Civic Intelligence

Institute for Behavioral Health Integration

EIN 46-1586273 • 501(c)3 • Corvallis, OR

Profile

Improving peoples health and well-being

10 NW Edgewood DrCorvallis, OR 97330

bhintegration.org

Siviq Scores

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

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on the latest valid filing.

Source year 2018

Liabilities / Revenue

Score unavailable

No value available

Liabilities-to-revenue requires both liabilities and revenue on the latest valid filing.

Source year 2018

Net Margin

2nd percentile

-3355%

Higher net margin than 2% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2018

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 2018

Asset Growth

10th percentile

-100%

Faster asset growth than 10% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2017 to 2018

Revenue Growth

5th percentile

-97%

Faster revenue growth than 5% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2017 to 2018

Balance Sheet
Liabilities / AssetsScore unavailable

Assets

Down

$0

Down $30,194 (-100%) from 2017

Liabilities

-

No earlier filing loaded for comparison.

Net Assets

Down

$0

Down $30,194 (-100%) from 2017

Operations
Liabilities / RevenueScore unavailableNet Margin2nd percentile

Revenue

Down

$900

Down $28,084 (-97%) from 2017

Expenses

Down

$31,094

Down $31,520 (-50%) from 2017

Net Income

Up

-$30,194

Up $3,436 (+10%) from 2017

Trend Graphs

Balance Sheet Trend

Asset Growth10th percentile

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

$100K$50K$0Assets 2014: $33,216Liabilities 2014: $3,658Net Assets 2014: $29,5582014Assets 2015: $81,569Liabilities 2015: $12,430Net Assets 2015: $69,1392015Assets 2016: $70,497Liabilities 2016: $6,673Net Assets 2016: $63,8242016Assets 2017: $30,194Net Assets 2017: $30,1942017Assets 2018: $0Net Assets 2018: $02018

Highlighted filing

2018

Assets$0
Liabilities-
Net Assets$0
Open 2018 Filing

Operations Trend

Revenue Growth5th percentile

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

$200K$150K$100K$50K$0-$50KRevenue 2014: $124,001Expenses 2014: $100,657Net Income 2014: $23,3442014Revenue 2015: $156,712Expenses 2015: $117,131Net Income 2015: $39,5812015Revenue 2016: $90,208Expenses 2016: $95,523Net Income 2016: -$5,3152016Revenue 2017: $28,984Expenses 2017: $62,614Net Income 2017: -$33,6302017Revenue 2018: $900Expenses 2018: $31,094Net Income 2018: -$30,1942018

Highlighted filing

2018

Revenue$900
Expenses$31,094
Net Income-$30,194
Open 2018 Filing

Filings

Most recent year

2018 • Form 990EZDetailed filing. Detailed filing data is available for this year.

Open filing
Assets
$0
Liabilities
-
Net assets
$0
Revenue
$900
Expenses
$31,094
Net income
-$30,194
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2018Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.01$0.31$0.30
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.30$0.30$0.29$0.63$0.34
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.70$0.07$0.64$0.90$0.96$0.05
2015Detailed filing. Detailed filing data is available for this year.$0.82$0.12$0.69$1.57$1.17$0.40
2014Detailed filing. Detailed filing data is available for this year.$0.33$0.04$0.30$1.24$1.01$0.23
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2018 to Dec 31, 2018
Signed
May 15, 2019
Return Version
2018v3.1
Gross Receipts
$900
Mission and Program Overview

Mission

Improving peoples health and well-being

Program Services

DescriptionGrantsExpenses
THE INSTITUTE FOR BEHAVIORAL HEALTH INTEGRATION IS DEDICATED TO IMPROVING PEOPLES HEALTH AND WELL-BEING. WE ACHIEVE THIS BY WORKING WITH COMMUNITIES TO INTEGRATE BEHAVIORAL HEALTH PRINCIPLES INTO THE EVERYDAY PRACTICES OF HEALTH-$31,094
DELIVERY AND HEALTH PROMOTION.--
Compensation and Service Providers
Top Officer Pay81st percentile

