvidedToGoverningBody | 0 | 0 |
| IRS990/FormersListed | 0 | 0 |
| IRS990/FSAudited | 0 | 1 |
| IRS990/FSAuditedBasis/FinancialStatementSeparate | 0 | X |
| IRS990/FundraisingActivities | 0 | 0 |
| IRS990/FundsToPayPremiums | 0 | 0 |
| IRS990/Gaming | 0 | 0 |
| IRS990/GrantsAndSimilarAmntsCY | 0 | 0 |
| IRS990/GrantsAndSimilarAmntsPriorYear | 0 | 0 |
| IRS990/GrantsToIndividuals | 0 | 0 |
| IRS990/GrantsToOrganizations | 0 | 0 |
| IRS990/GrantToRelatedPerson | 0 | 0 |
| IRS990/GrossReceipts | 0 | 1395999 |
| IRS990/GroupReturnForAffiliates | 0 | 0 |
| IRS990/Hospital | 0 | 0 |
| IRS990/IndependentAuditFinancialStmt | 0 | 1 |
| IRS990/IndoorTanningServices | 0 | 0 |
| IRS990/InfoInScheduleOPartVI | 0 | X |
| IRS990/InfoInScheduleOPartXII | 0 | X |
| IRS990/InvestmentIncomeCurrentYear | 0 | 0 |
| IRS990/InvestmentIncomePriorYear | 0 | 0 |
| IRS990/InvestmentInJointVenture | 0 | 0 |
| IRS990/InvestmentsOtherSecurities/EOY | 0 | 2790 |
| IRS990/LoanToOfficerOrDQP | 0 | 0 |
| IRS990/LocalChapters | 0 | 0 |
| IRS990/MaterialDiversionOrMisuse | 0 | 0 |
| IRS990/MembersOrStockholders | 0 | 0 |
| IRS990/MethodOfAccountingOther | 0 | X |
| IRS990/MinutesOfCommittees | 0 | 0 |
| IRS990/MinutesOfGoverningBody | 0 | 0 |
| IRS990/MissionDescription | 0 | VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION TO PROVIDE HEALTH AND SHORT TERM DISABILITY BENEFITS |
| IRS990/MoreThan5000KToIndividuals | 0 | 0 |
| IRS990/MoreThan5000KToOrganizations | 0 | 0 |
| IRS990/NameOfPrincipalOfficerPerson | 0 | BRADLEY MUHL |
| IRS990/NbrIndependentVotingMembers | 0 | 0 |
| IRS990/NbrVotingGoverningBodyMembers | 0 | 1 |
| IRS990/NbrVotingMembersGoverningBody | 0 | 1 |
| IRS990/NetAssetsOrFundBalancesBOY | 0 | 32705 |
| IRS990/NetAssetsOrFundBalancesEOY | 0 | 123414 |
| IRS990/NetUnrelatedBusinessTxblIncome | 0 | 0 |
| IRS990/NoListedPersonsCompensated | 0 | X |
| IRS990/NonDeductibleContributions | 0 | 0 |
| IRS990/NumberFormsTransmittedWith1096 | 0 | 0 |
| IRS990/NumberIndependentVotingMembers | 0 | 0 |
| IRS990/NumberIndividualsGT100K | 0 | 0 |
| IRS990/NumberOfContractorsGT100K | 0 | 0 |
| IRS990/NumberOfEmployees | 0 | 4 |
| IRS990/NumberW2GIncluded | 0 | 0 |
| IRS990/OfficerEntityWithBsnssRltnshp | 0 | 0 |
| IRS990/OfficerMailingAddress | 0 | 0 |
| IRS990/Organization501c | 0 | X |
| IRS990/OtherAssetsTotal/BOY | 0 | 24992 |
| IRS990/OtherAssetsTotal/EOY | 0 | 0 |
| IRS990/OtherExpensePriorYear | 0 | 320606 |
| IRS990/OtherExpensesCurrentYear | 0 | 331132 |
| IRS990/OtherExpenses/Description | 0 | INSURANCE PREMIUMS |
| IRS990/OtherExpenses/Description | 1 | CONTRACT ADMINISTRATOR |
| IRS990/OtherExpenses/ProgramServices | 0 | 212316 |
| IRS990/OtherExpenses/ProgramServices | 1 | 118816 |
| IRS990/OtherExpenses/Total | 0 | 212316 |
| IRS990/OtherExpenses/Total | 1 | 118816 |
| IRS990/OtherLiabilities/BOY | 0 | 53288 |
| IRS990/OtherLiabilities/EOY | 0 | 0 |
| IRS990/OtherRevenueCurrentYear | 0 | 59582 |
| IRS990/OtherRevenueMisc/BusinessCode | 0 | 900099 |
| IRS990/OtherRevenueMisc/Description | 0 | OTHER INCOME |
