Liabilities / Assets
72nd percentile
Higher debt load relative to assets than 72% of similar nonprofits.
EIN 68-0414571 • 501(c)3 • Mount Shasta, CA
Profile
Enhance the quality of life in Siskiyou County by improving community health and promoting economic development.
Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.
Liabilities / Assets
72nd percentile
Higher debt load relative to assets than 72% of similar nonprofits.
Liabilities / Revenue
76th percentile
Higher debt load relative to revenue than 76% of similar nonprofits.
Net Margin
95th percentile
Higher net margin than 95% 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
Score unavailable
No earlier valid filing was available within the previous three public years.
Revenue Growth
Score unavailable
No earlier valid filing was available within the previous three public years.
Assets
Up$126,707
Up $111,466 (+731%) from 2011
Liabilities
Up$3,555
Up $45 (+1.3%) from 2011
Net Assets
Up$123,152
Up $111,421 (+950%) from 2011
Revenue
Up$102,616
Up $72,183 (+237%) from 2011
Expenses
Up$26,246
Up $4,053 (+18%) from 2011
Net Income
Up$76,370
Up $68,130 (+827%) from 2011
Most recent year
2016 • Form 990EZDetailed filing. Detailed filing data is available for this year.
Enhance the quality of life in Siskiyou County by improving community health and promoting economic development.
| Description | Grants | Expenses |
|---|---|---|
| Community benefit activities of Klamath Health Services, Inc. focus on stakeholder education as well as community prevention, clinical screenings and early intervention programs. Pediatric Dental: KHSI coordinated outreach for children ages 0 5 by providing dental screenings, fluoride varnish, nutrition education and toothbrush kits to 454 kids through 28 preschool site clinics between January 1, 2015 and June 30, 2016. In addition, through a partnership with Siskiyou County Public Health Maternal, Child and Adolescent Health Department, 180 Dental Kits were distributed to pregnant moms through OB/GYN practitioners with the goal of promoting good oral hygiene during pregnancy and beyond. Lastly, KHSI provides travel support in the form of fuel and lodging stipends to families with children identified with a need for anesthesia dentistry or dental services not available close to home. Such services are available more than five hours drive away. Colorectal Cancer Screening: Reached readers of both newspapers in our county through paid publicity using print advertisements featuring celebrity spokespersons professionally developed by the Centers of Disease Control. The print ad featuring Meryl Streep ran 3 times in our local daily paper and twice in our local weekly.Vision Screening Lay Training: Co-sponsored community training to expand access to technology-enabled vision screenings for all residents, especially children 0 5.Countywide Collaboration: Participation in countywide coalition of healthcare delivery stakeholders to evaluate, plan for and implement new laws and regulations affecting rural healthcare in California. KHSI representative participates with the network adequacy sub-committee and outreach and insurance enrollment strategic initiative. In addition, participate with other stakeholders to support, enhance and coordinate efforts among dental care delivery stakeholders.Early Childhood Screening Expansion: Project and proposal development to integrate existing systems to allow us to add to the dental clinics - vision, hearing and social/emotional screenings in the preschool setting. | $26,246 | - |
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| JIM CROSS | Vice Chairman | - | $0 | - | - |
| JACKIE HAGERTY | Chairman | PT | $0 | - | - |
| DEBBIE WALSH | Secretary/Tres | - | $0 | - | - |
| ELIZABETH MITCHELL-COLLORD | Executive Direc | PT | $0 | - | - |
| GREG LIPPERT | Board Member | - | $0 | - | - |
| DANIELE MINOCK | Board Member | - | $0 | - | - |
| MICHAEL SCHAUB | Board Member | - | $0 | - | - |
“Advertising and Promotion $589”
“Travel $1514”
“Insurance $2319”
“PROGRAM EXPENSE $1631”
“DUES & FEES $305”
“Accounts Receivable - Beginning $7110 Accounts Receivable - Ending $94356”
“Prepaid Expenses and Deferred Charges - Beginning $290 Prepaid Expenses and Deferred Charges - Ending $30”
“Accounts Payable and Accrued Expenses - Beginning $1905 Accounts Payable and Accrued Expenses - Ending $3555”
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 | false |
| IRS990EZ/BooksInCareOfDetail/PersonNm | 0 | ELIZABETH MITCHELL-COLLORD |
| IRS990EZ/BooksInCareOfDetail/PhoneNum | 0 | 5309261300 |
