Civic Intelligence

Multi Choices Ctr Independent Livig

EIN 58-2581589 • 501(c)3 • Athens, GA

Profile

To breakdown all barriers by enhancing the quality of life for people with disabilities through advocacy, education and training.

145 Barrington RoadAthens, GA 30605

multiplechoices.us

Siviq Scores

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

Liabilities / Assets

33rd percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • $500k-$1M nonprofits • Source year 2025

Liabilities / Revenue

35th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • $500k-$1M nonprofits • Source year 2025

Net Margin

20th percentile

-14%

Higher net margin than 20% of similar nonprofits.

501(c)3 • $500k-$1M nonprofits • Source year 2025

Top Officer Pay

75th percentile

$69,438

Higher top officer pay than 75% of similar nonprofits.

Top officer pay equals 11.9% of source-year revenue.

501(c)3 • $500k-$1M nonprofits • Source year 2025

Asset Growth

6th percentile

-51%

Faster asset growth than 6% of similar nonprofits.

501(c)3 • $500k-$1M nonprofits • Annualized from 2024 to 2025

Revenue Growth

46th percentile

4.1%

Faster revenue growth than 46% of similar nonprofits.

501(c)3 • $500k-$1M nonprofits • Annualized from 2024 to 2025

Assets

Down

$77,267

Down $24,080 (-24%) from 2023

Liabilities

Flat

$0

Flat from 2023

Net Assets

Down

$77,267

Down $24,080 (-24%) from 2023

Revenue

Up

$582,913

Up $216,958 (+59%) from 2023

Expenses

Up

$663,553

Up $321,067 (+94%) from 2023

Net Income

Down

-$80,640

Down $104,109 (-444%) from 2023

Trend Graphs

Balance Sheet Trend

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

$400K$300K$200K$100K$0-$100KAssets 2011: $56,201Liabilities 2011: $56,201Net Assets 2011: $02011Assets 2012: $39,095Liabilities 2012: $39,095Net Assets 2012: $02012Assets 2013: $76,304Liabilities 2013: $0Net Assets 2013: $76,3042013Assets 2014: $11,750Liabilities 2014: $0Net Assets 2014: -$39,5332014Assets 2015: $109,981Liabilities 2015: $30,749Net Assets 2015: $79,2322015Assets 2016: $195,358Liabilities 2016: $0Net Assets 2016: $195,3582016Assets 2017: $194,578Liabilities 2017: $0Net Assets 2017: $194,5782017Assets 2018: $212,597Liabilities 2018: $0Net Assets 2018: $212,5972018Assets 2019: $273,274Liabilities 2019: $0Net Assets 2019: $273,2742019Assets 2020: $334,247Liabilities 2020: $0Net Assets 2020: $334,2472020Assets 2021: $229,546Liabilities 2021: $0Net Assets 2021: $229,5462021Assets 2022: $124,137Liabilities 2022: $0Net Assets 2022: $124,1372022Assets 2023: $101,347Liabilities 2023: $0Net Assets 2023: $101,3472023Assets 2025: $77,267Liabilities 2025: $0Net Assets 2025: $77,2672025

Highlighted filing

2025

Assets$77,267
Liabilities$0
Net Assets$77,267

Operations Trend

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

$800K$600K$400K$200K$0-$200KRevenue 2011: $231,228Expenses 2011: $230,610Net Income 2011: $6182011Revenue 2012: $192,865Expenses 2012: $191,326Net Income 2012: $1,5392012Expenses 2013: $155,1432013Revenue 2014: $128,576Expenses 2014: $182,873Net Income 2014: -$54,2972014Revenue 2015: $442,752Expenses 2015: $374,799Net Income 2015: $67,9532015Revenue 2016: $481,886Expenses 2016: $286,528Net Income 2016: $195,3582016Revenue 2017: $328,121Expenses 2017: $268,546Net Income 2017: $59,5752017Revenue 2018: $334,123Expenses 2018: $318,015Net Income 2018: $16,1082018Revenue 2019: $425,154Expenses 2019: $406,883Net Income 2019: $18,2712019Revenue 2020: $334,247Expenses 2020: $357,356Net Income 2020: -$23,1092020Revenue 2021: $434,389Expenses 2021: $368,701Net Income 2021: $65,6882021Revenue 2022: $262,495Expenses 2022: $377,543Net Income 2022: -$115,0482022Revenue 2023: $365,955Expenses 2023: $342,486Net Income 2023: $23,4692023Revenue 2025: $582,913Expenses 2025: $663,553Net Income 2025: -$80,6402025

