Civic Intelligence

Instiglio

990 • Fiscal year 2016 • EIN 45-5015494

Jan 01, 2016 to Dec 31, 2016 • Filed on Oct 20, 2017

1222 Hempstead RdNiskayuna, NY 12309-1210

(678) 296-7474

Siviq Scores

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

Liabilities / Assets

61st percentile

0.10x

Higher debt load relative to assets than 61% of similar nonprofits.

2016 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2016

Liabilities / Revenue

45th percentile

0.03x

Higher debt load relative to revenue than 45% of similar nonprofits.

2016 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2016

Net Margin

53rd percentile

3.9%

Higher net margin than 53% of similar nonprofits.

2016 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2016

Top Officer Pay

Score unavailable

No value available

This filing does not contain officer compensation rows.

Source year 2016

Asset Growth

20th percentile

-7.4%

Faster asset growth than 20% of similar nonprofits.

2016 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2014 to 2016

Revenue Growth

82nd percentile

32%

Faster revenue growth than 82% of similar nonprofits.

2016 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2014 to 2016

Assets

Up

$196,606

Up $25,588 (+15%) from 2015

Net Assets

Up

$176,866

Up $40,634 (+30%) from 2015

Liabilities

Down

$19,740

Down $15,046 (-43%) from 2015

Revenue

Up

$737,288

Up $242,822 (+49%) from 2015

Expenses

Up

$708,180

Up $131,466 (+23%) from 2015

Net Income

Up

$29,108

Up $111,356 (+135%) from 2015

Historical Trend

Balance Sheet Trend

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

$4.0M$3.0M$2.0M$1.0M$0Assets 2013: $221,548Liabilities 2013: $8,575Net Assets 2013: $212,9732013Assets 2014: $229,330Liabilities 2014: $10,850Net Assets 2014: $218,4802014Assets 2015: $171,018Liabilities 2015: $34,786Net Assets 2015: $136,2322015Assets 2016: $196,606Liabilities 2016: $19,740Net Assets 2016: $176,8662016Assets 2017: $683,072Liabilities 2017: $40,147Net Assets 2017: $642,9252017Assets 2018: $1,339,532Liabilities 2018: $321,422Net Assets 2018: $1,018,1102018Assets 2019: $1,332,272Liabilities 2019: $68,244Net Assets 2019: $1,264,0282019Assets 2020: $1,915,274Liabilities 2020: $142,733Net Assets 2020: $1,772,5412020Assets 2021: $750,033Liabilities 2021: $97,908Net Assets 2021: $652,1252021Assets 2022: $3,222,096Liabilities 2022: $93,897Net Assets 2022: $3,128,1992022Assets 2023: $3,992,974Liabilities 2023: $160,789Net Assets 2023: $3,832,1852023Assets 2024: $3,511,684Liabilities 2024: $392,164Net Assets 2024: $3,119,5202024

Highlighted filing

2016

Assets$196,606
Liabilities$19,740
Net Assets$176,866

Operations Trend

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

$8.0M$6.0M$4.0M$2.0M$0-$2.0MRevenue 2013: $445,467Expenses 2013: $241,959Net Income 2013: $203,5082013Revenue 2014: $425,128Expenses 2014: $419,621Net Income 2014: $5,5072014Revenue 2015: $494,466Expenses 2015: $576,714Net Income 2015: -$82,2482015Revenue 2016: $737,288Expenses 2016: $708,180Net Income 2016: $29,1082016Revenue 2017: $1,491,856Expenses 2017: $1,025,797Net Income 2017: $466,0592017Revenue 2018: $2,157,249Expenses 2018: $1,782,064Net Income 2018: $375,1852018Revenue 2019: $2,560,670Expenses 2019: $1,824,248Net Income 2019: $736,4222019Revenue 2020: $2,908,344Expenses 2020: $2,399,831Net Income 2020: $508,5132020Revenue 2021: $2,766,361Expenses 2021: $3,495,702Net Income 2021: -$729,3412021Revenue 2022: $5,716,140Expenses 2022: $3,353,387Net Income 2022: $2,362,7532022Revenue 2023: $4,891,769Expenses 2023: $3,939,082Net Income 2023: $952,6872023Revenue 2024: $5,618,021Expenses 2024: $6,554,859Net Income 2024: -$936,8382024

