Civic Intelligence

Claiborne County Healthcare Foundation

EIN 62-1838992 • 501(c)3 • Tazewell, TN

Profile

To support the healthcare needs of the community of claiborne county and the surrounding area

1850 Old Knoxville RdTazewell, TN 37879

n/A

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

97th percentile

95%

Higher net margin than 97% 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

63rd percentile

6.0%

Faster asset growth than 63% of similar nonprofits.

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

Revenue Growth

75th percentile

26%

Faster revenue growth than 75% of similar nonprofits.

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

Balance Sheet
Liabilities / AssetsScore unavailable

Assets

Up

$270,063

Up $15,254 (+6.0%) from 2017

Liabilities

-

No earlier filing loaded for comparison.

Net Assets

Up

$270,063

Up $15,254 (+6.0%) from 2017

Operations
Liabilities / RevenueScore unavailableNet Margin97th percentile

Revenue

Up

$16,063

Up $3,317 (+26%) from 2017

Expenses

Up

$809

Up $119 (+17%) from 2017

Net Income

Up

$15,254

Up $3,198 (+27%) from 2017

Trend Graphs

Balance Sheet Trend

Asset Growth63rd percentile

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

$600K$400K$200K$0Assets 2010: $405,111Liabilities 2010: $905Net Assets 2010: $404,2062010Assets 2011: $391,162Liabilities 2011: $985Net Assets 2011: $390,1772011Assets 2012: $254,545Liabilities 2012: $4,438Net Assets 2012: $250,1072012Assets 2013: $297,809Liabilities 2013: $11,114Net Assets 2013: $286,6952013Assets 2014: $305,903Liabilities 2014: $0Net Assets 2014: $305,9032014Assets 2015: $305,943Net Assets 2015: $305,9432015Assets 2016: $242,753Net Assets 2016: $242,7532016Assets 2017: $254,809Net Assets 2017: $254,8092017Assets 2018: $270,063Net Assets 2018: $270,0632018

Highlighted filing

2018

Assets$270,063
Liabilities-
Net Assets$270,063
Open 2018 Filing

Operations Trend

Revenue Growth75th percentile

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

$200K$100K$0-$100K-$200KRevenue 2010: $77,898Expenses 2010: $3,813Net Income 2010: $74,0852010Revenue 2011: $29,723Expenses 2011: $43,752Net Income 2011: -$14,0292011Revenue 2012: $28,323Expenses 2012: $168,393Net Income 2012: -$140,0702012Revenue 2013: $39,666Expenses 2013: $3,078Net Income 2013: $36,5882013Revenue 2014: $23,680Expenses 2014: $4,472Net Income 2014: $19,2082014Revenue 2015: $18,230Expenses 2015: $18,190Net Income 2015: $402015Revenue 2016: $14,241Expenses 2016: $77,431Net Income 2016: -$63,1902016Revenue 2017: $12,746Expenses 2017: $690Net Income 2017: $12,0562017Revenue 2018: $16,063Expenses 2018: $809Net Income 2018: $15,2542018

Highlighted filing

2018

Revenue$16,063
Expenses$809
Net Income$15,254
Open 2018 Filing

Filings

Most recent year

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

Open filing
Assets
$270,063
Liabilities
-
Net assets
$270,063
Revenue
$16,063
Expenses
$809
Net income
$15,254
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2018Detailed filing. Detailed filing data is available for this year.$2.70$2.70$0.16$0.01$0.15
2017Detailed filing. Detailed filing data is available for this year.$2.55$2.55$0.13$0.01$0.12
2016Detailed filing. Detailed filing data is available for this year.$2.43$2.43$0.14$0.77$0.63
2015Detailed filing. Detailed filing data is available for this year.$3.06$3.06$0.18$0.18$0.00
2014Detailed filing. Detailed filing data is available for this year.$3.06$0.00$3.06$0.24$0.04$0.19
2013Facts available. Structured filing facts are available, but richer extracted sections are limited.$2.98$0.11$2.87$0.40$0.03$0.37
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$2.55$0.04$2.50$0.28$1.68$1.40
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$3.91$0.01$3.90$0.30$0.44$0.14
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$4.05$0.01$4.04$0.78$0.04$0.74
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jul 1, 2017 to Jun 30, 2018
Signed
Sep 27, 2018
Return Version
2017v2.2
Gross Receipts
$24,783
Mission and Program Overview

Mission

To support the healthcare needs of the community of claiborne county and the surrounding area

