Civic Intelligence

New Horizons Health Systems Inc

EIN 61-1370196 • 501(c)3 • Owenton, KY

View Organization Page

Profile

Provide inpatient, outpatient and emergency medical services to the residents of owen and surrounding counties.

PO Box 40Owenton, KY 40359

newhorizonsmedicalcenter.com

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 2018

Liabilities / Revenue

35th percentile

0.00x

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

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

Net Margin

1st percentile

-505%

Higher net margin than 1% of similar nonprofits.

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

Top Officer Pay

55th percentile

$0

Higher top officer pay than 55% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

501(c)3 • $500k-$1M nonprofits • Source year 2017

Asset Growth

5th percentile

-58%

Faster asset growth than 5% of similar nonprofits.

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

Revenue Growth

1st percentile

-97%

Faster revenue growth than 1% of similar nonprofits.

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

Balance Sheet
Liabilities / Assets33rd percentile

Assets

Down

$657,437

Down $901,745 (-58%) from 2017

Liabilities

Flat

$0

Flat from 2017

Net Assets

Down

$657,437

Down $901,745 (-58%) from 2017

Operations
Liabilities / Revenue35th percentileNet Margin1st percentile

Revenue

Down

$8,949

Down $255,623 (-97%) from 2017

Expenses

Down

$54,134

Down $19,071 (-26%) from 2017

Net Income

Down

-$45,185

Down $236,552 (-124%) from 2017

Trend Graphs

Balance Sheet Trend

Asset Growth5th percentile

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

$10M$5.0M$0-$5.0M-$10MAssets 2010: $4,494,336Liabilities 2010: $7,337,404Net Assets 2010: -$2,843,0682010Assets 2011: $4,902,533Liabilities 2011: $7,373,528Net Assets 2011: -$2,470,9952011Assets 2012: $5,891,478Liabilities 2012: $8,001,194Net Assets 2012: -$2,109,7162012Assets 2013: $5,466,075Liabilities 2013: $7,959,011Net Assets 2013: -$2,492,9362013Assets 2014: $4,007,476Liabilities 2014: $7,643,622Net Assets 2014: -$3,636,1462014Assets 2015: $2,607,326Liabilities 2015: $7,729,408Net Assets 2015: -$5,122,0822015Assets 2016: $1,563,457Liabilities 2016: $195,928Net Assets 2016: $1,367,5292016Assets 2017: $1,559,182Liabilities 2017: $0Net Assets 2017: $1,559,1822017Assets 2018: $657,437Liabilities 2018: $0Net Assets 2018: $657,4372018

Highlighted filing

2018

Assets$657,437
Liabilities$0
Net Assets$657,437
Open 2018 Filing

Operations Trend

Revenue Growth1st percentile

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

$15M$10M$5.0M$0-$5.0MExpenses 2010: $11,103,6722010Expenses 2011: $10,508,3322011Expenses 2012: $10,954,3512012Revenue 2013: $10,198,244Expenses 2013: $10,581,464Net Income 2013: -$383,2202013Revenue 2014: $8,701,881Expenses 2014: $9,845,091Net Income 2014: -$1,143,2102014Revenue 2015: $7,616,860Expenses 2015: $9,102,796Net Income 2015: -$1,485,9362015Revenue 2016: $7,451,499Expenses 2016: $961,888Net Income 2016: $6,489,6112016Revenue 2017: $264,572Expenses 2017: $73,205Net Income 2017: $191,3672017Revenue 2018: $8,949Expenses 2018: $54,134Net Income 2018: -$45,1852018

Highlighted filing

2018

Revenue$8,949
Expenses$54,134
Net Income-$45,185
Open 2018 Filing

Filings

Most recent year

2018 • Form 990Summary only. Only limited summary data is available for this year.

Open filing
Assets
$657,437
Liabilities
$0
Net assets
$657,437
Revenue
$8,949
Expenses
$54,134
Net income
-$45,185
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2018Summary only. Only limited summary data is available for this year.$0.66$0.00$0.66$0.01$0.05$0.05
2017Detailed filing. Detailed filing data is available for this year.$1.56$0.00$1.56$0.26$0.07$0.19
2016Summary only. Only limited summary data is available for this year.$1.56$0.20$1.37$7.45$0.96$6.49
2015Summary only. Only limited summary data is available for this year.$2.61$7.73$5.12$7.62$9.10$1.49
2014Summary only. Only limited summary data is available for this year.$4.01$7.64$3.64$8.70$9.85$1.14
2013Detailed filing. Detailed filing data is available for this year.$5.47$7.96$2.49$10.2$10.6$0.38
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$5.89$8.00$2.11$11.0
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$4.90$7.37$2.47$10.5
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$4.49$7.34$2.84$11.1
Latest Detailed Filing

The latest 2018 filing currently has summary financial data only. Showing the latest detailed filing from 2017 below.

