Civic Intelligence

New Haven Development Center Inc

EIN 45-4488218 • 501(c)3 • Jacksonville, FL

Profile

The organization's mission is to provide employment assistance and educational services to the disabled.

7929 Los Robles CtJacksonville, FL 32256

n/A

Siviq Scores

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

Liabilities / Assets

100th percentile

45.79x

Higher debt load relative to assets than 100% of similar nonprofits.

501(c)3 • $500k-$1M nonprofits • Source year 2023

Liabilities / Revenue

89th percentile

0.69x

Higher debt load relative to revenue than 89% of similar nonprofits.

501(c)3 • $500k-$1M nonprofits • Source year 2023

Net Margin

22nd percentile

-11%

Higher net margin than 22% of similar nonprofits.

501(c)3 • $500k-$1M nonprofits • Source year 2023

Top Officer Pay

Score unavailable

No value available

No filing with officer rows is available for this organization yet.

Asset Growth

2nd percentile

-88%

Faster asset growth than 2% of similar nonprofits.

501(c)3 • $500k-$1M nonprofits • Annualized from 2022 to 2023

Revenue Growth

64th percentile

16%

Faster revenue growth than 64% of similar nonprofits.

501(c)3 • $500k-$1M nonprofits • Annualized from 2022 to 2023

Assets

Down

$11,089

Down $83,290 (-88%) from 2022

Liabilities

Up

$507,751

Up $507,751 from 2022

Net Assets

Down

-$496,662

Down $591,041 (-626%) from 2022

Revenue

Up

$735,367

Up $102,946 (+16%) from 2022

Expenses

Up

$818,657

Up $264,507 (+48%) from 2022

Net Income

Down

-$83,290

Down $161,561 (-206%) from 2022

Trend Graphs

Balance Sheet Trend

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

$1.0M$500K$0-$500KAssets 2015: $1Liabilities 2015: $9262015Assets 2016: $2,422Liabilities 2016: $02016Assets 2017: $0Liabilities 2017: $2,107Net Assets 2017: -$2,1072017Assets 2018: $0Liabilities 2018: $572Net Assets 2018: -$5722018Assets 2019: $18,501Liabilities 2019: $0Net Assets 2019: $18,5012019Assets 2020: $1,395Liabilities 2020: $37,500Net Assets 2020: -$36,1052020Assets 2021: $16,688Liabilities 2021: $0Net Assets 2021: $16,6882021Assets 2022: $94,379Liabilities 2022: $0Net Assets 2022: $94,3792022Assets 2023: $11,089Liabilities 2023: $507,751Net Assets 2023: -$496,6622023

Highlighted filing

2023

Assets$11,089
Liabilities$507,751
Net Assets-$496,662

Operations Trend

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

$1.0M$500K$0-$500KRevenue 2015: $53,561Expenses 2015: $54,690Net Income 2015: -$1,1292015Revenue 2016: $76,056Expenses 2016: $73,634Net Income 2016: $2,4222016Revenue 2017: $76,722Expenses 2017: $77,661Net Income 2017: -$9392017Revenue 2018: $420,112Expenses 2018: $393,751Net Income 2018: $26,3612018Revenue 2019: $475,740Expenses 2019: $457,239Net Income 2019: $18,5012019Revenue 2020: $541,667Expenses 2020: $558,773Net Income 2020: -$17,1062020Revenue 2021: $796,447Expenses 2021: $743,654Net Income 2021: $52,7932021Revenue 2022: $632,421Expenses 2022: $554,150Net Income 2022: $78,2712022Revenue 2023: $735,367Expenses 2023: $818,657Net Income 2023: -$83,2902023

Highlighted filing

2023

Revenue$735,367
Expenses$818,657
Net Income-$83,290

Filings

Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2023 to Dec 31, 2023
Signed
Apr 5, 2024
Return Version
2023v5.0
Gross Receipts
$735,367
Mission and Program Overview

