Civic Intelligence

Carebridge

990 • Fiscal year 2015 • EIN 45-4035065

Jan 01, 2015 to Dec 31, 2015 • Filed on May 12, 2016

1301 North Hagadorn RoadEast Lansing, MI 48823

(517) 336-1400

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

86th percentile

0.77x

Higher debt load relative to assets than 86% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Liabilities / Revenue

80th percentile

0.67x

Higher debt load relative to revenue than 80% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Net Margin

47th percentile

1.8%

Higher net margin than 47% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Top Officer Pay

35th percentile

$0

Higher top officer pay than 35% of similar nonprofits.

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

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Asset Growth

94th percentile

82%

Faster asset growth than 94% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2014 to 2015

Revenue Growth

81st percentile

29%

Faster revenue growth than 81% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2014 to 2015

Assets

Up

$1,973,864

Up $889,060 (+82%) from 2014

Net Assets

Up

$455,163

Up $41,307 (+10.0%) from 2014

Liabilities

Up

$1,518,701

Up $847,753 (+126%) from 2014

Revenue

Up

$2,273,426

Up $505,352 (+29%) from 2014

Expenses

Up

$2,232,119

Up $184,595 (+9.0%) from 2014

Net Income

Up

$41,307

Up $320,757 (+115%) from 2014

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$2.0M$1.5M$1.0M$500K$0Assets 2012: $994,700Liabilities 2012: $125,654Net Assets 2012: $869,0462012Assets 2013: $1,155,442Liabilities 2013: $462,136Net Assets 2013: $693,3062013Assets 2014: $1,084,804Liabilities 2014: $670,948Net Assets 2014: $413,8562014Assets 2015: $1,973,864Liabilities 2015: $1,518,701Net Assets 2015: $455,1632015Assets 2016: $1,406,550Liabilities 2016: $1,170,942Net Assets 2016: $235,6082016Assets 2017: $362,538Liabilities 2017: $286,584Net Assets 2017: $75,9542017Assets 2018: $55,632Liabilities 2018: $1,083Net Assets 2018: $54,5492018Assets 2019: $51,602Liabilities 2019: $148Net Assets 2019: $51,4542019Assets 2020: $49,589Liabilities 2020: $2912020Assets 2024: $184,535Liabilities 2024: $515Net Assets 2024: $184,0202024

Highlighted filing

2015

Assets$1,973,864
Liabilities$1,518,701
Net Assets$455,163

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$3.0M$2.0M$1.0M$0-$1.0MRevenue 2012: $2,288,609Expenses 2012: $1,419,563Net Income 2012: $869,0462012Revenue 2013: $1,910,749Expenses 2013: $2,086,489Net Income 2013: -$175,7402013Revenue 2014: $1,768,074Expenses 2014: $2,047,524Net Income 2014: -$279,4502014Revenue 2015: $2,273,426Expenses 2015: $2,232,119Net Income 2015: $41,3072015Revenue 2016: $2,257,654Expenses 2016: $2,477,209Net Income 2016: -$219,5552016Revenue 2017: $317,465Expenses 2017: $477,119Net Income 2017: -$159,6542017Revenue 2018: $235Expenses 2018: $21,640Net Income 2018: -$21,4052018Revenue 2019: $55Expenses 2019: $3,150Net Income 2019: -$3,0952019Revenue 2020: $0Expenses 2020: $2,156Net Income 2020: -$2,1562020Revenue 2024: $160,000Expenses 2024: $19,499Net Income 2024: $140,5012024

Highlighted filing

2015

Revenue$2,273,426
Expenses$2,232,119
Net Income$41,307
Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
May 12, 2016
Return Version
2015v2.1
Gross Receipts
$2,273,426
Mission and Program Overview

Mission

To improve the delivery of health care services in the state of michigan by supporting a governmental demonstration project and otherwise promoting the charitable provision of health care services in the state.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$66,865$140,371▲ $73,506
Prepaid Expenses and Deferred Charges$11,993$85,202▲ $73,209
Accounts Receivable$8,000--
Land, Buildings, and Equipment, Net$8,155$2,079▼ $6,076
Total Assets$1,084,804$1,973,864▲ $889,060
Other Assets Total$989,791$1,746,212▲ $756,421
Liabilities
Unsecured Notes Loans Payable$253,948$851,759▲ $597,811
Accounts Payable and Accrued Expenses$417,000$371,934▼ $45,066
Other Liabilities-$295,008-
Total Liabilities$670,948$1,518,701▲ $847,753
Net Assets / Fund Balance
Unrestricted Net Assets$413,856$455,163▲ $41,307
Total Net Assets Fund Balance$413,856$455,163▲ $41,307
Total Liabilities and Net Assets / Fund Balance$1,084,804$1,973,864▲ $889,060