| IRS990EZ/BooksInCareOfDetail/USAddress/AddressLine1Txt | 0 | 707 PINE STREET |
| IRS990EZ/BooksInCareOfDetail/USAddress/CityNm | 0 | MOUNT SHASTA |
| IRS990EZ/BooksInCareOfDetail/USAddress/StateAbbreviationCd | 0 | CA |
| IRS990EZ/BooksInCareOfDetail/USAddress/ZIPCd | 0 | 96067 |
| IRS990EZ/CashSavingsAndInvestmentsGrp/BOYAmt | 0 | 41287 |
| IRS990EZ/CashSavingsAndInvestmentsGrp/EOYAmt | 0 | 32321 |
| IRS990EZ/ChgMadeToOrgnzngDocNotRptInd | 0 | false |
| IRS990EZ/ContributionsGiftsGrantsEtcAmt | 0 | 102603 |
| IRS990EZ/CostOfGoodsSoldAmt | 0 | 0 |
| IRS990EZ/CostOrOtherBasisExpenseSaleAmt | 0 | 0 |
| IRS990EZ/DonorAdvisedFndsInd | 0 | false |
| IRS990EZ/EngagedInExcessBenefitTransInd | 0 | false |
| IRS990EZ/ExcessOrDeficitForYearAmt | 0 | 76370 |
| IRS990EZ/FeesAndOtherPymtToIndCntrctAmt | 0 | 15461 |
| IRS990EZ/FiledScheduleAInd | 0 | true |
| IRS990EZ/ForeignFinancialAccountInd | 0 | false |
| IRS990EZ/ForeignOfficeInd | 0 | false |
| IRS990EZ/Form1120PolFiledInd | 0 | false |
| IRS990EZ/Form720FiledInd | 0 | false |
| IRS990EZ/Form990TotalAssetsGrp/BOYAmt | 0 | 48687 |
| IRS990EZ/Form990TotalAssetsGrp/EOYAmt | 0 | 126707 |
| IRS990EZ/FundraisingGrossIncomeAmt | 0 | 0 |
| IRS990EZ/GrossReceiptsAmt | 0 | 102616 |
| IRS990EZ/GrossReceiptsForPublicUseAmt | 0 | 0 |
| IRS990EZ/InfoInScheduleOPartIIInd | 0 | X |
| IRS990EZ/InfoInScheduleOPartIInd | 0 | X |
| IRS990EZ/InfoInScheduleOPartVInd | 0 | X |
| IRS990EZ/InitiationFeesAndCapContriAmt | 0 | 0 |
| IRS990EZ/InvestmentIncomeAmt | 0 | 13 |
| IRS990EZ/LobbyingActivitiesInd | 0 | false |
| IRS990EZ/MadeLoansToFromOfficersInd | 0 | false |
| IRS990EZ/MethodOfAccountingAccrualInd | 0 | X |
| IRS990EZ/NetAssetsOrFundBalancesBOYAmt | 0 | 46782 |
| IRS990EZ/NetAssetsOrFundBalancesEOYAmt | 0 | 123152 |
| IRS990EZ/NetAssetsOrFundBalancesGrp/BOYAmt | 0 | 46782 |
| IRS990EZ/NetAssetsOrFundBalancesGrp/EOYAmt | 0 | 123152 |
| IRS990EZ/OccupancyRentUtltsAndMaintAmt | 0 | 4427 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 0 | 2.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 1 | 8.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 2 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 3 | 8.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 4 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 5 | 1.00 |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/AverageHrsPerWkDevotedToPosRt | 6 | 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/PersonNm | 0 | JIM CROSS |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 1 | JACKIE HAGERTY |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 2 | DEBBIE WALSH |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 3 | ELIZABETH MITCHELL-COLLORD |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 4 | GREG LIPPERT |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 5 | DANIELE MINOCK |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/PersonNm | 6 | MICHAEL SCHAUB |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 0 | Vice Chairman |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 1 | Chairman |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 2 | Secretary/TRES |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 3 | Executive Direc |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 4 | BOARD MEMBER |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 5 | BOARD MEMBER |
| IRS990EZ/OfficerDirectorTrusteeEmplGrp/TitleTxt | 6 | BOARD MEMBER |
| IRS990EZ/OperateHospitalInd | 0 | false |
| IRS990EZ/Organization501c3Ind | 0 | X |
| IRS990EZ/OrganizationDissolvedEtcInd | 0 | false |
| IRS990EZ/OrganizationFiled990TInd | 0 | false |
| IRS990EZ/OrganizationHadUBIInd | 0 | false |
| IRS990EZ/OtherAssetsTotalDetail/BOYAmt | 0 | 7400 |
| IRS990EZ/OtherAssetsTotalDetail/EOYAmt | 0 | 94386 |
| IRS990EZ/OtherExpensesTotalAmt | 0 | 6358 |
| IRS990EZ/PartVIHghstPdCntrctProfSrvcTxt | 0 | NONE |
| IRS990EZ/PartVIOfCompOfHghstPdEmplTxt | 0 | NONE |
| IRS990EZ/PoliticalCampaignActyInd | 0 | false |
| IRS990EZ/PrimaryExemptPurposeTxt | 0 | Enhance the quality of life in Siskiyou County by improving community health and promoting economic development. |
