Civic Intelligence

Bhs Hvhs Multispecialty Group Inc.

990 • Fiscal year 2018 • EIN 47-5177929

Jul 01, 2017 to Jun 30, 2018 • Filed on May 14, 2019

One Hospital WayButler, PA 16001

(724) 284-4166

Siviq Scores

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

Liabilities / Assets

91st percentile

0.77x

Higher debt load relative to assets than 91% of similar nonprofits.

2018 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2018

Liabilities / Revenue

80th percentile

0.31x

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

2018 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2018

Net Margin

1st percentile

-433%

Higher net margin than 1% of similar nonprofits.

2018 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2018

Top Officer Pay

Score unavailable

No value available

This filing does not contain officer compensation rows.

Source year 2018

Asset Growth

2nd percentile

-66%

Faster asset growth than 2% of similar nonprofits.

2018 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2017 to 2018

Revenue Growth

7th percentile

-41%

Faster revenue growth than 7% of similar nonprofits.

2018 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2017 to 2018

Assets

Flat

$295,117

Flat from 2018

Net Assets

Flat

$66,658

Flat from 2018

Liabilities

Flat

$228,459

Flat from 2018

Revenue

Flat

$743,527

Flat from 2018

Expenses

Flat

$3,961,384

Flat from 2018

Net Income

Flat

-$3,217,857

Flat from 2018

Historical Trend

Balance Sheet Trend

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

$1.5M$1.0M$500K$0Assets 2016: $1,280,107Liabilities 2016: $763,156Net Assets 2016: $516,9512016Assets 2017: $865,175Liabilities 2017: $287,462Net Assets 2017: $577,7132017Assets 2018: $295,117Liabilities 2018: $228,459Net Assets 2018: $66,6582018Assets 2018: $295,117Liabilities 2018: $228,459Net Assets 2018: $66,6582018Assets 2019: $43,946Liabilities 2019: $552Net Assets 2019: $43,3942019Assets 2020: $29,574Liabilities 2020: $12,168Net Assets 2020: $17,4062020

Highlighted filing

2018

Assets$295,117
Liabilities$228,459
Net Assets$66,658

Operations Trend

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

$6.0M$4.0M$2.0M$0-$2.0M-$4.0MRevenue 2016: $779,074Expenses 2016: $2,662,123Net Income 2016: -$1,883,0492016Revenue 2017: $1,262,671Expenses 2017: $4,326,740Net Income 2017: -$3,064,0692017Revenue 2018: $743,527Expenses 2018: $3,961,384Net Income 2018: -$3,217,8572018Revenue 2018: $743,527Expenses 2018: $3,961,384Net Income 2018: -$3,217,8572018Revenue 2019: $0Expenses 2019: $12,375Net Income 2019: -$12,3752019Revenue 2020: $0Expenses 2020: $25,988Net Income 2020: -$25,9882020

Highlighted filing

2018

Revenue$743,527
Expenses$3,961,384
Net Income-$3,217,857
Jump To
Filing Snapshot
Filing Period
Jul 1, 2017 to Jun 30, 2018
Signed
May 14, 2019
Return Version
2017v2.3
Gross Receipts
$743,527
Mission and Program Overview

Mission

To provide quality medical services through its providers and staff at medical practices in Butler and Beaver Counties

To provide quality medical services through its providers and staff at medical practices in butler and beaver counties.

Balance Sheet Detail
LineBeginningEndChange
Assets
Accounts Receivable$289,552$110,447▼ $179,105
Cash and Non-Interest-Bearing Accounts$425,454$63,983▼ $361,471
Land, Buildings, and Equipment, Net$84,464$63,923▼ $20,541
Prepaid Expenses and Deferred Charges$65,705$56,764▼ $8,941
Total Assets$865,175$295,117▼ $570,058
Liabilities
Accounts Payable and Accrued Expenses$287,462$228,459▼ $59,003
Total Liabilities$287,462$228,459▼ $59,003
Net Assets / Fund Balance
Unrestricted Net Assets$577,713$66,658▼ $511,055
Total Net Assets Fund Balance$577,713$66,658▼ $511,055
Total Liabilities and Net Assets / Fund Balance$865,175$295,117▼ $570,058