Jump To
Filing Snapshot
Filing Period
Jan 1, 2017 to Dec 31, 2017
Signed
Oct 26, 2018
Return Version
2017v2.2
Gross Receipts
$264,572
Mission and Program Overview

Mission

Provide inpatient, outpatient and emergency medical services owen and surrounding counties.organization filed bankruptcy may 29, 2015 and ceased providing all services january 31, 2016. Bankruptcy liquidation is still underway.

Provide inpatient, outpatient and emergency medical services owen and surrounding counties.organization filed bankruptcy may 29,2015. Organization ceased providing services of any kind february 1, 2016. Bankruptcy liquidation is still ongoing.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$856,560$856,560→ $0
Cash and Non-Interest-Bearing Accounts$707,183$702,622▼ $4,561
Savings and Temporary Cash Investments-$0-
Accounts Receivable-$0-
Other Notes and Loans Receivable, Net-$0-
Pledges and Grants Receivable-$0-
Receivable From Disqualified Prsn-$0-
Receivables From Officers Etc-$0-
Investments Other Securities-$0-
Investments Program Related-$0-
Investments in Publicly Traded Securities-$0-
Intangible Assets-$0-
Inventories for Sale or Use-$0-
Prepaid Expenses and Deferred Charges-$0-
Total Assets$1,563,743$1,559,182▼ $4,561
Other Assets Total-$0-
Liabilities
Accounts Payable and Accrued Expenses$195,928--
Total Liabilities$195,928$0▼ $195,928
Net Assets / Fund Balance
Unrestricted Net Assets$1,367,815$1,559,182▲ $191,367
Total Net Assets Fund Balance$1,367,815$1,559,182▲ $191,367
Total Liabilities and Net Assets / Fund Balance$1,563,743$1,559,182▼ $4,561

Asset Categories

AssetBook ValueDepreciationBasis
Buildings$242,985$4,094,232-
Other Land Buildings-$500-
Land$613,575--
Compensation and Service Providers
Top Officer Pay55th percentile

Board Members and Trustees

NameTitle
Bernard PoePresident & CEO
David LyonsDirector
David WotierDirector
Dr Ft ClementsDirector
Mark WrightDirector
Todd MarstonDirector
Bernard PoeCEO
Janet WrightPharmacist
Judy PoeSecretary
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$47,452
Investment Income
$0
Other Revenue
$217,120
Change in Net Assets
$191,367
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$73,205
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 Accounting-$18,464-$18,464
Occupancy-$10,329-$10,329
Insurance-$9,246-$9,246
Fees for Services Legal-$1,949-$1,949
Office Expenses-$386-$386
Other Expenses$1,352$191-$191
Fees for Services Other-$133-$133
Total Functional Expenses$4,984$68,221$0$73,205
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
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
Golden ScepterOwned by Key EmployRental of ClinicNo-

Loans and Receivables

Line ItemBeginningEndChange
Receivables from Disqualified Persons-$0-
Receivables from Officers, Directors, Trustees, and Key Employees-$0-
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
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et

“The following family relationships exist among board members. Mark and Janet wright are are husband and wife. Bernard Poe and Judy Poe are husband and wife. Janet wright is the daughter of Bernard and Judy Poe. Mark Wright is the son-in-law of Bernard and Judy Poe.”

Form 990, Part VI, Line 11B: Form 990 Review Process

“Form 990 is distributed to board members prior to filing.”

Form 990, Part VI, Line 12C: Explanation of Monitoring and Enforcement of Conflicts

“The organization annually required board members to attest to conflict of interest policy.”

Form 990, Part VI, Line 15A: Compensation Review & Approval Process - CEO, Top Management

“The compensation of the CEO was approved by the board members.”

Form 990, Part VI, Line 15B: Compensation Review and Approval Process for Officers and Key Employees

“The compensation of top company officials and key employees were approved by the board members.”

Form 990, Part VI, Line 19: Other Organization Documents Publicly Available

“The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.”

Filing and Contact Details

Filer

Filer Name
New Horizons Health Systems Inc
EIN
61-1370196
Phone
5025145272
Address
PO BOX 40, OWENTON, KY 40359

Signing Officer

Name
Bernard Poe
Title
CEO
Signed
2018-10-26
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Bernard Poe
Formed
2000
Legal Domicile
Ky
Voting Board Members
7
Independent Board Members
0
Employees
0

Preparer

Firm
E Thomas Associates
Address
1408 N MAIN ST, WILLIAMSTOWN, KY 41097-9478
Preparer
Kelley Gamble CPA
Phone
8598246242
Supplemental Narrative

Additional Explanations

Form 990, Part III, Line 3: Ceased Conducting or Significant Changes To Services

“Organization filed bankruptcy may 29,2015. Organization ceased providing services of any kind february 1, 2016. Bankruptcy liquidation is still ongoing.”

