Liabilities / Assets
60th percentile
Tied with the lowest-debt nonprofits in its peer group.
EIN 57-0943822 • 501(c)3 • Pickens, SC
Profile
We pledge careful stewardship of your funds, and a commitment and responsiveness to our community's immediate and emerging health care needs through the quality of health care provided by cannon memorial hospital.
Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.
Liabilities / Assets
60th percentile
Tied with the lowest-debt nonprofits in its peer group.
Liabilities / Revenue
62nd percentile
Tied with the lowest-debt nonprofits in its peer group.
Net Margin
5th percentile
Higher net margin than 5% of similar nonprofits.
Top Officer Pay
81st percentile
Higher top officer pay than 81% of similar nonprofits.
Top officer pay equals 0.0% of source-year revenue.
Asset Growth
31st percentile
Faster asset growth than 31% of similar nonprofits.
Revenue Growth
Score unavailable
A valid growth rate could not be computed from the available filing history.
Assets
Down$114,027
Down $32,470 (-22%) from 2020
Liabilities
Flat$0
Flat from 2020
Net Assets
Down$114,027
Down $32,470 (-22%) from 2020
Revenue
Up$9,580
Up $16,476 (+239%) from 2020
Expenses
Up$42,050
Up $41,010 (+3943%) from 2020
Net Income
Down-$32,470
Down $24,534 (-309%) from 2020
Most recent year
2021 • Form 990EZDetailed filing. Detailed filing data is available for this year.
We pledge careful stewardship of your funds, and a commitment and responsiveness to our community's immediate and emerging health care needs through the quality of health care provided by cannon memorial hospital.
We pledge careful stewardship of your funds, and a commitment and responsiveness to our community's immediate and emerging health care needs through the quality of health care provided by anmed health cannon.
| Description | Grants | Expenses |
|---|---|---|
| THE FOUNDATION PROVIDED FUNDS TO THE CITY OF PICKENS IN SUPPORT OF THE DOODLE TRAIL WHICH IS A WALKING TRAIL TO SUPPORT COMMUNITY HEALTH | $42,000 | $42,000 |
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| ELIZABETH M HOLDER | Chair | - | $0 | - | - |
| BURNETT KELLY | Vice Chair | - | $0 | - | - |
| NORM RENTZ | Treasurer | - | $0 | - | - |
| SEAN HINTON | Board Member | - | $0 | - | - |
| LINDA S CASSELL | Board Member | - | $0 | - | - |
| MARY BEELOW | Board Member | - | $0 | - | - |
| ALEX GETTYS JR | Secretary | - | $0 | - | - |
| DONNA OWEN | Board Member | - | $0 | - | - |
| TIM SELF | Ed Ah Foundation- Ex-Officio | - | $0 | - | - |
“Description: reimbursement check. Amount: 1,500.”
“Activity classification: charitable support. Grantee name: city of pickens . Grantee address: 219 pendleton street pickens, sc 29671. Grantee relationship: none. Amount given: 42,000.”
“Description: sc secretary of state. Amount: 50.”
“Description: edward jones account. Beg. Of year amount: 54,101. End of year amount: 54,101. Description: td ameritrade account. Beg. Of year amount: 445. End of year amount: 445.”