Employees

NameTitleFull / Part TimeBaseOtherTotal
BARBARA L TRIONE RN MBAChair-$0--
DR DAVID R GRUBEVice Chairsecretary-$0--
KEVIN CUCCAROBoard Member-$0--
RICK KUNNESBoard Member-$0--
SETH BERNSTEINExec. DirectorFT$0--
Filing and Contact Details

Filer

Filer Name
Institute for Behavioral Health Integration
EIN
46-1586273
Phone
5418449850
Address
10 NW EDGEWOOD DR, CORVALLIS, OR 97330

Signing Officer

Name
Seth Bernstein
Title
Executive Director
Signed
2019-05-15
Discuss with paid preparer
Yes

Preparer

Firm
A & S Accounting
Address
316 SW Washington Ave, Corvallis, OR 97333
Preparer
Ilene Anderton 2250C
Phone
5417571945
Supplemental Narrative

Additional Explanations

Form 990-EZ, Part I, Line 16, Other Expenses

“Travel 816”

Form 990-EZ, Part I, Line 16, Other Expenses

“Telephone 68”

Form 990-EZ, Part I, Line 16, Other Expenses

“Depreciation 281”

Form 990-EZ, Part I, Line 16, Other Expenses

“TAXES LICENSES 50”

Form 990-EZ, Part I, Line 16, Other Expenses

“OFFICE EXPENSE 716”

Form 990-EZ, Part I, Line 16, Other Expenses

“INTERNET CHARGES 40”

Form 990-EZ, Part I, Line 16, Other Expenses

“ADVERTISING 40”

Form 990-EZ, Part I, Line 16, Other Expenses

“Transferred to related 501c3 - final year 26,245”

Form 990-EZ, Part II, Line 24, Other Assets

“ACCOUNTS RECEIVABLE Beginning of year 2,354, End of year 0”