| IRS990/OtherRevenueMisc/ExclusionAmount | 0 | 59582 |
| IRS990/OtherRevenueMisc/TotalRevenueColumn | 0 | 59582 |
| IRS990/OtherRevenuePriorYear | 0 | 94994 |
| IRS990/PaidInCapSrplsLandBldgEqpFund/BOY | 0 | 0 |
| IRS990/PaidInCapSrplsLandBldgEqpFund/EOY | 0 | 0 |
| IRS990/PartialLiquidation | 0 | 0 |
| IRS990/PoliticalActivities | 0 | 0 |
| IRS990/PremiumsPaid | 0 | 0 |
| IRS990/ProfessionalFundraising | 0 | 0 |
| IRS990/ProgramServiceRevenue/BusinessCode | 0 | 900099 |
| IRS990/ProgramServiceRevenue/BusinessCode | 1 | 900099 |
| IRS990/ProgramServiceRevenueCY | 0 | 1336417 |
| IRS990/ProgramServiceRevenue/Description | 0 | EMPLOYER CONTRIBUTIONS |
| IRS990/ProgramServiceRevenue/Description | 1 | EMPLOYEE / PARTICIPANTS CONTRIBUT |
| IRS990/ProgramServiceRevenue/ExclusionAmount | 0 | 1093000 |
| IRS990/ProgramServiceRevenue/ExclusionAmount | 1 | 243417 |
| IRS990/ProgramServiceRevenuePriorYear | 0 | 1308428 |
| IRS990/ProgramServiceRevenue/TotalRevenueColumn | 0 | 1093000 |
| IRS990/ProgramServiceRevenue/TotalRevenueColumn | 1 | 243417 |
| IRS990/ProhibitedTaxShelterTrans | 0 | 0 |
| IRS990/QuidProQuoContributions | 0 | 0 |
| IRS990/ReconcilationOtherChanges | 0 | 0 |
| IRS990/ReconcilationRevenueExpenses | 0 | 90709 |
| IRS990/RelatedEntity | 0 | 0 |
| IRS990/RelatedOrgControlledEntity | 0 | 0 |
| IRS990/ReportFin48Footnote | 0 | 0 |
| IRS990/ReportInvestOthSecurities | 0 | 0 |
| IRS990/ReportLandBldgEquip | 0 | 0 |
| IRS990/ReportOtherAssets | 0 | 0 |
| IRS990/ReportOtherLiabilities | 0 | 0 |
| IRS990/ReportProgRelInvest | 0 | 0 |
| IRS990/RetainedEarningsEndowmentEtc/BOY | 0 | 32705 |
| IRS990/RetainedEarningsEndowmentEtc/EOY | 0 | 123414 |
| IRS990/RevenuesLessExpensesCY | 0 | 90709 |
| IRS990/RevenuesLessExpensesPriorYear | 0 | -41294 |
| IRS990/SalariesEtcCurrentYear | 0 | 0 |
| IRS990/SalariesEtcPriorYear | 0 | 0 |
| IRS990/SavingsAndTempCashInvestments/BOY | 0 | 27539 |
| IRS990/SavingsAndTempCashInvestments/EOY | 0 | 87162 |
| IRS990/ScheduleBRequired | 0 | 0 |
| IRS990ScheduleD/ExpensesNotRptdF990 | 0 | 0 |
| IRS990ScheduleD/ExpensesNotRptdOnFinStmt | 0 | 0 |
| IRS990ScheduleD/ExpensesSubtotal | 0 | 1305290 |
| IRS990ScheduleD/RevenueNotRptdF990 | 0 | 0 |
| IRS990ScheduleD/RevenueNotRptdOnFinStmt | 0 | 0 |
| IRS990ScheduleD/RevenueSubtotal | 0 | 1395999 |
| IRS990ScheduleD/TotalExpensesPerForm990 | 0 | 1305290 |
| IRS990ScheduleD/TotalOfBookValueLandBuildings | 0 | 0 |
| IRS990ScheduleD/TotalRevenuePerForm990 | 0 | 1395999 |
| IRS990ScheduleD/TotExpensesEtcAuditedFinclStmt | 0 | 1305290 |
| IRS990ScheduleD/TotRevenueEtcAuditedFinclStmt | 0 | 1395999 |
| IRS990/ScheduleJRequired | 0 | 0 |
| IRS990ScheduleO/GeneralExplanation/Explanation | 0 | THE ORGANIZATION DID NOT CONTEMPORANEOUSLY DOCUMENT THE GOVERNING BODY'S MEETINGS HELD OR WRITTEN ACTIONS TAKEN DURING THE YEAR BECAUSE THE EMPLOYEE HEALTH PLAN DID NOT REQUIRE A MEETING OF THE GOVERNING BODY. |