Program Services

DescriptionGrantsExpenses
CLAIBORNE COUNTY HEALTHCARE FOUNDATION PURCHASES EQUIPMENT FOR CLAIBORNE MDEICAL CENTER. THE HOSPITAL IS OPERATED BY A NONPROFIT ENTITY AND SERVES CLAIBORNE COUNTY & THE SURROUNDING AREA.--
Compensation and Service Providers
Top Officer Pay81st percentile

Employees

NameTitleFull / Part TimeBaseOtherTotal
LEE DAN STONE IIIDirector-$0--
JOHNNY HIBBETTDirector-$0--
RODNEY ENGLANDDirector-$0--
ALICE JOHNSONVice Chair-$0--
DANIEL ENGLANDDirector-$0--
STANLEY LEONARDChairman-$0--
GLENDA DUFFIELDDirector-$0--
NITA LOUTHANDirector-$0--
JEFFREY LEWISSecretary/Treasurer-$0--
DR MICHAEL WIETINGDirector-$0--
Fundraising, Events, and Gaming

Fundraising Events

EventGross ReceiptsGross RevenueDirect ExpensesNet Income
Golf Tournament$23,756$4,306$2,521$1,785
Total Events$23,756$4,306$8,720$-4,414
Filing and Contact Details

Filer

Filer Name
Claiborne County Healthcare Foundation Inc
EIN
62-1838992
Phone
4234897159
Address
1850 OLD KNOXVILLE RD, TAZEWELL, TN 37879

Signing Officer

Name
Stanley Leonard
Title
Chairman
Phone
4234897159
Signed
2018-09-27
Discuss with paid preparer
Yes

Preparer

Firm
Jim Bull CPA
Address
PO BOX 85, TAZEWELL, TN 37879-0085
Preparer
Jim Bull
Phone
4236265290
Supplemental Narrative

Additional Explanations

Pt V, PBC

“The organization did not, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract.”

Form 990EZ, Part I, Line 16

“TAXES & LICENSE 234.”