Highlighted filing

2016

Revenue$737,288
Expenses$708,180
Net Income$29,108
Jump To
Filing Snapshot
Filing Period
Jan 1, 2016 to Dec 31, 2016
Signed
Oct 20, 2017
Return Version
2016v3.0
Gross Receipts
$737,288
Mission and Program Overview

Mission

Instiglio's mission is to empower leaders in the social, public, and private sectors to improve the impact of social programs in developing countries by tying funding to results.

SEE PART III, LINE 1.

Balance Sheet Detail
LineBeginningEndChange
Assets
Accounts Receivable$10,510$94,634▲ $84,124
Cash and Non-Interest-Bearing Accounts$22,590$80,407▲ $57,817
Savings and Temporary Cash Investments$125,168$20,228▼ $104,940
Prepaid Expenses and Deferred Charges$12,750$1,337▼ $11,413
Total Assets$171,018$196,606▲ $25,588
Liabilities
Accounts Payable and Accrued Expenses$17,786$19,740▲ $1,954
Deferred Revenue$17,000--
Total Liabilities$34,786$19,740▼ $15,046
Net Assets / Fund Balance
Unrestricted Net Assets$136,232$176,866▲ $40,634
Total Net Assets Fund Balance$136,232$176,866▲ $40,634
Total Liabilities and Net Assets / Fund Balance$171,018$196,606▲ $25,588
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Avnish GungadurdossManaging PartnerFT$30,737$50,949$81,686
Gonzalo SanmartinLatam DirectorFT$56,633-$56,633
Ram AkersCFO (until 09/16)FT$5,761$26,042$31,803
Andres ThomasFinance AssociateFT$10,010-$10,010
Revenue and Support

Revenue Composition

Contributions and Grants
$122,000
Program Service Revenue
$615,253
Investment Income
$35
Other Revenue
$0
All Other Contributions
$122,000
Change in Net Assets
$29,108

Audited Revenue Reconciliation

Revenue per Audited Statements
$737,288
Revenue Not Reported on Financial Statements
$0
Revenue Not Reported on Form 990
$0
Total Revenue per Audited Statements
$737,288
Total Revenue per Form 990
$737,288
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Grants and Similar Amounts Paid$478,000
Other Expenses$127,039
Salaries, Compensation, and Employee Benefits$103,141
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Foreign Grants$478,000--$478,000
Current Officers, Directors, Trustees, and Key Employees$103,141--$103,141
Travel$49,632$12,875-$62,507
Fees for Services Other$19,520$15,349-$34,869
Fees for Services Accounting-$20,136-$20,136
Other Expenses$4,787$636-$5,423
Office Expenses$990$2,430-$3,420
Advertising$479$205-$684
Total Functional Expenses$656,549$51,631$0$708,180

Audited Expense Reconciliation

Line ItemAmount
Expenses per Audited Statements$708,180
Total Expenses per Audited Statements$708,180
Total Expenses per Form 990$708,180
Expenses Not Reported on Financial Statements$0
Expenses Not Reported on Form 990$0
International Activity

International Summary

Offices
0
Employees
0
Spending
$478,000

International Compliance

Foreign grant records maintained
Yes
Activity in boycott countries
No
Foreign corporation ownership
No
Foreign partnership interest
No
Interest in foreign trust
No
Passive foreign investment company interest
No
Transfers to foreign corporations
Yes

International Activities

RegionActivityServicesOfficesEmployeesSpending
South AmericaGrant to Recipient Located in the Region-00$478,000
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
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
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
No
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 form 990 was prepared by the outside accountants and reviewed by senior management. Individual members of the governing body were consulted for individual parts of the form 990 and the final 990 was provided to the board prior to filing the return with the irs.