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
| Path | # | Value |
|---|---|---|
| IRS990EZ/ActivitiesNotPreviouslyRptInd | 0 | 0 |
| IRS990EZ/BooksInCareOfDetail/BusinessName/BusinessNameLine1Txt | 0 | SHON HERRON |
| IRS990EZ/BooksInCareOfDetail/PhoneNum | 0 | 8648788360 |
| IRS990EZ/BooksInCareOfDetail/USAddress/AddressLine1Txt | 0 | PO BOX 188 |
| IRS990EZ/BooksInCareOfDetail/USAddress/CityNm | 0 | PICKENS |
| IRS990EZ/BooksInCareOfDetail/USAddress/StateAbbreviationCd | 0 | SC |
| IRS990EZ/BooksInCareOfDetail/USAddress/ZIPCd | 0 | 29671 |
| IRS990EZ/CashSavingsAndInvestmentsGrp/BOYAmt | 0 | 91951 |
| IRS990EZ/CashSavingsAndInvestmentsGrp/EOYAmt | 0 | 59481 |
| IRS990EZ/ChgMadeToOrgnzngDocNotRptInd | 0 | 0 |
| IRS990EZ/ContributionsGiftsGrantsEtcAmt | 0 | 8080 |
| IRS990EZ/DirectIndirectPltclExpendAmt | 0 | 0 |
| IRS990EZ/DonorAdvisedFndsInd | 0 | 0 |
| IRS990EZ/EngagedInExcessBenefitTransInd | 0 | 0 |
| IRS990EZ/ExcessOrDeficitForYearAmt | 0 | -32470 |
| IRS990EZ/FiledScheduleAInd | 0 | 1 |
| IRS990EZ/ForeignFinancialAccountInd | 0 | 0 |
| IRS990EZ/ForeignOfficeInd | 0 | 0 |
| IRS990EZ/Form990TotalAssetsGrp/BOYAmt | 0 | 146497 |
| IRS990EZ/Form990TotalAssetsGrp/EOYAmt | 0 | 114027 |
| IRS990EZ/GrantsAndSimilarAmountsPaidAmt | 0 | 42000 |
| IRS990EZ/GrossReceiptsAmt | 0 | 9580 |
| IRS990EZ/InfoInScheduleOPartIIIInd | 0 | X |
| IRS990EZ/InfoInScheduleOPartIIInd | 0 | X |
| IRS990EZ/InfoInScheduleOPartIInd | 0 | X |
| IRS990EZ/InfoInScheduleOPartVInd | 0 | X |
| IRS990EZ/LobbyingActivitiesInd | 0 | 0 |
| IRS990EZ/MadeLoansToFromOfficersInd | 0 | 0 |
| IRS990EZ/MethodOfAccountingAccrualInd | 0 | X |
| IRS990EZ/NetAssetsOrFundBalancesBOYAmt | 0 | 146497 |
| IRS990EZ/NetAssetsOrFundBalancesEOYAmt | 0 | 114027 |
| IRS990EZ/NetAssetsOrFundBalancesGrp/BOYAmt | 0 | 146497 |
| IRS990EZ/NetAssetsOrFundBalancesGrp/EOYAmt | 0 | 114027 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 0 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 1 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 2 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 3 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 4 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 5 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 6 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 7 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 8 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt | 0 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt | 1 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt | 2 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt | 3 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt | 4 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt | 5 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt | 6 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt | 7 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt | 8 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt | 0 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt | 1 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt | 2 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt | 3 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt | 4 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt | 5 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt | 6 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt | 7 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/EmployeeBenefitProgramAmt | 8 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt | 0 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt | 1 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt | 2 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt | 3 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt | 4 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt | 5 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt | 6 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt | 7 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/ExpenseAccountOtherAllwncAmt | 8 | 0 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 0 | ELIZABETH M HOLDER |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 