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$63,923$47,775$111,698
Compensation and Service Providers

Board Members and Trustees

Highest Paid Contractors

ContractorServicesLocationCompensation
Butler Medical ProvidersPurchased Physician, Advanced Practice PONE HOSPITAL WAY, Butler, PA 16001$3,596,939
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$743,527
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$-3,217,857
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$3,961,384
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Services Other$3,596,939--$3,596,939
Occupancy$121,103--$121,103
Insurance$110,923--$110,923
Depreciation Depletion$19,023--$19,023
Office Expenses$18,636--$18,636
Fees for Services Legal$12,161--$12,161
Other Expenses$6,434$47,226-$6,434
Total Functional Expenses$3,914,158$47,226$0$3,961,384
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
Annual disclosure for covered persons
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
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 6

The organization has two members, they are butler healthcare providers dba butler memorial hospital and heritage valley health system.

Form 990, Part VI, Section A, Line 7A

Butler health system, inc. And heritage valley health system, inc. , the corporate members of the organization, appoint the members of the board of directors.

Form 990, Part VI, Section A, Line 7B

As per the by-laws of the organization, the subject matters of the powers reserved to the member are as follows: a. To adopt, amend, modify or restate the articles of incorporation or bylaws of the corporation b. To amend, modify, restate, or renew any agreement between the corporation and a member or an affiliate of a member, including without limitation the management services agreement between the corporation and butler medical providers. C. To separately appoint designated numbers of directors of the corporation and to remove such directors (such removal power being reserved to the member who appointed the director) with or without cause. D. Any material change in the purposes of the corporation or the nature or scope of the business conducted by the corporation, including the addition of physician practices and/or additional practice locations. E. The merger or consolidation of the corporation with or into any other entity, the division of the corporation, the exchange of membership interests in the corporation for equity interests of any other entity, or the sale or lease of any portion of the assets of the corporation other than in the ordinary course of business. F. The corporation's creation of, or participation by the corporation in, a subsidiary, joint venture, partnership, limited liability company or other similar arrangement. G. Any material change in the billing methodology or any material change in the accounting method affecting the financial statements or tax returns of the corporation, other than a change required under generally accepted accounting principles. H. Any issuance of additional, or transfer of existing, membership interests in the corporation (except for transfers described in section 2.03). I. Any loan to any person or entity other than for payables and receivables in ordinary course of business. J. Any distributions by the corporation to its members. K. Any incurrence of indebtedness, or agreement to incur indebtedness, or settlement of any demand, claim, charge, litigation or administrative filing, in any amount greater than 50,000 (or such other amount as in determined by resolution of the members from time to time) or a prepayment of debt in any amount where such loan does not require prepayment, other than as set forth in an approved budget. L. Execution of a mortgage, lien, encumbrance or pledge in an amount greater than 50,000 with regard to the property of the corporation. M. Any lease commitment of the corporation in excess of one year's duration or, if less than one year including a financial commitment of 50,000 or greater, other than as set forth in an approved budget. N. Any unbudgeted capital expenditure if, after giving effect thereto, the aggregate of all unbudgeted capital expenditures of the corporation in any fiscal year would be greater than 50,000. O. The approval of annual operating and capital budgets for the corporation. P. Any mandatory capital contributions of the members in excess of capital contributions required by the corporate membership agreement. Q. Except as otherwise set forth herein, the execution, material modification (including any modification in fees, charges or rates), or termination of any management, managed care or third party payor contract, or any other contract not in the ordinary course of business. R. Voluntary declaration of bankruptcy or seeking of reorganization under the insolvency laws by the corporation.

Form 990, Part VI, Section A, Line 8B

The organization does not have additional committees besides the board of directors.