Mission

The organization's mission is to provide employment assistance and educational services to the disabled.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$94,379$11,089▼ $83,290
Savings and Temporary Cash Investments-$0-
Accounts Receivable-$0-
Other Notes and Loans Receivable, Net-$0-
Pledges and Grants Receivable-$0-
Receivable From Disqualified Prsn-$0-
Receivables From Officers Etc-$0-
Investments Other Securities-$0-
Investments Program Related-$0-
Investments in Publicly Traded Securities-$0-
Land, Buildings, and Equipment, Net-$0-
Intangible Assets-$0-
Inventories for Sale or Use-$0-
Prepaid Expenses and Deferred Charges-$0-
Rtn Earn Endowment Incm Other Fnds$94,379$-496,662▼ $591,041
Total Assets$94,379$11,089▼ $83,290
Other Assets Total-$0-
Liabilities
Unsecured Notes Loans Payable-$507,751-
Total Liabilities$0$507,751▲ $507,751
Net Assets / Fund Balance
Total Net Assets Fund Balance$94,379$-496,662▼ $591,041
Total Liabilities and Net Assets / Fund Balance$94,379$11,089▼ $83,290
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseTotal
Jada JamesPresidentFT$12,400$12,400

Board Members and Trustees

NameTitle
Mark FordSecretary
June LawTreasurer
Randel BrigginsTreasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$735,367
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$-83,290
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$572,549
Salaries, Compensation, and Employee Benefits$229,108
Grants and Similar Amounts Paid$17,000
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$208,525--$208,525
All Other Expenses$131,358--$131,358
Occupancy$68,745--$68,745
Other Expenses$32,003--$32,003
Interest$13,397--$13,397
Current Officers, Directors, Trustees, and Key Employees$12,400--$12,400
Grants to Domestic Individuals$12,000--$12,000
Office Expenses$11,458--$11,458
Payroll Taxes$8,183--$8,183
Grants to Domestic Orgs$5,000--$5,000
Advertising-$4,855-$4,855
Fees for Services Legal-$1,443-$1,443
Fees for Services Other-$1,250-$1,250
Fees for Services Accounting-$750-$750
Total Functional Expenses$810,359$8,298$0$818,657
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

Loans and Receivables

Line ItemBeginningEndChange
Receivables from Disqualified Persons-$0-
Receivables from Officers, Directors, Trustees, and Key Employees-$0-
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
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
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, Line 11B

The Board members review the tax return form 990 at one of the board meetings and vote on approval.

Form 990, Part VI, Section B, Line 12C

Independent Board members review and vote on issues that include a potential conflict.

Form 990, Part VI, Section B, Line 15A

Independent Board members review comparable market compensations and vote on the compensation for the officers.

Form 990, Part VI, Section B, Line 15B

Independent Board members review comparable market compensations and vote on the compensation for the officers or key employees.

Form 990, Part VI, Section C, Line 19

Documents are provided by postal mail or email upon request.

Filing and Contact Details

Filer

Filer Name
New Haven Development Center Inc
EIN
45-4488218
Phone
9046310999
Address
7929 Los Robles Ct, Jacksonville, FL 32256

Signing Officer

Name
Jada James
Title
President
Signed
2024-04-05
Discuss with paid preparer
Yes

Organization Details

Principal Officer
2
Formed
2012
Legal Domicile
Fl
Voting Board Members
4
Independent Board Members
4
Employees
3
Volunteers
3

Preparer

Firm
Zik Taxes LLC
Address
790 SADDLE RIDGE TRCE, ROSWELL, GA 30076
Preparer
Zlatina Mikova
Phone
4049442586
Supplemental Narrative

Additional Explanations

Form 990, Part IX, Line 24E

Dues & Subscriptions: Column (A) - Total = $4850; Column (B) - Program Services = $4850; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

Form 990, Part IX, Line 24E

Food Spring Camp: Column (A) - Total = $12003; Column (B) - Program Services = $12003; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