| IRS990ScheduleO/GeneralExplanation/Explanation | 1 | THE ORGANIZATION DID NOT CONTEMPORANEOUSLY DOCUMENT COMMITTEE MEETINGS HELD OR WRITTEN ACTIONS TAKEN DURING THE YEAR BECAUSE THE EMPLOYEE HEALTH PLAN DOES NOT HAVE COMMITTEES OR COMMITTEE MEETINGS. |
| IRS990ScheduleO/GeneralExplanation/Explanation | 2 | A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S TRUSTEE BEFORE IT WAS FILED. UPON APPROVAL OF THE RETURN, THE FORM 990 WAS PROCESSED AND SENT TO THE INTERNAL REVENUE SERVICE. |
| IRS990ScheduleO/GeneralExplanation/Explanation | 3 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION DOES NOT CURRENTLY HAVE A CONFLICT OF INTEREST POLICY. |
| IRS990ScheduleO/GeneralExplanation/Explanation | 4 | THE ORGANIZATION UTILIZES THE MODIFIED CASH BASIS OF ACCOUNTING. |
| IRS990ScheduleO/GeneralExplanation/Explanation | 5 | THE ORGANIZATION HAS AN INFORMAL COMMITTEE (CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER) THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 0 | FORM 990, PART VI, SECTION A, LINE 8A |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 1 | FORM 990, PART VI, SECTION A, LINE 8B |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 2 | FORM 990, PART VI, SECTION B, LINE 11 |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 3 | FORM 990, PART VI, SECTION C, LINE 19 |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 4 | FORM 990, PART XI, LINE 1: |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 5 | FORM 990, PART XII, LINE 2C: |
| IRS990/ScheduleORequired | 0 | 1 |
| IRS990/School | 0 | 0 |
| IRS990/SignificantChange | 0 | 0 |
| IRS990/SignificantNewProgramServices | 0 | 0 |
| IRS990/StateLegalDomicile | 0 | IA |
| IRS990/SubjectToProxyTax | 0 | 0 |
| IRS990/TaxablePartyNotification | 0 | 0 |
| IRS990/TaxExemptBonds | 0 | 0 |
| IRS990/Terminated | 0 | 0 |
| IRS990/TermOrPermanentEndowments | 0 | 0 |
| IRS990/TheBooksAreInCareOf/AddressUS/AddressLine1 | 0 | PO BOX 50 |
| IRS990/TheBooksAreInCareOf/AddressUS/City | 0 | OSKALOOSA |
| IRS990/TheBooksAreInCareOf/AddressUS/State | 0 | IA |
| IRS990/TheBooksAreInCareOf/AddressUS/ZIPCode | 0 | 52577 |
| IRS990/TheBooksAreInCareOf/NameBusiness/BusinessNameLine1 | 0 | MAHASKA BOTTLING COMPANY |
| IRS990/TheBooksAreInCareOf/TelephoneNumber | 0 | 8007473481 |
| IRS990/TotalAssets/BOY | 0 | 85993 |
| IRS990/TotalAssetsBOY | 0 | 85993 |
| IRS990/TotalAssets/EOY | 0 | 123414 |
| IRS990/TotalAssetsEOY | 0 | 123414 |
| IRS990/TotalCompGT150K | 0 | 0 |
| IRS990/TotalExpensesCurrentYear | 0 | 1305290 |
| IRS990/TotalExpensesPriorYear | 0 | 1444716 |
| IRS990/TotalFunctionalExpenses/Fundraising | 0 | 0 |
| IRS990/TotalFunctionalExpenses/ManagementAndGeneral | 0 | 0 |
| IRS990/TotalFunctionalExpenses/ProgramServices | 0 | 1305290 |
| IRS990/TotalFunctionalExpenses/Total | 0 | 1305290 |
| IRS990/TotalFundrsngExpCurrentYear | 0 | 0 |
| IRS990/TotalGrossUBI | 0 | 0 |
| IRS990/TotalLiabilities/BOY | 0 | 53288 |
| IRS990/TotalLiabilitiesBOY | 0 | 53288 |
| IRS990/TotalLiabilities/EOY | 0 | 0 |
| IRS990/TotalLiabilitiesEOY | 0 | 0 |
| IRS990/TotalLiabNetAssetsFundBalances/BOY | 0 | 85993 |
| IRS990/TotalLiabNetAssetsFundBalances/EOY | 0 | 123414 |