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$2,079$36,285$38,364
Other Assets Org$1,746,212--
Compensation and Service Providers

Board Members and Trustees

Highest Paid Contractors

ContractorServicesLocationCompensation
Michigan Medical Advantage INCManagement1301 N HAGADORN RD, East Lansing, MI 48823$171,980
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$2,273,426
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$41,307
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$1,300,526
Salaries, Compensation, and Employee Benefits$931,593
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$794,485--$794,485
Fees for Services Other$339,390$148,981-$488,371
Information Technology$261,000$1,650-$262,650
Payroll Taxes$68,472--$68,472
Other Employee Benefits$64,773--$64,773
Fees for Services Accounting$40,043--$40,043
Interest$37,702--$37,702
Fees for Services Management-$23,333-$23,333
Insurance$19,949--$19,949
Conferences and Meetings$11,931--$11,931
Travel$11,827--$11,827
Depreciation Depletion$6,076--$6,076
Advertising$4,420--$4,420
Other Expenses$7,773$3,876-$3,876
Pension Plan Contributions$3,863--$3,863
Office Expenses$3,497--$3,497
Total Functional Expenses$2,054,279$177,840$0$2,232,119
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
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
-DirectorManagement FeesNo$171,980
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Mipct Advance From Cipa$295,008
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
Yes
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
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
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
Yes

Governance Explanations

Form 990, Page 6, Part VI, Line 2

Michael sparkia mag director mag emp, dir of this entity paul maclellan mag director mag emp, dir of this entity greg laidlaw mag exec direct mag emp, ex dir of this entity

Form 990, Page 6, Part VI, Line 3

Carebridge has contracted medical advantage group (mag) to perform all management services including, but not limited to, business operations, client services and contracts, finances, staffing levels, and human resources. Greg laidlaw is the executive director of carebridge, however, he is not paid directly by carebridge. He is paid by mag for his services provided to multiple entities in his capacity as a mag representative providing management services. Carebridge pays mag management fees for the management services received. Since mag is not a related entity the compensation paid to greg from mag has not been disclosed on part vii.

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

The organization provides the completed form 990 as part of the subsequent board packet following completion of the form 990. The executive director reviews the form 990 before it is signed and filed.

Form 990, Page 6, Part VI, Line 12C

Each director, principal officer, and member of a committee with board- delegated powers must read and sign annually a statement stating they received a copy of the policy, they read and understand it, and agree to comply with it.

Form 990, Page 6, Part VI, Line 19

Documentation is available upon request.

Form 990, Part VII

The compensation for the executive director is paid by mag, the management company contracted to perform management services. This organization pays mag management fees for these services. See form 990 part vi, line 3 for more information.

Filing and Contact Details

Filer

Filer Name
Carebridge
EIN
45-4035065
Phone
5173361400
Address
1301 NORTH HAGADORN ROAD, EAST LANSING, MI 48823

Signing Officer

Name
Gregory Laidlaw
Title
Executive Director
Phone
5173361400
Signed
2016-05-12
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Gregory Laidlaw
Formed
2011
Legal Domicile
Mi
Voting Board Members
5
Independent Board Members
3
Employees
19
Volunteers
3

Preparer

Firm
Andrews Hooper Pavlik Plc
Address
5300 GRATIOT RD, SAGINAW, MI 48638-6035
Preparer
Laura M Ebel
Phone
9894975300
Supplemental Narrative

Additional Explanations

Form 990

All lines left blank are not applicable to this organization.