Raw XML Appendix193 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
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IRS990EZ/BooksInCareOfDetail/PersonNm0A S ACCOUNTING
IRS990EZ/BooksInCareOfDetail/PhoneNum05417571945
IRS990EZ/BooksInCareOfDetail/USAddress/AddressLine1Txt0316 SW WASHINGTON
IRS990EZ/BooksInCareOfDetail/USAddress/CityNm0CORVALLIS
IRS990EZ/BooksInCareOfDetail/USAddress/StateAbbreviationCd0OR
IRS990EZ/BooksInCareOfDetail/USAddress/ZIPCd097333
IRS990EZ/CashSavingsAndInvestmentsGrp/BOYAmt027559
IRS990EZ/ChgMadeToOrgnzngDocNotRptInd0false
IRS990EZ/DonorAdvisedFndsInd0false
IRS990EZ/EngagedInExcessBenefitTransInd0false
IRS990EZ/ExcessOrDeficitForYearAmt0-30194
IRS990EZ/FeesAndOtherPymtToIndCntrctAmt01750
IRS990EZ/FiledScheduleAInd0true
IRS990EZ/FinalReturnInd0X
IRS990EZ/ForeignFinancialAccountInd0false
IRS990EZ/ForeignOfficeInd0false
IRS990EZ/Form1120PolFiledInd0false
IRS990EZ/Form720FiledInd0false
IRS990EZ/Form990TotalAssetsGrp/BOYAmt030194
IRS990EZ/Form990TotalAssetsGrp/EOYAmt00
IRS990EZ/GrossReceiptsAmt0900
IRS990EZ/InfoInScheduleOPartIIInd0X
IRS990EZ/InfoInScheduleOPartIInd0X
IRS990EZ/LandAndBuildingsGrp/BOYAmt0281
IRS990EZ/LobbyingActivitiesInd0false
IRS990EZ/MadeLoansToFromOfficersInd0false
IRS990EZ/MethodOfAccountingAccrualInd0X
IRS990EZ/NetAssetsOrFundBalancesBOYAmt030194
IRS990EZ/NetAssetsOrFundBalancesEOYAmt00
IRS990EZ/NetAssetsOrFundBalancesGrp/BOYAmt030194
IRS990EZ/NetAssetsOrFundBalancesGrp/EOYAmt00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt0002.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt1002.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt2002.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt3002.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt4040.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt10
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt20
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt30
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt40
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm0BARBARA L TRIONE RN MBA
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm1DR DAVID R GRUBE
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm2KEVIN CUCCARO
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm3RICK KUNNES
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm4SETH BERNSTEIN
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt0CHAIR
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt1VICE CHAIRSECRETARY
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt2BOARD MEMBER
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt3BOARD MEMBER
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt4EXEC. DIRECTOR
IRS990EZ/OperateHospitalInd0false
IRS990EZ/Organization501c3Ind0X
IRS990EZ/OrganizationDissolvedEtcInd0true
IRS990EZ/OrganizationHadUBIInd0false
IRS990EZ/OtherAssetsTotalDetail/BOYAmt02354
IRS990EZ/OtherExpensesTotalAmt028256
IRS990EZ/PartVIHghstPdCntrctProfSrvcTxt0NONE
IRS990EZ/PartVIOfCompOfHghstPdEmplTxt0NONE
IRS990EZ/PoliticalCampaignActyInd0false
IRS990EZ/PrimaryExemptPurposeTxt0IMPROVING PEOPLES HEALTH AND WELL-BEING
IRS990EZ/ProgramServiceRevenueAmt0900
IRS990EZ/ProgramSrvcAccomplishmentGrp/DescriptionProgramSrvcAccomTxt0THE INSTITUTE FOR BEHAVIORAL HEALTH INTEGRATION IS DEDICATED TO IMPROVING PEOPLES HEALTH AND WELL-BEING. WE ACHIEVE THIS BY WORKING WITH COMMUNITIES TO INTEGRATE BEHAVIORAL HEALTH PRINCIPLES INTO THE EVERYDAY PRACTICES OF HEALTH
IRS990EZ/ProgramSrvcAccomplishmentGrp/DescriptionProgramSrvcAccomTxt1DELIVERY AND HEALTH PROMOTION.
IRS990EZ/ProgramSrvcAccomplishmentGrp/ProgramServiceExpensesAmt031094
IRS990EZ/ProhibitedTaxShelterTransInd0false
IRS990EZ/RelatedOrganizationCtrlEntInd0false
IRS990EZ/SalariesOtherCompEmplBnftAmt01088
IRS990EZ/ScheduleBNotRequiredInd0X
IRS990EZ/SchoolOperatingInd0false
IRS990EZ/StatesWhereCopyOfReturnIsFldCd0OR
IRS990EZ/SubjectToProxyTaxInd0false
IRS990EZ/TanningServicesProvidedInd0false
IRS990EZ/TaxImposedUnderIRC4911Amt00
IRS990EZ/TaxImposedUnderIRC4912Amt00
IRS990EZ/TaxImposedUnderIRC4955Amt00
IRS990EZ/TotalExpensesAmt031094
IRS990EZ/TotalProgramServiceExpensesAmt031094
IRS990EZ/TotalRevenueAmt0900
IRS990EZ/TransactionWithControlEntInd0false
IRS990EZ/TypeOfOrganizationCorpInd0X
IRS990EZ/WebsiteAddressTxt0bhintegration.org
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearAmt0900
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus2YearsAmt051710
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus3YearsAmt0113134
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus4YearsAmt058717
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/TotalAmt0224461
IRS990ScheduleA/GrossInvestmentIncome509Grp/TotalAmt00
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus1YearAmt028984
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus2YearsAmt038498
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus3YearsAmt043578
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus4YearsAmt065285
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/TotalAmt0176345
IRS990ScheduleA/InvestmentIncomeCYPct00.00000
IRS990ScheduleA/NetIncomeFromOtherUBIGrp/TotalAmt00
IRS990ScheduleA/OtherIncome509Grp/TotalAmt00
IRS990ScheduleA/Post1975UBTIGrp/TotalAmt00
IRS990ScheduleA/PubliclySupportedOrg509a2Ind0X
IRS990ScheduleA/PublicSupportCY170Pct00.00000
IRS990ScheduleA/PublicSupportCY509Pct01.00000
IRS990ScheduleA/PublicSupportPY509Pct01.00000
IRS990ScheduleA/PublicSupportTotal170Amt00
IRS990ScheduleA/PublicSupportTotal509Amt0400806
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY509Ind0X
IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt0900
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt028984