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

The completed 990 was reviewed by the treasurer and an outside independent public accounting firm. Relevant sections were reviewed by the general counsel of the managing member. After this review, but prior to filing, the completed 990 was provided electronically to all trustees.

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

The responses to the conflict of interest disclosure form are collected and reviewed annually by general counsel of the managing member. Conflict of interest disclosure forms are completed by all directors. In the event of a relationship that results in a potential conflict for an issue being discussed by the board, the director recuses himself/herself from the discussion and vote. The recusal is documented in the minutes.

Form 990, Part VI, Section C, Line 19

The organization's governing documents, conflict of interest policy, and financial statements are available upon request.

Filing and Contact Details

Filer

Filer Name
Bhs Hvhs Multispecialty Group Inc
EIN
47-5177929
Phone
7242844166
Address
ONE HOSPITAL WAY, BUTLER, PA 16001
Doing Business As
Pa Brain & Spine Institute

Signing Officer

Name
Richard J Lusk
Title
Treasurer
Phone
7242844166
Signed
2019-05-14
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Richard J Lusk
Formed
2015
Legal Domicile
Pa
Voting Board Members
6
Independent Board Members
6
Employees
0
Volunteers
0

Preparer

Firm
Blue & Co LLC
Address
9200 WORTHINGTON RD STE 200, WESTERVILLE, OH 43082
Preparer
Angela N Crawford CPA
Phone
6148852583
Supplemental Narrative

Additional Explanations

Form 990, Part IX, Line 11G

Purchased services: program service expenses 3,596,939. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,596,939.

FORM 990, PART XI, LINE 9:

Capital contributions 2,706,802.