Form 990, Part IX, Line 11G

Bank fees 45 0 0 contract employees 339,345 0 0 other professional services 0 148,981 0

Raw XML Appendix384 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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IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearAmt02273426
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus1YearAmt01768074
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus2YearsAmt01910749
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus3YearsAmt02288609
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/TotalAmt08240858
IRS990ScheduleA/PubliclySupportedOrg509a2Ind0X
IRS990ScheduleA/PublicSupportTotal509Amt08240858
IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt02273426
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt01768074
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt01910749
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt02288609
IRS990ScheduleA/Total509Grp/TotalAmt08240858
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt02273426
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt01768074
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt01910749
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt02288609
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt08240858
IRS990/ScheduleBRequiredInd0false
IRS990ScheduleD/EquipmentGrp/BookValueAmt02079
IRS990ScheduleD/EquipmentGrp/DepreciationAmt036285
IRS990ScheduleD/EquipmentGrp/OtherCostOrOtherBasisAmt038364
IRS990ScheduleD/OtherAssetsOrgGrp/BookValueAmt01746212
IRS990ScheduleD/OtherAssetsOrgGrp/Desc0ACCRUED REVENUE
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt0295008
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc0MIPCT ADVANCE FROM CIPA
IRS990ScheduleD/TotalBookValueLandBuildingsAmt02079
IRS990ScheduleD/TotalBookValueOtherAssetsAmt01746212
IRS990ScheduleD/TotalLiabilityAmt0295008
IRS990/ScheduleJRequiredInd0false
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/NameOfInterested/BusinessName/BusinessNameLine1Txt0MEDICAL ADVANTAGE GROUP
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/NameOfInterested/BusinessName/BusinessNameLine2Txt0MEDICAL ADVANTAGE GROUP
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/RelationshipDescriptionTxt0DIRECTOR
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/SharingOfRevenuesInd0false
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionAmt0171980
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionDesc0MANAGEMENT FEES
IRS990ScheduleL/SupplementalInformationDetail/ExplanationTxt0MICHAEL SPARKIA, PAUL MACLELLAN, AND GREG LAIDLAW ARE ALL EMPLOYEES OF MEDICAL ADVANTAGE GROUP (MAG). THE COMPENSATION THEY RECEIVE FROM MAG IS FOR THEIR SERVICES AS A MAG EMPLOYEE. CAREBRIDGE PAYS MAG MANAGEMENT FEES FOR SERVICES RENDERED UNDER THEIR CONTRACT WITH MAG, THEREFORE, THIS RELATIONSHIP HAS BEEN DISCLOSED ON SCHEDULE L.
IRS990ScheduleL/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE L, PART V
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THIS ORGANIZATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1MICHAEL SPARKIA MAG DIRECTOR MAG EMP, DIR OF THIS ENTITY PAUL MACLELLAN MAG DIRECTOR MAG EMP, DIR OF THIS ENTITY GREG LAIDLAW MAG EXEC DIRECT MAG EMP, EX DIR OF THIS ENTITY
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2CAREBRIDGE HAS CONTRACTED MEDICAL ADVANTAGE GROUP (MAG) TO PERFORM ALL MANAGEMENT SERVICES INCLUDING, BUT NOT LIMITED TO, BUSINESS OPERATIONS, CLIENT SERVICES AND CONTRACTS, FINANCES, STAFFING LEVELS, AND HUMAN RESOURCES. GREG LAIDLAW IS THE EXECUTIVE DIRECTOR OF CAREBRIDGE, HOWEVER, HE IS NOT PAID DIRECTLY BY CAREBRIDGE. HE IS PAID BY MAG FOR HIS SERVICES PROVIDED TO MULTIPLE ENTITIES IN HIS CAPACITY AS A MAG REPRESENTATIVE PROVIDING MANAGEMENT SERVICES. CAREBRIDGE PAYS MAG MANAGEMENT FEES FOR THE MANAGEMENT SERVICES RECEIVED. SINCE MAG IS NOT A RELATED ENTITY THE COMPENSATION PAID TO GREG FROM MAG HAS NOT BEEN DISCLOSED ON PART VII.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3THE ORGANIZATION PROVIDES THE COMPLETED FORM 990 AS PART OF THE SUBSEQUENT BOARD PACKET FOLLOWING COMPLETION OF THE FORM 990. THE EXECUTIVE DIRECTOR REVIEWS THE FORM 990 BEFORE IT IS SIGNED AND FILED.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4EACH DIRECTOR, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH BOARD- DELEGATED POWERS MUST READ AND SIGN ANNUALLY A STATEMENT STATING THEY RECEIVED A COPY OF THE POLICY, THEY READ AND UNDERSTAND IT, AND AGREE TO COMPLY WITH IT.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5DOCUMENTATION IS AVAILABLE UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6THE COMPENSATION FOR THE EXECUTIVE DIRECTOR IS PAID BY MAG, THE MANAGEMENT COMPANY CONTRACTED TO PERFORM MANAGEMENT SERVICES. THIS ORGANIZATION PAYS MAG MANAGEMENT FEES FOR THESE SERVICES. SEE FORM 990 PART VI, LINE 3 FOR MORE INFORMATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7BANK FEES 45 0 0 CONTRACT EMPLOYEES 339,345 0 0 OTHER PROFESSIONAL SERVICES 0 148,981 0