Form 990, Part VI, Section B, Line 15

Salaries were set following consultation of independent advisors and discussion amongst members of the governing body. Compensatory data of other 990 was used in the compensation process and the last compensation review took place in september 2016.

Form 990, Part VI, Section C, Line 19

The organization does not make its governing documents or policies available to the public. Financial statements are available upon request.

Filing and Contact Details

Filer

Filer Name
Instiglio Inc
EIN
45-5015494
Phone
6782967474
Address
1222 HEMPSTEAD RD, NISKAYUNA, NY 12309-1210

Signing Officer

Name
Avnish Gungadurdoss
Title
Managing Partner and Director
Phone
6782967474
Signed
2017-10-20
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Avnish Gungadurdoss
Formed
2012
Legal Domicile
Ma
Voting Board Members
1
Independent Board Members
0
Employees
0
Volunteers
0

Preparer

Firm
Gelman Rosenberg & Freedman
Address
4550 MONTGOMERY AVE SUITE 650N, BETHESDA, MD 20814-2930
Phone
3019519090
Supplemental Narrative

Financial Statement Notes

PART X, LINE 2:

For the year ended december 31, 2016, the organization has documented its consideration of fasb asc 740-10, income taxes, that provides guidance for reporting uncertainty in income taxes and has determined that no material uncertain tax positions qualify for either recognition or disclosure in the financial statements.