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt090208
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt0156712
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt0124002
IRS990ScheduleA/Total509Grp/TotalAmt0400806
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt0900
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt028984
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt090208
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt0156712
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus4YearsAmt0124002
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt0400806
IRS990ScheduleN/DirectorOfSuccessorInd0false
IRS990ScheduleN/EmployeeOfSuccessorInd0false
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc0CASH
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc1CASH
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine1Txt0GREATER OREGON BEHAVIORAL HEALTH INC
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine1Txt1PAYE
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt02018-12-31
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt12018-12-31
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/EIN0931144014
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/EIN1200047050
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt015000
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt1931
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/IRCSectionTxt0501c3
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/IRCSectionTxt1501c3
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine1Txt0401 E 3RD ST STE 101
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine1Txt1316 SW WASHINGTON AVE
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/CityNm0THE DALLES
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/CityNm1CORVALLI
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/StateAbbreviationCd0OR
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/StateAbbreviationCd1OR
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/ZIPCd097058
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/ZIPCd197330
IRS990ScheduleN/OwnerOfSuccessorInd0false
IRS990ScheduleN/ReceiveCompensationInd0false
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0Travel 816
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1Telephone 68
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2Depreciation 281
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3TAXES LICENSES 50
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4OFFICE EXPENSE 716
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5INTERNET CHARGES 40
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6ADVERTISING 40
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7TRANSFERRED TO RELATED 501C3 - FINAL YEAR 26,245
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt8ACCOUNTS RECEIVABLE Beginning of year 2,354, End of year 0
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Form 990-EZ, Part I, Line 16, Other Expenses
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Form 990-EZ, Part I, Line 16, Other Expenses
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2Form 990-EZ, Part I, Line 16, Other Expenses
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3Form 990-EZ, Part I, Line 16, Other Expenses
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4Form 990-EZ, Part I, Line 16, Other Expenses
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5Form 990-EZ, Part I, Line 16, Other Expenses
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6Form 990-EZ, Part I, Line 16, Other Expenses
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7Form 990-EZ, Part I, Line 16, Other Expenses
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc8Form 990-EZ, Part II, Line 24, Other Assets
ReturnHeader/BuildTS02019-02-21 02:37:17Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0SETH BERNSTEIN
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0EXECUTIVE DIRECTOR
ReturnHeader/BusinessOfficerGrp/SignatureDt02019-05-15
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0INSTITUTE FOR BEHAVIORAL HEALTH INTEGRATION
ReturnHeader/Filer/BusinessNameControlTxt0INST
ReturnHeader/Filer/EIN0461586273
ReturnHeader/Filer/PhoneNum05418449850
ReturnHeader/Filer/USAddress/AddressLine1Txt010 NW EDGEWOOD DR
ReturnHeader/Filer/USAddress/CityNm0CORVALLIS
ReturnHeader/Filer/USAddress/StateAbbreviationCd0OR
ReturnHeader/Filer/USAddress/ZIPCd097330
ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId0951F1A3339300DB313BFE75C0AADC00826E1242A
ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId0B9F8154216AF1CA3BA0E8EF63E03544BA65628F2
ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd0P
ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt0199.91.231.136
ReturnHeader/FilingSecurityInformation/IPDt02019-05-15
ReturnHeader/FilingSecurityInformation/IPTimezoneCd0PD
ReturnHeader/FilingSecurityInformation/IPTm022:18:49
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0A & S Accounting
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0316 SW Washington Ave
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0Corvallis
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0OR
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd097333
ReturnHeader/PreparerPersonGrp/PhoneNum05417571945
ReturnHeader/PreparerPersonGrp/PreparationDt02019-05-15
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0Ilene Anderton 2250C
ReturnHeader/PreparerPersonGrp/SelfEmployedInd0X
ReturnHeader/ReturnTs02019-05-15T03:37:20-00:00
ReturnHeader/ReturnTypeCd0990EZ
ReturnHeader/TaxPeriodBeginDt02018-01-01
ReturnHeader/TaxPeriodEndDt02018-12-31
ReturnHeader/TaxYr02018

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