Highlighted filing

2025

Revenue$582,913
Expenses$663,553
Net Income-$80,640

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2025Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.77$0.00$0.77$5.83$6.64$0.81
2023Summary only. Only limited summary data is available for this year.$1.01$0.00$1.01$3.66$3.42$0.23
2022Summary only. Only limited summary data is available for this year.$1.24$0.00$1.24$2.62$3.78$1.15
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$2.30$0.00$2.30$4.34$3.69$0.66
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$3.34$0.00$3.34$3.34$3.57$0.23
2019Facts available. Structured filing facts are available, but richer extracted sections are limited.$2.73$0.00$2.73$4.25$4.07$0.18
2018XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$2.13$0.00$2.13$3.34$3.18$0.16
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.95$0.00$1.95$3.28$2.69$0.60
2016Detailed filing. Detailed filing data is available for this year.$1.95$0.00$1.95$4.82$2.87$1.95
2015Detailed filing. Detailed filing data is available for this year.$1.10$0.31$0.79$4.43$3.75$0.68
2014Detailed filing. Detailed filing data is available for this year.$0.12$0.00$0.40$1.29$1.83$0.54
2013Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.76$0.00$0.76$1.55
2012Summary only. Only limited summary data is available for this year.$0.39$0.39$0.00$1.93$1.91$0.02
2011Summary only. Only limited summary data is available for this year.$0.56$0.56$0.00$2.31$2.31$0.01
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Oct 1, 2024 to Sep 30, 2025
Signed
Jan 16, 2026
Return Version
2024v5.0
Gross Receipts
$582,913
Mission and Program Overview

Mission

To break all barriers by enhancing the quality of life for people with disabilities, including veterans, through advoacy, education, and training.

To break all barriers by enhancing the quality of life for people with disabliities, including veterans, through advocacy, education and training.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$157,907$60,539▼ $97,368
Land, Buildings, and Equipment, Net-$16,728-
Total Assets$157,907$77,267▼ $80,640
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$157,907$77,267▼ $80,640
Total Net Assets Fund Balance$157,907$77,267▼ $80,640
Total Liabilities and Net Assets / Fund Balance$157,907$77,267▼ $80,640

Asset Categories

AssetBook ValueDepreciationBasis
Equipment-$44,759$44,759
Buildings-$1,500-
Leasehold Improvements$16,728$199-
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseTotal
Garrick G ScotExecutive DirectorFT$69,438$69,438
Kenya WarnerKey EmployeeFT$56,641$56,641
Justin P InghaKey EmployeeFT$31,914$31,914
Ashia S JacksoKey EmployeeFT$29,665$29,665
Tanya J CollinKey EmployeePT$26,302$26,302
Makayla RobinsKey EmployeeFT$22,870$22,870
Stephanie BergKey EmployeePT$12,874$12,874
Mary Duffoo SmKey EmployeePT$10,469$10,469
Nathan RiceKey EmployeePT$8,291$8,291
Daniel H MyersKey EmployeePT$8,058$8,058
Nastassia D GrKey EmployeePT$4,456$4,456
Revenue and Support

Revenue Composition

Contributions and Grants
$582,913
Program Service Revenue
$0
Investment Income
$0
Other Revenue
$0
All Other Contributions
$7,462
Change in Net Assets
$-80,640

Audited Revenue Reconciliation

Revenue per Audited Statements
$586,373
Total Revenue per Audited Statements
$586,373
Total Revenue per Form 990
$586,373
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$367,994
Other Expenses$295,559
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$136,181$136,181-$272,362
Fees for Services Management$77,119$4,059-$81,178
Current Officers, Directors, Trustees, and Key Employees$34,719$34,719-$69,438
Occupancy$34,342$34,342-$68,684
Payroll Taxes$13,097$13,097-$26,194
Conferences and Meetings$18,415--$18,415
Travel$918$17,441-$18,359
Office Expenses$2,334$13,228-$15,562
Insurance$7,469$7,469-$14,938
Other Expenses$7,629$5,087-$12,716
Fees for Services Accounting$9,900--$9,900
Information Technology$816$816-$1,632
Fees for Services Legal$298--$298
Depreciation Depletion$199--$199
Total Functional Expenses$375,677$287,876$0$663,553
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
Governance and Compliance

Governance Checklist

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

Filer

Filer Name
Multiple Choices Center for in
EIN
58-2581589
Phone
7068504025
Address
145 BARRINGTON ROAD, ATHENS, GA 30605

Signing Officer

Name
Garrick Scott
Title
Executive Director
Phone
7068504025
Signed
2026-01-16
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Garrick Scott
Formed
2001
Legal Domicile
Ga
Voting Board Members
11
Independent Board Members
10
Employees
11

Preparer

Firm
Raymond Robinson Jr CPA
Address
1080 WELLERS COURT, ROSWELL, GA 30076
Preparer
Raymond Robinson Jr Cp
Phone
7706566130
Supplemental Narrative

Additional Explanations

1

Part 1 Line 20 There were no answers to questions that require a response to by our organization.