Raw XML Appendix351 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/Form990ScheduleAPartVIGrp/ExplanationTxt0ALTHOUGH EXEMPT FROM TAXATION AS A HOSPITAL, THE ORGANIZATION IS NOT, AND IS NOT REQUIRED TO BE, LICENSED AS A HOSPITAL IN THE STATE OF PENNSYLVANIA. THEREFORE, IRC 501(R) DOES NOT APPLY AND SCHEDULE H IS NOT REQUIRED.
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IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0THE ORGANIZATION HAS TWO MEMBERS, THEY ARE BUTLER HEALTHCARE PROVIDERS DBA BUTLER MEMORIAL HOSPITAL AND HERITAGE VALLEY HEALTH SYSTEM.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1BUTLER HEALTH SYSTEM, INC. AND HERITAGE VALLEY HEALTH SYSTEM, INC. , THE CORPORATE MEMBERS OF THE ORGANIZATION, APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2AS PER THE BY-LAWS OF THE ORGANIZATION, THE SUBJECT MATTERS OF THE POWERS RESERVED TO THE MEMBER ARE AS FOLLOWS: A. TO ADOPT, AMEND, MODIFY OR RESTATE THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION B. TO AMEND, MODIFY, RESTATE, OR RENEW ANY AGREEMENT BETWEEN THE CORPORATION AND A MEMBER OR AN AFFILIATE OF A MEMBER, INCLUDING WITHOUT LIMITATION THE MANAGEMENT SERVICES AGREEMENT BETWEEN THE CORPORATION AND BUTLER MEDICAL PROVIDERS. C. TO SEPARATELY APPOINT DESIGNATED NUMBERS OF DIRECTORS OF THE CORPORATION AND TO REMOVE SUCH DIRECTORS (SUCH REMOVAL POWER BEING RESERVED TO THE MEMBER WHO APPOINTED THE DIRECTOR) WITH OR WITHOUT CAUSE. D. ANY MATERIAL CHANGE IN THE PURPOSES OF THE CORPORATION OR THE NATURE OR SCOPE OF THE BUSINESS CONDUCTED BY THE CORPORATION, INCLUDING THE ADDITION OF PHYSICIAN PRACTICES AND/OR ADDITIONAL PRACTICE LOCATIONS. E. THE MERGER OR CONSOLIDATION OF THE CORPORATION WITH OR INTO ANY OTHER ENTITY, THE DIVISION OF THE CORPORATION, THE EXCHANGE OF MEMBERSHIP INTERESTS IN THE CORPORATION FOR EQUITY INTERESTS OF ANY OTHER ENTITY, OR THE SALE OR LEASE OF ANY PORTION OF THE ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS. F. THE CORPORATION'S CREATION OF, OR PARTICIPATION BY THE CORPORATION IN, A SUBSIDIARY, JOINT VENTURE, PARTNERSHIP, LIMITED LIABILITY COMPANY OR OTHER SIMILAR ARRANGEMENT. G. ANY MATERIAL CHANGE IN THE BILLING METHODOLOGY OR ANY MATERIAL CHANGE IN THE ACCOUNTING METHOD AFFECTING THE FINANCIAL STATEMENTS OR TAX RETURNS OF THE CORPORATION, OTHER THAN A CHANGE REQUIRED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. H. ANY ISSUANCE OF ADDITIONAL, OR TRANSFER OF EXISTING, MEMBERSHIP INTERESTS IN THE CORPORATION (EXCEPT FOR TRANSFERS DESCRIBED IN SECTION 2.03). I. ANY LOAN TO ANY PERSON OR ENTITY OTHER THAN FOR PAYABLES AND RECEIVABLES IN ORDINARY COURSE OF BUSINESS. J. ANY DISTRIBUTIONS BY THE CORPORATION TO ITS MEMBERS. K. ANY INCURRENCE OF INDEBTEDNESS, OR AGREEMENT TO INCUR INDEBTEDNESS, OR SETTLEMENT OF ANY DEMAND, CLAIM, CHARGE, LITIGATION OR ADMINISTRATIVE FILING, IN ANY AMOUNT GREATER THAN 50,000 (OR SUCH OTHER AMOUNT AS IN DETERMINED BY RESOLUTION OF THE MEMBERS FROM TIME TO TIME) OR A PREPAYMENT OF DEBT IN ANY AMOUNT WHERE SUCH LOAN DOES NOT REQUIRE PREPAYMENT, OTHER THAN AS SET FORTH IN AN APPROVED BUDGET. L. EXECUTION OF A MORTGAGE, LIEN, ENCUMBRANCE OR PLEDGE IN AN AMOUNT GREATER THAN 50,000 WITH REGARD TO THE PROPERTY OF THE CORPORATION. M. ANY LEASE COMMITMENT OF THE CORPORATION IN EXCESS OF ONE YEAR'S DURATION OR, IF LESS THAN ONE YEAR INCLUDING A FINANCIAL COMMITMENT OF 50,000 OR GREATER, OTHER THAN AS SET FORTH IN AN APPROVED BUDGET. N. ANY UNBUDGETED CAPITAL EXPENDITURE IF, AFTER GIVING EFFECT THERETO, THE AGGREGATE OF ALL UNBUDGETED CAPITAL EXPENDITURES OF THE CORPORATION IN ANY FISCAL YEAR WOULD BE GREATER THAN 50,000. O. THE APPROVAL OF ANNUAL OPERATING AND CAPITAL BUDGETS FOR THE CORPORATION. P. ANY MANDATORY CAPITAL CONTRIBUTIONS OF THE MEMBERS IN EXCESS OF CAPITAL CONTRIBUTIONS REQUIRED BY THE CORPORATE MEMBERSHIP AGREEMENT. Q. EXCEPT AS OTHERWISE SET FORTH HEREIN, THE EXECUTION, MATERIAL MODIFICATION (INCLUDING ANY MODIFICATION IN FEES, CHARGES OR RATES), OR TERMINATION OF ANY MANAGEMENT, MANAGED CARE OR THIRD PARTY PAYOR CONTRACT, OR ANY OTHER CONTRACT NOT IN THE ORDINARY COURSE OF BUSINESS. R. VOLUNTARY DECLARATION OF BANKRUPTCY OR SEEKING OF REORGANIZATION UNDER THE INSOLVENCY LAWS BY THE CORPORATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3THE ORGANIZATION DOES NOT HAVE ADDITIONAL COMMITTEES BESIDES THE BOARD OF DIRECTORS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4THE COMPLETED 990 WAS REVIEWED BY THE TREASURER AND AN OUTSIDE INDEPENDENT PUBLIC ACCOUNTING FIRM. RELEVANT SECTIONS WERE REVIEWED BY THE GENERAL COUNSEL OF THE MANAGING MEMBER. AFTER THIS REVIEW, BUT PRIOR TO FILING, THE COMPLETED 990 WAS PROVIDED ELECTRONICALLY TO ALL TRUSTEES.