Raw XML Appendix198 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/PersonNm0STANLEY LEONARD
IRS990EZ/BooksInCareOfDetail/PhoneNum04234897159
IRS990EZ/BooksInCareOfDetail/USAddress/AddressLine1Txt01850 OLD KNOXVILLE RD
IRS990EZ/BooksInCareOfDetail/USAddress/CityNm0TAZEWELL
IRS990EZ/BooksInCareOfDetail/USAddress/StateAbbreviationCd0TN
IRS990EZ/BooksInCareOfDetail/USAddress/ZIPCd037879
IRS990EZ/CashSavingsAndInvestmentsGrp/BOYAmt0244509
IRS990EZ/CashSavingsAndInvestmentsGrp/EOYAmt0259763
IRS990EZ/ChgMadeToOrgnzngDocNotRptInd0false
IRS990EZ/ContributionsGiftsGrantsEtcAmt019450
IRS990EZ/CostOfGoodsSoldAmt00
IRS990EZ/CostOrOtherBasisExpenseSaleAmt00
IRS990EZ/DonorAdvisedFndsInd0false
IRS990EZ/EngagedInExcessBenefitTransInd0false
IRS990EZ/ExcessOrDeficitForYearAmt015254
IRS990EZ/FeesAndOtherPymtToIndCntrctAmt0575
IRS990EZ/FiledScheduleAInd0true
IRS990EZ/ForeignFinancialAccountInd0false
IRS990EZ/ForeignOfficeInd0false
IRS990EZ/Form1120PolFiledInd0false
IRS990EZ/Form990TotalAssetsGrp/BOYAmt0254809
IRS990EZ/Form990TotalAssetsGrp/EOYAmt0270063
IRS990EZ/FundraisingGrossIncomeAmt04306
IRS990EZ/GainOrLossFromSaleOfAssetsAmt00
IRS990EZ/GamingGrossIncomeAmt00
IRS990EZ/GrossProfitLossSlsOfInvntryAmt00
IRS990EZ/GrossReceiptsAmt024783
IRS990EZ/InfoInScheduleOPartIInd0X
IRS990EZ/InfoInScheduleOPartVInd0X
IRS990EZ/InvestmentIncomeAmt01027
IRS990EZ/LandAndBuildingsGrp/BOYAmt010300
IRS990EZ/LandAndBuildingsGrp/EOYAmt010300
IRS990EZ/LobbyingActivitiesInd0false
IRS990EZ/MadeLoansToFromOfficersInd0false
IRS990EZ/MembershipDuesAmt00
IRS990EZ/MethodOfAccountingCashInd0X
IRS990EZ/NetAssetsOrFundBalancesBOYAmt0254809
IRS990EZ/NetAssetsOrFundBalancesEOYAmt0270063
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IRS990EZ/NetAssetsOrFundBalancesGrp/EOYAmt0270063
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt01.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt11.00
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IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt41.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt51.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt61.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt71.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt81.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt91.00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt00
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt10
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt20
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt30
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt40
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt50
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt60
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt70
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt80
IRS990EZ/OfficerDirectorTrusteeEmplGrp/CompensationAmt90
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm0LEE DAN STONE III
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm1JOHNNY HIBBETT
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm2RODNEY ENGLAND
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm3ALICE JOHNSON
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm4DANIEL ENGLAND
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm5STANLEY LEONARD
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm6GLENDA DUFFIELD
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm7NITA LOUTHAN
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm8JEFFREY LEWIS
IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm9DR MICHAEL WIETING
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt0DIRECTOR
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt1DIRECTOR
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt2DIRECTOR
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt3VICE CHAIR
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt4DIRECTOR
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt5CHAIRMAN
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt6DIRECTOR
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt7DIRECTOR
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt8SECRETARY/TREASURER
IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt9DIRECTOR
IRS990EZ/OperateHospitalInd0false
IRS990EZ/Organization501c3Ind0X
IRS990EZ/OrganizationDissolvedEtcInd0false
IRS990EZ/OrganizationHadUBIInd0false
IRS990EZ/OtherExpensesTotalAmt0234
IRS990EZ/PartVIHghstPdCntrctProfSrvcTxt0NONE
IRS990EZ/PartVIOfCompOfHghstPdEmplTxt0NONE
IRS990EZ/PoliticalCampaignActyInd0false
IRS990EZ/PrimaryExemptPurposeTxt0TO SUPPORT THE HEALTHCARE NEEDS OF THE COMMUNITY OF CLAIBORNE COUNTY AND THE SURROUNDING AREA
IRS990EZ/ProgramServiceRevenueAmt00
IRS990EZ/ProgramSrvcAccomplishmentGrp/DescriptionProgramSrvcAccomTxt0CLAIBORNE COUNTY HEALTHCARE FOUNDATION PURCHASES EQUIPMENT FOR CLAIBORNE MDEICAL CENTER. THE HOSPITAL IS OPERATED BY A NONPROFIT ENTITY AND SERVES CLAIBORNE COUNTY & THE SURROUNDING AREA.
IRS990EZ/ProhibitedTaxShelterTransInd0false
IRS990EZ/RelatedOrganizationCtrlEntInd0false
IRS990EZ/ScheduleBNotRequiredInd0X
IRS990EZ/SchoolOperatingInd0false
IRS990EZ/SpecialEventsDirectExpensesAmt08720
IRS990EZ/SpecialEventsNetIncomeLossAmt0-4414
IRS990EZ/StatesWhereCopyOfReturnIsFldCd0TN
IRS990EZ/SubjectToProxyTaxInd0false
IRS990EZ/TanningServicesProvidedInd0false
IRS990EZ/TotalExpensesAmt0809
IRS990EZ/TotalRevenueAmt016063
IRS990EZ/TransactionWithControlEntInd0false
IRS990EZ/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990EZ/TypeOfOrganizationCorpInd0X
IRS990EZ/WebsiteAddressTxt0N/A
IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt0Other Income Part II, Line 10 Description: FUNDRAISING EVENTS 2013: 7764. 2014: 12016. 2015: 6500. 2016: 5531. 2017: 4306.