2

Part III Statement Program Services Accomplishments There were no answers to questions that require a response to by our organization.

3

Part IV Checklist of Required Schedules There were no answers to questions that require a response to by our organization.

4

Part V Statement Regarding Other IRS Filings and Tax Complia There were no answers to questions that require a response to by our organization.

5

Part VI Governance, Management, and Disclosure There were no answers to questions that require a response to by our organization.

6

Part VII Compensationof Officers, Directors, Trustees, Key There were no answers to questions that require a response by our organization.

7

Part VIII Statement of Revenue There were no answers to questions that require a response by our organization.

8

Part IX Statement of Functional Expenses Other Expenses reflect 19.2% of Total Functional Expenses Staff Development;Utilities Expense;Donations & Gifts; and OTHER FUNCTIONAL $66,394

9

Part X Balance Sheet There were no answers to questions that require a response by our organization.

10

Part XI Reconciliation of Net Assets There were no answers to questions that require a response by our organization.

11

Part XII Financial Statement and Reporting There were no answers to questions that require a response by our organization.

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IRS990/OfficeExpensesGrp/ProgramServicesAmt02334
IRS990/OfficeExpensesGrp/TotalAmt015562
IRS990/OfficerMailingAddressInd0false
IRS990/OperateHospitalInd0false
IRS990/Organization501c3Ind0X
IRS990/OrganizationFollowsFASB117Ind0X
IRS990/OtherExpensesGrp/Desc0Staff Development
IRS990/OtherExpensesGrp/Desc1Utilities Expense
IRS990/OtherExpensesGrp/Desc2Donations & Gifts
IRS990/OtherExpensesGrp/Desc3OTHER FUNCTIONAL
IRS990/OtherExpensesGrp/ManagementAndGeneralAmt021437
IRS990/OtherExpensesGrp/ManagementAndGeneralAmt15087
IRS990/OtherExpensesGrp/ProgramServicesAmt0781
IRS990/OtherExpensesGrp/ProgramServicesAmt110023
IRS990/OtherExpensesGrp/ProgramServicesAmt221437
IRS990/OtherExpensesGrp/ProgramServicesAmt37629
IRS990/OtherExpensesGrp/TotalAmt0781
IRS990/OtherExpensesGrp/TotalAmt110023
IRS990/OtherExpensesGrp/TotalAmt242874
IRS990/OtherExpensesGrp/TotalAmt312716
IRS990/OtherSalariesAndWagesGrp/ManagementAndGeneralAmt0136181
IRS990/OtherSalariesAndWagesGrp/ProgramServicesAmt0136181
IRS990/OtherSalariesAndWagesGrp/TotalAmt0272362
IRS990/PartialLiquidationInd0false
IRS990/PayrollTaxesGrp/ManagementAndGeneralAmt013097
IRS990/PayrollTaxesGrp/ProgramServicesAmt013097
IRS990/PayrollTaxesGrp/TotalAmt026194
IRS990/PoliticalCampaignActyInd0false
IRS990/PrincipalOfficerNm0GARRICK SCOTT
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IRS990/ProhibitedTaxShelterTransInd0false
IRS990/PYContributionsGrantsAmt0560070
IRS990/PYExcessBenefitTransInd0false
IRS990/PYOtherExpensesAmt0241098
IRS990/PYRevenuesLessExpensesAmt056560
IRS990/PYSalariesCompEmpBnftPaidAmt0262412
IRS990/PYTotalExpensesAmt0503510
IRS990/PYTotalRevenueAmt0560070
IRS990/ReconcilationRevenueExpnssAmt0-80640
IRS990/RegularMonitoringEnfrcInd0false
IRS990/RelatedEntityInd0false
IRS990/RelatedOrganizationCtrlEntInd0false
IRS990/ReportInvestmentsOtherSecInd0false
IRS990/ReportLandBuildingEquipmentInd0true
IRS990/ReportOtherAssetsInd0true
IRS990/ReportOtherLiabilitiesInd0false
IRS990/ReportProgramRelatedInvstInd0false
IRS990/RevenueAmt0582913
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearAmt0582913
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus1YearAmt0560070
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus2YearsAmt0365956
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus3YearsAmt0262494
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus4YearsAmt0434389
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IRS990ScheduleA/OtherSupportSumAmt00
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IRS990ScheduleA/PublicSupportTotal170Amt02205822
IRS990ScheduleA/SupportSumAmt00
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IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearAmt0582913
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus1YearAmt0560070
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus2YearsAmt0365956
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus3YearsAmt0262494
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus4YearsAmt0434389
IRS990ScheduleA/TotalCalendarYear170Grp/TotalAmt02205822
IRS990ScheduleA/TotalSupportAmt02205822
IRS990ScheduleB/ContributorInformationGrp/ContributorBusinessName/BusinessNameLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorNum0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine20RESTRICTED
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IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/ZIPCode0RESTRICTED
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IRS990ScheduleD/BuildingsGrp/InvestmentCostOrOtherBasisAmt01500
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IRS990ScheduleD/EquipmentGrp/OtherCostOrOtherBasisAmt044759