Form 990, Part IX, Line 24E

Food Summer Camp: Column (A) - Total = $30001; Column (B) - Program Services = $30001; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

Form 990, Part IX, Line 24E

Other: Column (A) - Total = $0; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

Form 990, Part IX, Line 24E

Postage and Shipping: Column (A) - Total = $6825; Column (B) - Program Services = $6825; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

Form 990, Part IX, Line 24E

Printing and Publications: Column (A) - Total = $9815; Column (B) - Program Services = $9815; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

Form 990, Part IX, Line 24E

Repair & Maintenance: Column (A) - Total = $3500; Column (B) - Program Services = $3500; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

Form 990, Part IX, Line 24E

Spring Camp Virtual: Column (A) - Total = $18500; Column (B) - Program Services = $18500; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

Form 990, Part IX, Line 24E

Spring Camp: Column (A) - Total = $22875; Column (B) - Program Services = $22875; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

Form 990, Part IX, Line 24E

Telephone: Column (A) - Total = $6986; Column (B) - Program Services = $6986; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

Form 990, Part IX, Line 24E

Transportation/Spring Tour: Column (A) - Total = $16003; Column (B) - Program Services = $16003; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

Form 990, Part XI, Line 9

SBA LOAN = -$507751

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IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus4YearsAmt0475740
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/TotalAmt03181642
IRS990ScheduleA/GrossReceiptsNonUnrltBusGrp/TotalAmt00
IRS990ScheduleA/InvestmentIncomeCYPct00.00000
IRS990ScheduleA/NetIncomeFromOtherUBIGrp/TotalAmt00
IRS990ScheduleA/OtherIncome509Grp/TotalAmt00
IRS990ScheduleA/Post1975UBTIGrp/TotalAmt00
IRS990ScheduleA/PubliclySupportedOrg509a2Ind0X
IRS990ScheduleA/PublicSupportCY509Pct01.00000
IRS990ScheduleA/PublicSupportPY509Pct01.00000
IRS990ScheduleA/PublicSupportTotal509Amt03181642
IRS990ScheduleA/SubstantialContributorsAmtGrp/TotalAmt00
IRS990ScheduleA/TaxRevLeviedOrgnztnlBnft509Grp/TotalAmt00
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY509Ind0X
IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt0735367
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt0632421
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt0796447
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt0541667
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt0475740
IRS990ScheduleA/Total509Grp/TotalAmt03181642
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt0735367
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt0632421
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt0796447
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt0541667
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus4YearsAmt0475740
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt03181642
IRS990/ScheduleBRequiredInd0false
IRS990ScheduleI/GrantRecordsMaintainedInd0true
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/CashGrantAmt012000
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/GrantTypeTxt0Tuition
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/RecipientCnt064
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/ValuationMethodUsedDesc0cash
IRS990ScheduleI/Total501c3OrgCnt00
IRS990ScheduleI/TotalOtherOrgCnt00
IRS990/ScheduleJRequiredInd0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0The Board members review the tax return form 990 at one of the board meetings and vote on approval.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1Independent Board members review and vote on issues that include a potential conflict.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2Independent Board members review comparable market compensations and vote on the compensation for the officers.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3Independent Board members review comparable market compensations and vote on the compensation for the officers or key employees.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4Documents are provided by postal mail or email upon request.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5Dues & Subscriptions: Column (A) - Total = $4850; Column (B) - Program Services = $4850; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6Food Spring Camp: Column (A) - Total = $12003; Column (B) - Program Services = $12003; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7Food Summer Camp: Column (A) - Total = $30001; Column (B) - Program Services = $30001; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt8Other: Column (A) - Total = $0; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt9Postage and Shipping: Column (A) - Total = $6825; Column (B) - Program Services = $6825; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt10Printing and Publications: Column (A) - Total = $9815; Column (B) - Program Services = $9815; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt11Repair & Maintenance: Column (A) - Total = $3500; Column (B) - Program Services = $3500; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt12Spring Camp Virtual: Column (A) - Total = $18500; Column (B) - Program Services = $18500; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt13Spring Camp: Column (A) - Total = $22875; Column (B) - Program Services = $22875; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt14Telephone: Column (A) - Total = $6986; Column (B) - Program Services = $6986; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt15Transportation/Spring Tour: Column (A) - Total = $16003; Column (B) - Program Services = $16003; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt16SBA LOAN = -$507751