1 | BURNETT KELLY |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 2 | NORM RENTZ |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 3 | SEAN HINTON |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 4 | LINDA S CASSELL |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 5 | MARY BEELOW |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 6 | ALEX GETTYS JR |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 7 | DONNA OWEN |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 8 | TIM SELF |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 0 | CHAIR |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 1 | VICE CHAIR |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 2 | TREASURER |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 3 | BOARD MEMBER |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 4 | BOARD MEMBER |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 5 | BOARD MEMBER |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 6 | SECRETARY |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 7 | BOARD MEMBER |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 8 | ED AH FOUNDATION- EX-OFFICIO |
| IRS990EZ/OperateHospitalInd | 0 | 0 |
| IRS990EZ/Organization501c3Ind | 0 | X |
| IRS990EZ/OrganizationDissolvedEtcInd | 0 | 0 |
| IRS990EZ/OrganizationHadUBIInd | 0 | 0 |
| IRS990EZ/OtherAssetsTotalDetail/BOYAmt | 0 | 54546 |
| IRS990EZ/OtherAssetsTotalDetail/EOYAmt | 0 | 54546 |
| IRS990EZ/OtherChangesInNetAssetsAmt | 0 | 0 |
| IRS990EZ/OtherExpensesTotalAmt | 0 | 50 |
| IRS990EZ/OtherRevenueTotalAmt | 0 | 1500 |
| IRS990EZ/PartVIHghstPdCntrctProfSrvcTxt | 0 | NONE |
| IRS990EZ/PartVIOfCompOfHghstPdEmplTxt | 0 | NONE |
| IRS990EZ/PoliticalCampaignActyInd | 0 | 0 |
| IRS990EZ/PrimaryExemptPurposeTxt | 0 | WE PLEDGE CAREFUL STEWARDSHIP OF YOUR FUNDS, AND A COMMITMENT AND RESPONSIVENESS TO OUR COMMUNITY'S IMMEDIATE AND EMERGING HEALTH CARE NEEDS THROUGH THE QUALITY OF HEALTH CARE PROVIDED BY ANMED HEALTH CANNON. |
| IRS990EZ/ProgramSrvcAccomplishmentGrp/DescriptionProgramSrvcAccomTxt | 0 | THE FOUNDATION PROVIDED FUNDS TO THE CITY OF PICKENS IN SUPPORT OF THE DOODLE TRAIL WHICH IS A WALKING TRAIL TO SUPPORT COMMUNITY HEALTH |
| IRS990EZ/ProgramSrvcAccomplishmentGrp/GrantsAndAllocationsAmt | 0 | 42000 |
| IRS990EZ/ProgramSrvcAccomplishmentGrp/ProgramServiceExpensesAmt | 0 | 42000 |
| IRS990EZ/ProhibitedTaxShelterTransInd | 0 | 0 |
| IRS990EZ/RelatedOrganizationCtrlEntInd | 0 | 0 |
| IRS990EZ/ScheduleBNotRequiredInd | 0 | X |
| IRS990EZ/SchoolOperatingInd | 0 | 0 |
| IRS990EZ/StatesWhereCopyOfReturnIsFldCd | 0 | SC |
| IRS990EZ/SubjectToProxyTaxInd | 0 | 0 |
| IRS990EZ/SumOfTotalLiabilitiesGrp/BOYAmt | 0 | 0 |
| IRS990EZ/SumOfTotalLiabilitiesGrp/EOYAmt | 0 | 0 |
| IRS990EZ/TanningServicesProvidedInd | 0 | 0 |
| IRS990EZ/TaxImposedOnOrganizationMgrAmt | 0 | 0 |
| IRS990EZ/TaxImposedUnderIRC4911Amt | 0 | 0 |
| IRS990EZ/TaxImposedUnderIRC4912Amt | 0 | 0 |
| IRS990EZ/TaxImposedUnderIRC4955Amt | 0 | 0 |
| IRS990EZ/TaxReimbursedByOrganizationAmt | 0 | 0 |
| IRS990EZ/TotalExpensesAmt | 0 | 42050 |
| IRS990EZ/TotalProgramServiceExpensesAmt | 0 | 42000 |
| IRS990EZ/TotalRevenueAmt | 0 | 9580 |
| IRS990EZ/TrnsfrExmptNonChrtblRltdOrgInd | 0 | 0 |
| IRS990EZ/TypeOfOrganizationCorpInd | 0 | X |
| IRS990EZ/WebsiteAddressTxt | 0 | N/A |
| IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearAmt | 0 | 8080 |
| IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus1YearAmt | 0 | 10271 |
| IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus2YearsAmt | 0 | 25521 |
| IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus3YearsAmt | 0 | 32973 |
| IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus4YearsAmt | 0 | 27566 |
| IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/TotalAmt | 0 | 104411 |
| IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus1YearAmt | 0 | 1164 |
| IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus2YearsAmt | 0 | 1620 |
| IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus3YearsAmt | 0 | 253 |
| IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus4YearsAmt | 0 | 285 |