Raw XML AppendixShowing 400 of 402 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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IRS990/OtherExpensesGrp/Desc2PROVIDER REPAYMENTS
IRS990/OtherExpensesGrp/Desc3Postage and Shipping
IRS990/OtherExpensesGrp/ManagementAndGeneralAmt027523
IRS990/OtherExpensesGrp/ManagementAndGeneralAmt1191
IRS990/OtherExpensesGrp/ProgramServicesAmt03632
IRS990/OtherExpensesGrp/ProgramServicesAmt11352
IRS990/OtherExpensesGrp/TotalAmt027523
IRS990/OtherExpensesGrp/TotalAmt13632
IRS990/OtherExpensesGrp/TotalAmt21352
IRS990/OtherExpensesGrp/TotalAmt3191
IRS990/OtherRevenueMiscGrp/BusinessCd0900099
IRS990/OtherRevenueMiscGrp/BusinessCd1900099
IRS990/OtherRevenueMiscGrp/Desc0CHAPTER 11 DEBT CANCELLAT
IRS990/OtherRevenueMiscGrp/Desc1REFUNDS/REIMBURSEMENTS
IRS990/OtherRevenueMiscGrp/RelatedOrExemptFuncIncomeAmt0195928
IRS990/OtherRevenueMiscGrp/RelatedOrExemptFuncIncomeAmt121192
IRS990/OtherRevenueMiscGrp/TotalRevenueColumnAmt0195928
IRS990/OtherRevenueMiscGrp/TotalRevenueColumnAmt121192
IRS990/OtherRevenueTotalAmt0217120
IRS990/OtherSalariesAndWagesGrp/TotalAmt00
IRS990/OthNotesLoansReceivableNetGrp/EOYAmt00
IRS990/PartialLiquidationInd0false
IRS990/PaymentsToAffiliatesGrp/TotalAmt00
IRS990/PayPremiumsPrsnlBnftCntrctInd0false
IRS990/PayrollTaxesGrp/TotalAmt00
IRS990/PensionPlanContributionsGrp/TotalAmt00
IRS990/PledgesAndGrantsReceivableGrp/EOYAmt00
IRS990/PoliticalCampaignActyInd0false
IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt00
IRS990/PrincipalOfficerNm0BERNARD POE
IRS990/ProfessionalFundraisingInd0false
IRS990/ProgramServiceRevenueGrp/BusinessCd0621110
IRS990/ProgramServiceRevenueGrp/Desc0PATIENT SERVICE REVENUE
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt047452
IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt047452
IRS990/ProhibitedTaxShelterTransInd0false
IRS990/PYExcessBenefitTransInd0false
IRS990/PYInvestmentIncomeAmt0539633
IRS990/PymtTravelEntrtnmntPubOfclGrp/TotalAmt00
IRS990/PYOtherExpensesAmt0686038
IRS990/PYOtherRevenueAmt06094408
IRS990/PYProgramServiceRevenueAmt0817458
IRS990/PYRevenuesLessExpensesAmt06489611
IRS990/PYSalariesCompEmpBnftPaidAmt0275850
IRS990/PYTotalExpensesAmt0961888
IRS990/PYTotalRevenueAmt07451499
IRS990/QuidProQuoContributionsInd0false
IRS990/RcvblFromDisqualifiedPrsnGrp/EOYAmt00
IRS990/RcvFndsToPayPrsnlBnftCntrctInd0false
IRS990/ReceivablesFromOfficersEtcGrp/EOYAmt00
IRS990/ReconcilationRevenueExpnssAmt0191367
IRS990/RegularMonitoringEnfrcInd0true
IRS990/RelatedEntityInd0false
IRS990/RelatedOrganizationCtrlEntInd0false
IRS990/ReportInvestmentsOtherSecInd0false
IRS990/ReportLandBuildingEquipmentInd0true
IRS990/ReportOtherAssetsInd0false
IRS990/ReportOtherLiabilitiesInd0false
IRS990/ReportProgramRelatedInvstInd0false
IRS990/RoyaltiesGrp/TotalAmt00
IRS990/RoyaltiesRevenueGrp/TotalRevenueColumnAmt00
IRS990/SavingsAndTempCashInvstGrp/EOYAmt00
IRS990ScheduleA/HospitalInd0X
IRS990/ScheduleBRequiredInd0false
IRS990ScheduleD/BuildingsGrp/BookValueAmt0242985
IRS990ScheduleD/BuildingsGrp/DepreciationAmt04094232
IRS990ScheduleD/BuildingsGrp/InvestmentCostOrOtherBasisAmt04337217
IRS990ScheduleD/LandGrp/BookValueAmt0613575
IRS990ScheduleD/LandGrp/InvestmentCostOrOtherBasisAmt0613575
IRS990ScheduleD/OtherLandBuildingsGrp/DepreciationAmt0500
IRS990ScheduleD/OtherLandBuildingsGrp/InvestmentCostOrOtherBasisAmt0500
IRS990ScheduleD/TotalBookValueLandBuildingsAmt0856560
IRS990/ScheduleJRequiredInd0false
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/NameOfInterested/PersonNm0GOLDEN SCEPTER
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/RelationshipDescriptionTxt0OWNED BY KEY EMPLOY
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/SharingOfRevenuesInd0false
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionDesc0RENTAL OF CLINIC
IRS990ScheduleL/SupplementalInformationDetail/ExplanationTxt0BUILDING RENTED BY THE ORGANIZATION IS OWNED BY CEO, SOME BOARD MEMBERS, AND KEY EMPLOYEES
IRS990ScheduleL/SupplementalInformationDetail/FormAndLineReferenceDesc0Schedule L, Part V Supplemental Information