| IRS990EZ/ProgramSrvcAccomplishmentGrp/DescriptionProgramSrvcAccomTxt | 0 | Community benefit activities of Klamath Health Services, Inc. focus on stakeholder education as well as community prevention, clinical screenings and early intervention programs. Pediatric Dental: KHSI coordinated outreach for children ages 0 5 by providing dental screenings, fluoride varnish, nutrition education and toothbrush kits to 454 kids through 28 preschool site clinics between January 1, 2015 and June 30, 2016. In addition, through a partnership with Siskiyou County Public Health Maternal, Child and Adolescent Health Department, 180 Dental Kits were distributed to pregnant moms through OB/GYN practitioners with the goal of promoting good oral hygiene during pregnancy and beyond. Lastly, KHSI provides travel support in the form of fuel and lodging stipends to families with children identified with a need for anesthesia dentistry or dental services not available close to home. Such services are available more than five hours drive away. Colorectal Cancer Screening: Reached readers of both newspapers in our county through paid publicity using print advertisements featuring celebrity spokespersons professionally developed by the Centers of Disease Control. The print ad featuring Meryl Streep ran 3 times in our local daily paper and twice in our local weekly.Vision Screening Lay Training: Co-sponsored community training to expand access to technology-enabled vision screenings for all residents, especially children 0 5.Countywide Collaboration: Participation in countywide coalition of healthcare delivery stakeholders to evaluate, plan for and implement new laws and regulations affecting rural healthcare in California. KHSI representative participates with the network adequacy sub-committee and outreach and insurance enrollment strategic initiative. In addition, participate with other stakeholders to support, enhance and coordinate efforts among dental care delivery stakeholders.Early Childhood Screening Expansion: Project and proposal development to integrate existing systems to allow us to add to the dental clinics - vision, hearing and social/emotional screenings in the preschool setting. |
| IRS990EZ/ProgramSrvcAccomplishmentGrp/GrantsAndAllocationsAmt | 0 | 26246 |
| IRS990EZ/ProhibitedTaxShelterTransInd | 0 | false |
| IRS990EZ/RelatedOrganizationCtrlEntInd | 0 | false |
| IRS990EZ/RelatedOrgSect527OrgInd | 0 | false |
| IRS990EZ/SchoolOperatingInd | 0 | false |
| IRS990EZ/SpecialEventsDirectExpensesAmt | 0 | 0 |
| IRS990EZ/StatesWhereCopyOfReturnIsFldCd | 0 | CA |
| IRS990EZ/SubjectToProxyTaxInd | 0 | false |
| IRS990EZ/SumOfTotalLiabilitiesGrp/BOYAmt | 0 | 1905 |
| IRS990EZ/SumOfTotalLiabilitiesGrp/EOYAmt | 0 | 3555 |
| IRS990EZ/TanningServicesProvidedInd | 0 | false |
| IRS990EZ/TotalExpensesAmt | 0 | 26246 |
| IRS990EZ/TotalProgramServiceExpensesAmt | 0 | 26246 |
| IRS990EZ/TotalRevenueAmt | 0 | 102616 |
| IRS990EZ/TransactionWithControlEntInd | 0 | false |
| IRS990EZ/TrnsfrExmptNonChrtblRltdOrgInd | 0 | false |
| IRS990EZ/WebsiteAddressTxt | 0 | www.healthysiskiyou.com |
| IRS990ScheduleA/AmountsRcvdDsqlfyPersonGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearAmt | 0 | 102603 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus1YearAmt | 0 | 26789 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus2YearsAmt | 0 | 16313 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus3YearsAmt | 0 | 30026 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus4YearsAmt | 0 | 15164 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/TotalAmt | 0 | 190895 |
| IRS990ScheduleA/GovtFurnSrvcFcltsVl509Grp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/GrossInvestmentIncome509Grp/CurrentTaxYearAmt | 0 | 13 |
| IRS990ScheduleA/GrossInvestmentIncome509Grp/CurrentTaxYearMinus1YearAmt | 0 | 1 |
| IRS990ScheduleA/GrossInvestmentIncome509Grp/CurrentTaxYearMinus2YearsAmt | 0 | 1 |
| IRS990ScheduleA/GrossInvestmentIncome509Grp/TotalAmt | 0 | 15 |
| IRS990ScheduleA/GrossReceiptsAdmissionsGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/GrossReceiptsNonUnrltBusGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearAmt | 0 | 13 |
| IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearMinus1YearAmt | 0 | 1 |
| IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearMinus2YearsAmt | 0 | 1 |
| IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/TotalAmt | 0 | 15 |
| IRS990ScheduleA/InvestmentIncomeCYPct | 0 | 0.00010 |
| IRS990ScheduleA/NetIncomeFromOtherUBIGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/OtherIncome509Grp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/Post1975UBTIGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/PubliclySupportedOrg509a2Ind | 0 | X |
| IRS990ScheduleA/PublicSupportCY509Pct | 0 | 0.99990 |
| IRS990ScheduleA/PublicSupportTotal509Amt | 0 | 190895 |