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Form 990, Part VI, Section B, Line 11b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Form 990, Part VI, Section B, Line 12c
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2Form 990, Part VI, Section B, Line 15a
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3Form 990, Part VI, Section B, Line 15b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4Form 990, Part VI, Section C, Line 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5Form 990, Part IX, Line 24e
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6Form 990, Part IX, Line 24e
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7Form 990, Part IX, Line 24e
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc8Form 990, Part IX, Line 24e
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc9Form 990, Part IX, Line 24e
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc10Form 990, Part IX, Line 24e
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc11Form 990, Part IX, Line 24e
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc12Form 990, Part IX, Line 24e
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc13Form 990, Part IX, Line 24e
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc14Form 990, Part IX, Line 24e
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc15Form 990, Part IX, Line 24e
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc16Form 990, Part XI, Line 9
IRS990/SchoolOperatingInd0false
IRS990/SignificantChangeInd0false
IRS990/SignificantNewProgramSrvcInd0false
IRS990/StatesWhereCopyOfReturnIsFldCd0FL
IRS990/SubjectToExcsTaxNetInvstIncInd0false
IRS990/SubjectToProxyTaxInd0false
IRS990/SubjToTaxRmnrtnExPrchtPymtInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt094379
IRS990/TotalAssetsEOYAmt011089
IRS990/TotalAssetsGrp/BOYAmt094379
IRS990/TotalAssetsGrp/EOYAmt011089
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt00
IRS990/TotalEmployeeCnt03
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt08298
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0810359
IRS990/TotalFunctionalExpensesGrp/TotalAmt0818657
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesEOYAmt0507751
IRS990/TotalLiabilitiesGrp/BOYAmt00
IRS990/TotalLiabilitiesGrp/EOYAmt0507751
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt094379
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0-496662
IRS990/TotalProgramServiceExpensesAmt0810359
IRS990/TotalProgramServiceRevenueAmt0735367
IRS990/TotalReportableCompFromOrgAmt012400
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt0735367
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0735367
IRS990/TotalVolunteersCnt03
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt094379
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt011089
IRS990/TravelGrp/TotalAmt00
IRS990/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UnsecuredNotesLoansPayableGrp/EOYAmt0507751
IRS990/UponRequestInd0X
IRS990/VotingMembersGoverningBodyCnt04
IRS990/VotingMembersIndependentCnt04
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd0false
ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/AuthenticationAssuranceLevelCd0AAL1
ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/FederatedAssuranceLevelCd0FAL1
ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/IdentityAssuranceLevelCd0IAL1
ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/TrustedCustomerCd00
ReturnHeader/BuildTS02023-04-26 12:10:37Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0Jada James
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0President
ReturnHeader/BusinessOfficerGrp/SignatureDt02024-04-05
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0New Haven Development Center Inc
ReturnHeader/Filer/BusinessNameControlTxt0NEWH
ReturnHeader/Filer/EIN0454488218
ReturnHeader/Filer/PhoneNum09046310999
ReturnHeader/Filer/USAddress/AddressLine1Txt07929 Los Robles Ct
ReturnHeader/Filer/USAddress/CityNm0Jacksonville
ReturnHeader/Filer/USAddress/StateAbbreviationCd0FL
ReturnHeader/Filer/USAddress/ZIPCd032256
ReturnHeader/IRSResponsiblePrtyInfoCurrInd0true
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0872035854
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0ZIK TAXES LLC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0790 SADDLE RIDGE TRCE
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0ROSWELL
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0GA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd030076
ReturnHeader/PreparerPersonGrp/PhoneNum04049442586

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