Raw XML AppendixShowing 400 of 405 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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IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0FOR THE YEAR ENDED DECEMBER 31, 2016, THE ORGANIZATION HAS DOCUMENTED ITS CONSIDERATION OF FASB ASC 740-10, INCOME TAXES, THAT PROVIDES GUIDANCE FOR REPORTING UNCERTAINTY IN INCOME TAXES AND HAS DETERMINED THAT NO MATERIAL UNCERTAIN TAX POSITIONS QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS.
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0PART X, LINE 2:
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IRS990ScheduleF/ContinutationTotalOfficeCnt00
IRS990ScheduleF/ForeignCorpOwnershipInd00
IRS990ScheduleF/ForeignPartnershipInd00
IRS990ScheduleF/GrantRecordsMaintainedInd01
IRS990ScheduleF/GrantsToOrgOutsideUSGrp/CashGrantAmt0478000
IRS990ScheduleF/GrantsToOrgOutsideUSGrp/MannerOfCashDisbursementTxt0WIRE
IRS990ScheduleF/GrantsToOrgOutsideUSGrp/PurposeOfGrantTxt0SERVICE AGREEMENT WITH CORPORACION INSTIGLIO, WHERE INSTIGLIO INC WOULD FUND CORPORACION INSTIGLIO'S ACTIVITIES IN EXCHANGE OF SERVICES THAT WOULD HELP INSTIGLIO INC DELIVER TO ITS CLIENTS AND TO ITS MISSION
IRS990ScheduleF/GrantsToOrgOutsideUSGrp/RegionTxt0SOUTH AMERICA
IRS990ScheduleF/InterestInForeignTrustInd00
IRS990ScheduleF/PassiveForeignInvestmestCoInd00
IRS990ScheduleF/SubtotalEmployeesCnt00
IRS990ScheduleF/SubtotalOfficesCnt00
IRS990ScheduleF/SubtotalSpentAmt0478000
IRS990ScheduleF/SupplementalInformationDetail/ExplanationTxt0TO MONITOR THE USE OF GRANT FUNDS OUTSIDE THE UNITED STATES, THE ORGANIZATION'S REQUIRES GRANTEES TO SUBMIT EXPENSE ALLOCATION REPORTS AFTER RECEIVING GRANT FUNDS.
IRS990ScheduleF/SupplementalInformationDetail/FormAndLineReferenceDesc0PART I, LINE 2:
IRS990ScheduleF/Total501c3OrgCnt01
IRS990ScheduleF/TotalEmployeeCnt00
IRS990ScheduleF/TotalOfficeCnt00
IRS990ScheduleF/TotalOtherOrgCnt00
IRS990ScheduleF/TotalSpentAmt0478000
IRS990ScheduleF/TransferToForeignCorpInd01
IRS990/ScheduleJRequiredInd00
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0THE FORM 990 WAS PREPARED BY THE OUTSIDE ACCOUNTANTS AND REVIEWED BY SENIOR MANAGEMENT. INDIVIDUAL MEMBERS OF THE GOVERNING BODY WERE CONSULTED FOR INDIVIDUAL PARTS OF THE FORM 990 AND THE FINAL 990 WAS PROVIDED TO THE BOARD PRIOR TO FILING THE RETURN WITH THE IRS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1SALARIES WERE SET FOLLOWING CONSULTATION OF INDEPENDENT ADVISORS AND DISCUSSION AMONGST MEMBERS OF THE GOVERNING BODY. COMPENSATORY DATA OF OTHER 990 WAS USED IN THE COMPENSATION PROCESS AND THE LAST COMPENSATION REVIEW TOOK PLACE IN SEPTEMBER 2016.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR POLICIES AVAILABLE TO THE PUBLIC. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION B, LINE 15
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleR/AssetExchangeInd00
IRS990ScheduleR/AssetPurchaseFromOtherOrgInd00
IRS990ScheduleR/AssetSaleToOtherOrgInd00
IRS990ScheduleR/DivRelatedOrganizationInd00
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd00
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd01
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd00
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt0CORPORACION INSTIGLIO
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ForeignAddress/AddressLine1Txt071TH STREET 5-41 5TH FLOOR
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ForeignAddress/CityNm0BOGOTA
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ForeignAddress/CountryCd0CO
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileForeignCountryCd0CO
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt0EXPLORE PAY FOR SUCCEES MODEL FOR SOCIAL PROJECTS
IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd00
IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd00
IRS990ScheduleR/PaidEmployeesSharingInd01
IRS990ScheduleR/PerformOfServicesByOtherOrgInd00
IRS990ScheduleR/PerformOfServicesForOthOrgInd00
IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd00
IRS990ScheduleR/ReimbursementPaidByOtherOrgInd00
IRS990ScheduleR/ReimbursementPaidToOtherOrgInd00
IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd00
IRS990ScheduleR/RentalOfFcltsFromOthOrgInd00
IRS990ScheduleR/SharingOfFacilitiesInd01
IRS990ScheduleR/TransactionsRelatedOrgGrp/InvolvedAmt0478000
IRS990ScheduleR/TransactionsRelatedOrgGrp/InvolvedAmt10
IRS990ScheduleR/TransactionsRelatedOrgGrp/InvolvedAmt20
IRS990ScheduleR/TransactionsRelatedOrgGrp/MethodOfAmountDeterminationTxt0ACTUAL AMOUNT