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IRS990ScheduleD/LeaseholdImprovementsGrp/DepreciationAmt0199
IRS990ScheduleD/LeaseholdImprovementsGrp/InvestmentCostOrOtherBasisAmt016927
IRS990ScheduleD/RevenueSubtotalAmt0586373
IRS990ScheduleD/TotalBookValueLandBuildingsAmt016728
IRS990ScheduleD/TotalRevenuePerForm990Amt0586373
IRS990ScheduleD/TotalRevEtcAuditedFinclStmtAmt0586373
IRS990/ScheduleJRequiredInd0false
IRS990/ScheduleORequiredInd0false
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0Part 1 Line 20 There were no answers to questions that require a response to by our organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1Part III Statement Program Services Accomplishments There were no answers to questions that require a response to by our organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2Part IV Checklist of Required Schedules There were no answers to questions that require a response to by our organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3Part V Statement Regarding Other IRS Filings and Tax Complia There were no answers to questions that require a response to by our organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4Part VI Governance, Management, and Disclosure There were no answers to questions that require a response to by our organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5Part VII Compensationof Officers, Directors, Trustees, Key There were no answers to questions that require a response by our organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6Part VIII Statement of Revenue There were no answers to questions that require a response by our organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7Part IX Statement of Functional Expenses Other Expenses reflect 19.2% of Total Functional Expenses Staff Development;Utilities Expense;Donations & Gifts; and OTHER FUNCTIONAL $66,394
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt8Part X Balance Sheet There were no answers to questions that require a response by our organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt9Part XI Reconciliation of Net Assets There were no answers to questions that require a response by our organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt10Part XII Financial Statement and Reporting There were no answers to questions that require a response by our organization.
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IRS990/SubjectToExcsTaxNetInvstIncInd0false
IRS990/SubjToTaxRmnrtnExPrchtPymtInd0false
IRS990/TaxableDistributionsInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt0157907
IRS990/TotalAssetsEOYAmt077267
IRS990/TotalAssetsGrp/BOYAmt0157907
IRS990/TotalAssetsGrp/EOYAmt077267
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt0582913
IRS990/TotalEmployeeCnt011
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt0287876
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0375677
IRS990/TotalFunctionalExpensesGrp/TotalAmt0663553
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt00
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0157907
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt077267
IRS990/TotalProgramServiceExpensesAmt0663353
IRS990/TotalReportableCompFromOrgAmt0280978
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0582913
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0157907
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt077267
IRS990/TravelGrp/ManagementAndGeneralAmt017441
IRS990/TravelGrp/ProgramServicesAmt0918
IRS990/TravelGrp/TotalAmt018359
IRS990/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/USAddress/AddressLine1Txt0145 BARRINGTON ROAD
IRS990/USAddress/CityNm0ATHENS
IRS990/USAddress/StateAbbreviationCd0GA
IRS990/USAddress/ZIPCd030605
IRS990/VotingMembersGoverningBodyCnt011
IRS990/VotingMembersIndependentCnt010
IRS990/WhistleblowerPolicyInd0false
ReturnHeader/BuildTS02025-03-06 01:10:19Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0GARRICK SCOTT
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0EXECUTIVE DIRECTOR
ReturnHeader/BusinessOfficerGrp/PhoneNum07068504025
ReturnHeader/BusinessOfficerGrp/SignatureDt02026-01-16
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0MULTIPLE CHOICES CENTER FOR IN
ReturnHeader/Filer/BusinessNameControlTxt0MULT
ReturnHeader/Filer/EIN0582581589
ReturnHeader/Filer/PhoneNum07068504025
ReturnHeader/Filer/USAddress/AddressLine1Txt0145 BARRINGTON ROAD
ReturnHeader/Filer/USAddress/CityNm0ATHENS
ReturnHeader/Filer/USAddress/StateAbbreviationCd0GA
ReturnHeader/Filer/USAddress/ZIPCd030605
ReturnHeader/IRSResponsiblePrtyInfoCurrInd0true
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0814673645
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0RAYMOND ROBINSON JR CPA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt01080 WELLERS COURT
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0ROSWELL
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0GA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd030076
ReturnHeader/PreparerPersonGrp/PhoneNum07706566130

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