| IRS990ScheduleA/GrossInvestmentIncome170Grp/TotalAmt | 0 | 3322 |
| IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearAmt | 0 | 1500 |
| IRS990ScheduleA/OtherIncome170Grp/TotalAmt | 0 | 1500 |
| IRS990ScheduleA/PublicOrganization170Ind | 0 | X |
| IRS990ScheduleA/PublicSupportCY170Pct | 0 | 0.95590 |
| IRS990ScheduleA/PublicSupportPY170Pct | 0 | 0.96380 |
| IRS990ScheduleA/PublicSupportTotal170Amt | 0 | 104411 |
| IRS990ScheduleA/ThirtyThrPctSuprtTestsCY170Ind | 0 | X |
| IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearAmt | 0 | 8080 |
| IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus1YearAmt | 0 | 10271 |
| IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus2YearsAmt | 0 | 25521 |
| IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus3YearsAmt | 0 | 32973 |
| IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus4YearsAmt | 0 | 27566 |
| IRS990ScheduleA/TotalCalendarYear170Grp/TotalAmt | 0 | 104411 |
| IRS990ScheduleA/TotalSupportAmt | 0 | 109233 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | DESCRIPTION: REIMBURSEMENT CHECK. AMOUNT: 1,500. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | ACTIVITY CLASSIFICATION: CHARITABLE SUPPORT. GRANTEE NAME: CITY OF PICKENS . GRANTEE ADDRESS: 219 PENDLETON STREET PICKENS, SC 29671. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 42,000. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | DESCRIPTION: SC SECRETARY OF STATE. AMOUNT: 50. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | DESCRIPTION: EDWARD JONES ACCOUNT. BEG. OF YEAR AMOUNT: 54,101. END OF YEAR AMOUNT: 54,101. DESCRIPTION: TD AMERITRADE ACCOUNT. BEG. OF YEAR AMOUNT: 445. END OF YEAR AMOUNT: 445. |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | FORM 990-EZ, PART I, LINE 8 - OTHER REVENUE |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS |
| TransferPrsnlBnftContractsDecl/DeclarationDesc | 0 | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. |
| ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/AuthenticationAssuranceLevelCd | 0 | AAL1 |
| ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/IdentityAssuranceLevelCd | 0 | IAL1 |
| ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/TrustedCustomerCd | 0 | 3 |
| ReturnHeader/BuildTS | 0 | 2022-09-23 18:48:47Z |
| ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd | 0 | 1 |
| ReturnHeader/BusinessOfficerGrp/PersonNm | 0 | NORMAN RENTZ |
| ReturnHeader/BusinessOfficerGrp/PersonTitleTxt | 0 | TREASURER |
| ReturnHeader/BusinessOfficerGrp/PhoneNum | 0 | 8648788360 |
| ReturnHeader/BusinessOfficerGrp/SignatureDt | 0 | 2022-11-15 |
| ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt | 0 | CANNON MEMORIAL HOSPITAL FOUNDATION |
| ReturnHeader/Filer/BusinessNameControlTxt | 0 | CANN |
| ReturnHeader/Filer/EIN | 0 | 570943822 |
| ReturnHeader/Filer/PhoneNum | 0 | 8648788360 |
| ReturnHeader/Filer/USAddress/AddressLine1Txt | 0 | PO BOX 188 |
| ReturnHeader/Filer/USAddress/CityNm | 0 | PICKENS |
| ReturnHeader/Filer/USAddress/StateAbbreviationCd | 0 | SC |
| ReturnHeader/Filer/USAddress/ZIPCd | 0 | 296710188 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmEIN | 0 | 440160260 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt | 0 | FORVIS LLP |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt | 0 | 500 RIDGEFIELD COURT |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm | 0 | ASHEVILLE |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd | 0 | NC |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd | 0 | 28806 |
| ReturnHeader/PreparerPersonGrp/PhoneNum | 0 | 8282542254 |
| ReturnHeader/PreparerPersonGrp/PreparationDt | 0 | 2022-11-15 |
| ReturnHeader/PreparerPersonGrp/PreparerPersonNm | 0 | AMY BIBBY |
| ReturnHeader/ReturnTs | 0 | 2022-11-15T12:32:10-06:00 |
| ReturnHeader/ReturnTypeCd | 0 | 990EZ |
| ReturnHeader/SigningOfficerGrp/PersonFullName/PersonFirstNm | 0 | NORMAN |
| ReturnHeader/SigningOfficerGrp/PersonFullName/PersonLastNm | 0 | RENTZ |
| ReturnHeader/TaxPeriodBeginDt | 0 | 2021-01-01 |
| ReturnHeader/TaxPeriodEndDt | 0 | 2021-12-31 |
| ReturnHeader/TaxYr | 0 | 2021 |
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