| IRS990/TotalNbrEmployees | 0 | 4 |
| IRS990/TotalNbrVolunteers | 0 | 0 |
| IRS990/TotalNetAssetsFundBalances/BOY | 0 | 32705 |
| IRS990/TotalNetAssetsFundBalances/EOY | 0 | 123414 |
| IRS990/TotalOtherCompensation | 0 | 0 |
| IRS990/TotalOtherRevenue | 0 | 59582 |
| IRS990/TotalProfFundrsngExpCY | 0 | 0 |
| IRS990/TotalProfFundrsngExpPriorYear | 0 | 0 |
| IRS990/TotalProgramServiceExpense | 0 | 1305290 |
| IRS990/TotalProgramServiceRevenue | 0 | 1336417 |
| IRS990/TotalReportableCompFrmRltdOrgs | 0 | 0 |
| IRS990/TotalReportableCompFromOrg | 0 | 0 |
| IRS990/TotalRevenueCurrentYear | 0 | 1395999 |
| IRS990/TotalRevenue/ExclusionAmount | 0 | 1395999 |
| IRS990/TotalRevenuePriorYear | 0 | 1403422 |
| IRS990/TotalRevenue/RelatedOrExemptFunctionIncome | 0 | 0 |
| IRS990/TotalRevenue/TotalRevenueColumn | 0 | 1395999 |
| IRS990/TotalRevenue/UnrelatedBusinessRevenue | 0 | 0 |
| IRS990/TypeOfOrganizationCorporation | 0 | X |
| IRS990/UnrelatedBusinessIncome | 0 | 0 |
| IRS990/UponRequest | 0 | X |
| IRS990/WebSite | 0 | N/A |
| IRS990/WhistleblowerPolicy | 0 | 0 |
| IRS990/YearFormation | 0 | 1984 |
| ReturnHeader/BuildTS | 0 | 2015-11-30 17:44:51Z |
| ReturnHeader/Filer/EIN | 0 | 421210714 |
| ReturnHeader/Filer/Name/BusinessNameLine1 | 0 | PEPSI-COLA BOTTLING COMPANY EMPLOYEES HEALTH PLAN |
| ReturnHeader/Filer/NameControl | 0 | PEPS |
| ReturnHeader/Filer/Phone | 0 | 8007473481 |
| ReturnHeader/Filer/USAddress/AddressLine1 | 0 | PO BOX 50 |
| ReturnHeader/Filer/USAddress/City | 0 | OSKALOOSA |
| ReturnHeader/Filer/USAddress/State | 0 | IA |
| ReturnHeader/Filer/USAddress/ZIPCode | 0 | 52577 |
| ReturnHeader/Officer/AuthorizeThirdParty | 0 | 1 |
| ReturnHeader/Officer/DateSigned | 0 | 2014-07-25 |
| ReturnHeader/Officer/Name | 0 | BRADLEY MUHL |
| ReturnHeader/Officer/Phone | 0 | 8007473481 |
| ReturnHeader/Officer/Title | 0 | TRUSTEE |
| ReturnHeader/PreparerFirm/EIN | 0 | 481238645 |
| ReturnHeader/PreparerFirm/PreparerFirmBusinessName/BusinessNameLine1 | 0 | MARKSNELSON VOHLAND CAMPBELL RADETIC LLC |
| ReturnHeader/PreparerFirm/PreparerFirmUSAddress/AddressLine1 | 0 | 1310 E 104TH ST SUITE 300 |
| ReturnHeader/PreparerFirm/PreparerFirmUSAddress/City | 0 | KANSAS CITY |
| ReturnHeader/PreparerFirm/PreparerFirmUSAddress/State | 0 | MO |
| ReturnHeader/PreparerFirm/PreparerFirmUSAddress/ZIPCode | 0 | 64131 |
| ReturnHeader/Preparer/Name | 0 | LAWRENCE W VOHLAND |
| ReturnHeader/Preparer/Phone | 0 | 8167437700 |
| ReturnHeader/ReturnType | 0 | 990 |
| ReturnHeader/TaxPeriodBeginDate | 0 | 2012-11-01 |
| ReturnHeader/TaxPeriodEndDate | 0 | 2013-10-31 |
| ReturnHeader/TaxYear | 0 | 2012 |
| ReturnHeader/Timestamp | 0 | 2014-08-25T14:07:30-05:00 |
Document Assets
No mirrored PDF or thumbnail assets are attached yet.
Filings
Displayed year
2013 • Form 990Facts available. Structured filing facts are available, but richer extracted sections are limited.
- Assets
- $123,414
- Liabilities
- $0
- Net assets
- $123,414
- Revenue
- -
- Expenses
- $1,305,290
- Net income
- -