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5THE RESPONSES TO THE CONFLICT OF INTEREST DISCLOSURE FORM ARE COLLECTED AND REVIEWED ANNUALLY BY GENERAL COUNSEL OF THE MANAGING MEMBER. CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED BY ALL DIRECTORS. IN THE EVENT OF A RELATIONSHIP THAT RESULTS IN A POTENTIAL CONFLICT FOR AN ISSUE BEING DISCUSSED BY THE BOARD, THE DIRECTOR RECUSES HIMSELF/HERSELF FROM THE DISCUSSION AND VOTE. THE RECUSAL IS DOCUMENTED IN THE MINUTES.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,596,939. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,596,939.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt8CAPITAL CONTRIBUTIONS 2,706,802.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION A, LINE 6
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION A, LINE 7A
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION A, LINE 7B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VI, SECTION A, LINE 8B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7FORM 990, PART IX, LINE 11G
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc8FORM 990, PART XI, LINE 9:
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IRS990/SignificantChangeInd00
IRS990/SignificantNewProgramSrvcInd00
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IRS990/SubjectToProxyTaxInd00
IRS990/TaxablePartyNotificationInd00
IRS990/TaxExemptBondsInd00
IRS990/TempOrPermanentEndowmentsInd00
IRS990/TerminateOperationsInd00
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IRS990/TotalReportableCompFromOrgAmt00
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IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0743527
IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt00
IRS990/TotalVolunteersCnt00
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IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt0295117
IRS990/TotReportableCompRltdOrgAmt00
IRS990/TrnsfrExmptNonChrtblRltdOrgInd00
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd00
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IRS990/UponRequestInd0X
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IRS990/USAddress/CityNm0BUTLER
IRS990/USAddress/StateAbbreviationCd0PA
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IRS990/VotingMembersIndependentCnt06
IRS990/WebsiteAddressTxt0PABRAINSPINE.COM
IRS990/WhistleblowerPolicyInd00
ReturnHeader/BuildTS02019-02-21 02:37:17Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0RICHARD J LUSK
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0TREASURER
ReturnHeader/BusinessOfficerGrp/PhoneNum07242844166
ReturnHeader/BusinessOfficerGrp/SignatureDt02019-05-14
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0BHS HVHS MULTISPECIALTY GROUP INC
ReturnHeader/Filer/BusinessNameControlTxt0BHSH
ReturnHeader/Filer/EIN0475177929
ReturnHeader/Filer/PhoneNum07242844166
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ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId0DA39A3EE5E6B4B0D3255BFEF95601890AFD80709
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ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd0P
ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt0165.225.0.63
ReturnHeader/FilingSecurityInformation/IPDt02019-05-14
ReturnHeader/FilingSecurityInformation/IPTimezoneCd0ED
ReturnHeader/FilingSecurityInformation/IPTm009:42:27
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0351178661
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0BLUE & CO LLC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt09200 WORTHINGTON RD STE 200
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0WESTERVILLE
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0OH
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd043082
ReturnHeader/PreparerPersonGrp/PhoneNum06148852583
ReturnHeader/PreparerPersonGrp/PreparationDt02019-05-13
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0ANGELA N CRAWFORD CPA
ReturnHeader/ReturnTs02019-05-14T09:42:30-05:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02017-07-01
ReturnHeader/TaxPeriodEndDt02018-06-30
ReturnHeader/TaxYr02017

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