IRS990ScheduleR/TransactionsRelatedOrgGrp/OtherOrganizationName/BusinessNameLine1Txt0CORPORACION INSTIGLIO
IRS990ScheduleR/TransactionsRelatedOrgGrp/OtherOrganizationName/BusinessNameLine1Txt1CORPORACION INSTIGLIO
IRS990ScheduleR/TransactionsRelatedOrgGrp/OtherOrganizationName/BusinessNameLine1Txt2CORPORACION INSTIGLIO
IRS990ScheduleR/TransactionsRelatedOrgGrp/TransactionTypeTxt0B
IRS990ScheduleR/TransactionsRelatedOrgGrp/TransactionTypeTxt1N
IRS990ScheduleR/TransactionsRelatedOrgGrp/TransactionTypeTxt2O
IRS990ScheduleR/TransferFromOtherOrgInd00
IRS990ScheduleR/TransferToOtherOrgInd00
IRS990/SchoolOperatingInd00
IRS990/SignificantChangeInd00
IRS990/SignificantNewProgramSrvcInd00
IRS990/StatesWhereCopyOfReturnIsFldCd0MA
IRS990/SubjectToProxyTaxInd00
IRS990/TaxablePartyNotificationInd00
IRS990/TaxExemptBondsInd00
IRS990/TempOrPermanentEndowmentsInd00
IRS990/TerminateOperationsInd00
IRS990/TotalAssetsBOYAmt0171018
IRS990/TotalAssetsEOYAmt0196606
IRS990/TotalAssetsGrp/BOYAmt0171018
IRS990/TotalAssetsGrp/EOYAmt0196606
IRS990/TotalCompGreaterThan150KInd00
IRS990/TotalContributionsAmt0122000
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt051631
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0656549
IRS990/TotalFunctionalExpensesGrp/TotalAmt0708180
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt034786
IRS990/TotalLiabilitiesEOYAmt019740
IRS990/TotalLiabilitiesGrp/BOYAmt034786
IRS990/TotalLiabilitiesGrp/EOYAmt019740
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0136232
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0176866
IRS990/TotalOtherCompensationAmt00
IRS990/TotalProgramServiceExpensesAmt0656549
IRS990/TotalProgramServiceRevenueAmt0615253
IRS990/TotalReportableCompFromOrgAmt0103141
IRS990/TotalRevenueGrp/ExclusionAmt035
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt0615253
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0737288
IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt00
IRS990/TotalVolunteersCnt00
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0171018
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt0196606
IRS990/TotReportableCompRltdOrgAmt076991
IRS990/TravelGrp/ManagementAndGeneralAmt012875
IRS990/TravelGrp/ProgramServicesAmt049632
IRS990/TravelGrp/TotalAmt062507
IRS990/TrnsfrExmptNonChrtblRltdOrgInd00
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd00
IRS990/UnrestrictedNetAssetsGrp/BOYAmt0136232
IRS990/UnrestrictedNetAssetsGrp/EOYAmt0176866
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt01222 HEMPSTEAD RD
IRS990/USAddress/CityNm0NISKAYUNA
IRS990/USAddress/StateAbbreviationCd0NY
IRS990/USAddress/ZIPCd0123091210
IRS990/VotingMembersGoverningBodyCnt01
IRS990/VotingMembersIndependentCnt00
IRS990/WebsiteAddressTxt0WWW.INSTIGLIO.ORG
IRS990/WhistleblowerPolicyInd00
ReturnHeader/BuildTS02017-02-10 21:41:12Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0AVNISH GUNGADURDOSS
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0MANAGING PARTNER AND DIRECTOR
ReturnHeader/BusinessOfficerGrp/PhoneNum06782967474
ReturnHeader/BusinessOfficerGrp/SignatureDt02017-10-20
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0INSTIGLIO INC
ReturnHeader/Filer/BusinessNameControlTxt0INST
ReturnHeader/Filer/EIN0455015494
ReturnHeader/Filer/PhoneNum06782967474
ReturnHeader/Filer/USAddress/AddressLine1Txt01222 HEMPSTEAD RD
ReturnHeader/Filer/USAddress/CityNm0NISKAYUNA
ReturnHeader/Filer/USAddress/StateAbbreviationCd0NY
ReturnHeader/Filer/USAddress/ZIPCd0123091210
ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId024E2B1EDDFB7997E904F8C8AA54720A5F314F67A
ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId0B0767C5434AF612094479A14CF214538D894849F
ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd0P
ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt075.103.231.202
ReturnHeader/FilingSecurityInformation/IPDt02017-10-20
ReturnHeader/FilingSecurityInformation/IPTimezoneCd0ED
ReturnHeader/FilingSecurityInformation/IPTm013:59:16
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0521392008
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0GELMAN ROSENBERG & FREEDMAN
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt04550 MONTGOMERY AVE SUITE 650N
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0BETHESDA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0MD
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0208142930
ReturnHeader/PreparerPersonGrp/PhoneNum03019519090

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