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc0Pt II Ln 10
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearAmt019450
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus1YearAmt016060
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus2YearsAmt015242
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus3YearsAmt015200
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus4YearsAmt024336
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/TotalAmt090288
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearAmt01027
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus1YearAmt0964
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus2YearsAmt01040
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus3YearsAmt01212
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus4YearsAmt01115
IRS990ScheduleA/GrossInvestmentIncome170Grp/TotalAmt05358
IRS990ScheduleA/InvestmentIncomeCYPct00
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearAmt04306
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus1YearAmt05531
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus2YearsAmt06500
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus3YearsAmt012016
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus4YearsAmt07764
IRS990ScheduleA/OtherIncome170Grp/TotalAmt036117
IRS990ScheduleA/PublicOrganization170Ind0X
IRS990ScheduleA/PublicSupportCY170Pct00.68520
IRS990ScheduleA/PublicSupportCY509Pct00
IRS990ScheduleA/PublicSupportPY170Pct00.66920
IRS990ScheduleA/PublicSupportTotal170Amt090288
IRS990ScheduleA/PublicSupportTotal509Amt00
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY170Ind0X
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearAmt019450
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus1YearAmt016060
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus2YearsAmt015242
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus3YearsAmt015200
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus4YearsAmt024336
IRS990ScheduleA/TotalCalendarYear170Grp/TotalAmt090288
IRS990ScheduleA/TotalSupportAmt0131763
IRS990ScheduleG/FundraisingEventInformationGrp/CashPrizesEvent1Amt01600
IRS990ScheduleG/FundraisingEventInformationGrp/CashPrizesTotalEventsAmt01600
IRS990ScheduleG/FundraisingEventInformationGrp/CharitableContributionsTotAmt019450
IRS990ScheduleG/FundraisingEventInformationGrp/CharitableContriEvent1Amt019450
IRS990ScheduleG/FundraisingEventInformationGrp/DirectExpenseSummaryEventsAmt08720
IRS990ScheduleG/FundraisingEventInformationGrp/Event1Nm0GOLF TOURNAMENT
IRS990ScheduleG/FundraisingEventInformationGrp/GrossReceiptsEvent1Amt023756
IRS990ScheduleG/FundraisingEventInformationGrp/GrossReceiptsTotalAmt023756
IRS990ScheduleG/FundraisingEventInformationGrp/GrossRevenueEvent1Amt04306
IRS990ScheduleG/FundraisingEventInformationGrp/GrossRevenueTotalEventsAmt04306
IRS990ScheduleG/FundraisingEventInformationGrp/NetIncomeSummaryAmt0-4414
IRS990ScheduleG/FundraisingEventInformationGrp/NonCashPrizesEvent1Amt0699
IRS990ScheduleG/FundraisingEventInformationGrp/NonCashPrizesTotalEventsAmt0699
IRS990ScheduleG/FundraisingEventInformationGrp/OthDirectExpnssTotalEventsAmt02521
IRS990ScheduleG/FundraisingEventInformationGrp/OtherDirectExpensesEvent1Amt02521
IRS990ScheduleG/FundraisingEventInformationGrp/RentFacilityCostsEvent1Amt03900
IRS990ScheduleG/FundraisingEventInformationGrp/RentFcltyCostsTotalEventsAmt03900
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1TAXES & LICENSE 234.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Pt V, PBC
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Form 990EZ, Part I, Line 16
ReturnHeader/BuildTS02018-06-14 16:35:46Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0STANLEY LEONARD
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0CHAIRMAN
ReturnHeader/BusinessOfficerGrp/PhoneNum04234897159
ReturnHeader/BusinessOfficerGrp/SignatureDt02018-09-27
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0CLAIBORNE COUNTY HEALTHCARE FOUNDATION INC
ReturnHeader/Filer/BusinessNameControlTxt0CLAI
ReturnHeader/Filer/EIN0621838992
ReturnHeader/Filer/PhoneNum04234897159
ReturnHeader/Filer/USAddress/AddressLine1Txt01850 OLD KNOXVILLE RD
ReturnHeader/Filer/USAddress/CityNm0TAZEWELL
ReturnHeader/Filer/USAddress/StateAbbreviationCd0TN
ReturnHeader/Filer/USAddress/ZIPCd037879
ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId0DCB6F5B1BC36046600A3FEB72112796E5F0A94A4
ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId00500EB9E37233B530954A45E59293A55746650DD
ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd0P
ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt0184.159.230.231
ReturnHeader/FilingSecurityInformation/IPDt02018-09-28
ReturnHeader/FilingSecurityInformation/IPTimezoneCd0PD
ReturnHeader/FilingSecurityInformation/IPTm011:45:29
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0JIM BULL CPA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0PO BOX 85
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0TAZEWELL
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0TN
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0378790085
ReturnHeader/PreparerPersonGrp/PhoneNum04236265290
ReturnHeader/PreparerPersonGrp/PreparationDt02018-09-28
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0JIM BULL
ReturnHeader/PreparerPersonGrp/SelfEmployedInd0X
ReturnHeader/ReturnTs02018-09-28T11:45:38-07:00
ReturnHeader/ReturnTypeCd0990EZ
ReturnHeader/TaxPeriodBeginDt02017-07-01
ReturnHeader/TaxPeriodEndDt02018-06-30
ReturnHeader/TaxYr02017

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