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PAGE 6, PART VI, LINE 2
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PAGE 6, PART VI, LINE 3
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PAGE 6, PART VI, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PAGE 6, PART VI, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5FORM 990, PAGE 6, PART VI, LINE 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6FORM 990, PART VII
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7FORM 990, PART IX, LINE 11G
IRS990/SchoolOperatingInd0false
IRS990/SignificantChangeInd0false
IRS990/SignificantNewProgramSrvcInd0false
IRS990/SubjectToProxyTaxInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TempOrPermanentEndowmentsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt01084804
IRS990/TotalAssetsEOYAmt01973864
IRS990/TotalAssetsGrp/BOYAmt01084804
IRS990/TotalAssetsGrp/EOYAmt01973864
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalEmployeeCnt019
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt0177840
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt02054279
IRS990/TotalFunctionalExpensesGrp/TotalAmt02232119
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt0670948
IRS990/TotalLiabilitiesEOYAmt01518701
IRS990/TotalLiabilitiesGrp/BOYAmt0670948
IRS990/TotalLiabilitiesGrp/EOYAmt01518701
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0413856
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0455163
IRS990/TotalOthProgramServiceRevGrp/RelatedOrExemptFuncIncomeAmt0151580
IRS990/TotalOthProgramServiceRevGrp/TotalRevenueColumnAmt0151580
IRS990/TotalProgramServiceExpensesAmt02054279
IRS990/TotalProgramServiceRevenueAmt02273426
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt02273426
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt02273426
IRS990/TotalVolunteersCnt03
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt01084804
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt01973864
IRS990/TravelGrp/ProgramServicesAmt011827
IRS990/TravelGrp/TotalAmt011827
IRS990/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UnrestrictedNetAssetsGrp/BOYAmt0413856
IRS990/UnrestrictedNetAssetsGrp/EOYAmt0455163
IRS990/UnsecuredNotesLoansPayableGrp/BOYAmt0253948
IRS990/UnsecuredNotesLoansPayableGrp/EOYAmt0851759
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt01301 NORTH HAGADORN ROAD
IRS990/USAddress/CityNm0EAST LANSING
IRS990/USAddress/StateAbbreviationCd0MI
IRS990/USAddress/ZIPCd048823
IRS990/VotingMembersGoverningBodyCnt05
IRS990/VotingMembersIndependentCnt03
IRS990/WebsiteAddressTxt0WWW.THE-CAREBRIDGE.COM
IRS990/WhistleblowerPolicyInd0false
ReturnHeader/BuildTS02016-09-27 15:27:22Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0GREGORY LAIDLAW
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0EXECUTIVE DIRECTOR
ReturnHeader/BusinessOfficerGrp/PhoneNum05173361400
ReturnHeader/BusinessOfficerGrp/SignatureDt02016-05-12
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0CAREBRIDGE
ReturnHeader/Filer/BusinessNameControlTxt0CARE
ReturnHeader/Filer/EIN0454035065
ReturnHeader/Filer/PhoneNum05173361400
ReturnHeader/Filer/USAddress/AddressLine1Txt01301 NORTH HAGADORN ROAD
ReturnHeader/Filer/USAddress/CityNm0EAST LANSING
ReturnHeader/Filer/USAddress/StateAbbreviationCd0MI
ReturnHeader/Filer/USAddress/ZIPCd048823
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0383133790
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0ANDREWS HOOPER PAVLIK PLC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt05300 GRATIOT RD
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0SAGINAW
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0MI
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0486386035
ReturnHeader/PreparerPersonGrp/PhoneNum09894975300
ReturnHeader/PreparerPersonGrp/PreparationDt02016-05-12
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0LAURA M EBEL
ReturnHeader/ReturnTs02016-05-16T13:35:34-05:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02015-01-01
ReturnHeader/TaxPeriodEndDt02015-12-31
ReturnHeader/TaxYr02015

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