| IRS990ScheduleA/SubstantialContributorsAmtGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/TaxRevLeviedOrgnztnlBnft509Grp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/ThirtyThrPctSuprtTestsCY509Ind | 0 | X |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt | 0 | 102603 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt | 0 | 26789 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt | 0 | 16313 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt | 0 | 30026 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt | 0 | 15164 |
| IRS990ScheduleA/Total509Grp/TotalAmt | 0 | 190895 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt | 0 | 102616 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt | 0 | 26790 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt | 0 | 16314 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt | 0 | 30026 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus4YearsAmt | 0 | 15164 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt | 0 | 190910 |
| IRS990ScheduleB/ContributorInformationGrp/ContributorBusinessName/BusinessNameLine1 | 0 | RESTRICTED |
| IRS990ScheduleB/ContributorInformationGrp/ContributorNum | 0 | RESTRICTED |
| IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine1 | 0 | RESTRICTED |
| IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine2 | 0 | RESTRICTED |
| IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/City | 0 | RESTRICTED |
| IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State | 0 | RESTRICTED |
| IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/ZIPCode | 0 | RESTRICTED |
| IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt | 0 | RESTRICTED |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | Advertising and Promotion $589 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | Travel $1514 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | Insurance $2319 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | PROGRAM EXPENSE $1631 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 4 | DUES & FEES $305 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 5 | Accounts Receivable - Beginning $7110 Accounts Receivable - Ending $94356 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 6 | Prepaid Expenses and Deferred Charges - Beginning $290 Prepaid Expenses and Deferred Charges - Ending $30 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 7 | Accounts Payable and Accrued Expenses - Beginning $1905 Accounts Payable and Accrued Expenses - Ending $3555 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | Other Expenses.1001 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | Other Expenses.1005 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | Other Expenses.1012 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | Other Expenses.1 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 4 | Other Expenses.2 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 5 | Other Assets.1005 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 6 | Other Assets.1011 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 7 | Total Liabilities.1001 |
| ReturnHeader/BuildTS | 0 | 2017-02-10 21:41:12Z |
| ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd | 0 | true |
| ReturnHeader/BusinessOfficerGrp/PersonNm | 0 | ELIZABETH MITCHELL-COLLORD |
| ReturnHeader/BusinessOfficerGrp/PersonTitleTxt | 0 | Executive Director |
| ReturnHeader/BusinessOfficerGrp/SignatureDt | 0 | 2017-01-26 |
| ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt | 0 | KLAMATH HEALTH SERVICES INC |
| ReturnHeader/Filer/BusinessNameControlTxt | 0 | KLAM |
| ReturnHeader/Filer/EIN | 0 | 680414571 |
| ReturnHeader/Filer/PhoneNum | 0 | 5309261300 |
| ReturnHeader/Filer/USAddress/AddressLine1Txt | 0 | 707 PINE STREET |
| ReturnHeader/Filer/USAddress/CityNm | 0 | MOUNT SHASTA |
| ReturnHeader/Filer/USAddress/StateAbbreviationCd | 0 | CA |
| ReturnHeader/Filer/USAddress/ZIPCd | 0 | 96067 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt | 0 | Aiello Goodrich & Teuscher Accountancy Corp |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt | 0 | PO Box 158 |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm | 0 | Mt Shasta |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd | 0 | CA |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd | 0 | 960670158 |
| ReturnHeader/PreparerPersonGrp/PhoneNum | 0 | 5309263881 |
| ReturnHeader/PreparerPersonGrp/PreparerPersonNm | 0 | Lynn E Teuscher CPA |
| ReturnHeader/ReturnTs | 0 | 2017-01-26T16:28:13-08:00 |
| ReturnHeader/ReturnTypeCd | 0 | 990EZ |
| ReturnHeader/TaxPeriodBeginDt | 0 | 2015-07-01 |
| ReturnHeader/TaxPeriodEndDt | 0 | 2016-06-30 |
| ReturnHeader/TaxYr | 0 | 2015 |
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