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0ORGANIZATION FILED BANKRUPTCY MAY 29,2015. ORGANIZATION CEASED PROVIDING SERVICES OF ANY KIND FEBRUARY 1, 2016. BANKRUPTCY LIQUIDATION IS STILL ONGOING.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1The following family relationships exist among board members. Mark and Janet wright are are husband and wife. Bernard Poe and Judy Poe are husband and wife. Janet wright is the daughter of Bernard and Judy Poe. Mark Wright is the son-in-law of Bernard and Judy Poe.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2Form 990 is distributed to board members prior to filing.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3The organization annually required board members to attest to conflict of interest policy.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4The compensation of the CEO was approved by the board members.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5The compensation of top company officials and key employees were approved by the board members.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Form 990, Part III, Line 3: Ceased Conducting or Significant Changes To Services
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2Form 990, Part VI, Line 11b: Form 990 Review Process
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
IRS990/SchoolOperatingInd0false
IRS990/SignificantChangeInd0true
IRS990/SignificantNewProgramSrvcInd0false
IRS990/SubjectToProxyTaxInd0false
IRS990/TaxableDistributionsInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TempOrPermanentEndowmentsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt01563743
IRS990/TotalAssetsEOYAmt01559182
IRS990/TotalAssetsGrp/BOYAmt01563743
IRS990/TotalAssetsGrp/EOYAmt01559182
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt00
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt068221
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt04984
IRS990/TotalFunctionalExpensesGrp/TotalAmt073205
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt0195928
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt0195928
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt01367815
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt01559182
IRS990/TotalProgramServiceExpensesAmt04984
IRS990/TotalProgramServiceRevenueAmt047452
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt0264572
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0264572
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt01563743
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt01559182
IRS990/TravelGrp/TotalAmt00
IRS990/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UnrestrictedNetAssetsGrp/BOYAmt01367815
IRS990/UnrestrictedNetAssetsGrp/EOYAmt01559182
IRS990/UponRequestInd0X
IRS990/VotingMembersGoverningBodyCnt07
IRS990/VotingMembersIndependentCnt00
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd0true
ReturnHeader/BuildTS02018-06-14 16:35:46Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0BERNARD POE
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0CEO
ReturnHeader/BusinessOfficerGrp/SignatureDt02018-10-26
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0NEW HORIZONS HEALTH SYSTEMS INC
ReturnHeader/Filer/BusinessNameControlTxt0NEWH
ReturnHeader/Filer/EIN0611370196
ReturnHeader/Filer/PhoneNum05025145272
ReturnHeader/Filer/USAddress/AddressLine1Txt0PO BOX 40
ReturnHeader/Filer/USAddress/CityNm0OWENTON
ReturnHeader/Filer/USAddress/StateAbbreviationCd0KY
ReturnHeader/Filer/USAddress/ZIPCd040359
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0611236365
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0E THOMAS ASSOCIATES
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt01408 N MAIN ST
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0WILLIAMSTOWN
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0KY
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0410979478
ReturnHeader/PreparerPersonGrp/PhoneNum08598246242
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0Kelley Gamble CPA
ReturnHeader/PreparerPersonGrp/SelfEmployedInd0X
ReturnHeader/ReturnTs02018-10-26T13:48:03-07:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02017-01-01

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