Civic Intelligence

Nurseadvice New Mexico

990 • Fiscal year 2015 • EIN 71-0924113

Jan 01, 2015 to Dec 31, 2015 • Filed on Nov 14, 2016

PO Box 37437Albuquerque, NM 87176

(505) 873-7461

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

87th percentile

0.80x

Higher debt load relative to assets than 87% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Liabilities / Revenue

74th percentile

0.43x

Higher debt load relative to revenue than 74% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Net Margin

20th percentile

-11%

Higher net margin than 20% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Top Officer Pay

61st percentile

$83,763

Higher top officer pay than 61% of similar nonprofits.

Top officer pay equals 3.9% of source-year revenue.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Asset Growth

4th percentile

-28%

Faster asset growth than 4% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2014 to 2015

Revenue Growth

31st percentile

-3.6%

Faster revenue growth than 31% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2014 to 2015

Assets

Down

$1,154,677

Down $443,391 (-28%) from 2014

Net Assets

Down

$235,029

Down $232,594 (-50%) from 2014

Liabilities

Down

$919,648

Down $210,797 (-19%) from 2014

Revenue

Down

$2,161,800

Down $80,963 (-3.6%) from 2014

Expenses

Down

$2,394,394

Down $92,978 (-3.7%) from 2014

Net Income

Up

-$232,594

Up $12,015 (+4.9%) from 2014

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$2.0M$1.0M$0-$1.0MAssets 2011: $1,498,529Liabilities 2011: $1,459,861Net Assets 2011: $38,6682011Assets 2012: $1,825,416Liabilities 2012: $1,363,305Net Assets 2012: $462,1112012Assets 2013: $1,962,986Liabilities 2013: $1,250,754Net Assets 2013: $712,2322013Assets 2014: $1,598,068Liabilities 2014: $1,130,445Net Assets 2014: $467,6232014Assets 2015: $1,154,677Liabilities 2015: $919,648Net Assets 2015: $235,0292015Assets 2016: $379,410Liabilities 2016: $609,425Net Assets 2016: -$230,0152016Assets 2017: $111,503Liabilities 2017: $424,359Net Assets 2017: -$312,8562017Assets 2018: $0Net Assets 2018: $02018

Highlighted filing

2015

Assets$1,154,677
Liabilities$919,648
Net Assets$235,029

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$3.0M$2.0M$1.0M$0-$1.0MExpenses 2011: $2,060,9622011Expenses 2012: $2,160,1332012Revenue 2013: $2,497,972Expenses 2013: $2,247,851Net Income 2013: $250,1212013Revenue 2014: $2,242,763Expenses 2014: $2,487,372Net Income 2014: -$244,6092014Revenue 2015: $2,161,800Expenses 2015: $2,394,394Net Income 2015: -$232,5942015Revenue 2016: $1,601,910Expenses 2016: $2,076,767Net Income 2016: -$474,8572016Revenue 2017: $7,348Expenses 2017: $83,375Net Income 2017: -$76,0272017Expenses 2018: $6,1902018

Highlighted filing

2015

Revenue$2,161,800
Expenses$2,394,394
Net Income-$232,594
Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
Nov 14, 2016
Return Version
2015v2.1
Gross Receipts
$2,161,800
Mission and Program Overview

Mission

The mission of nurseadvice new mexico is to offer every new mexican an opportunity to access healthcare whether insured or not, by providing quality, cost effective and culturally sensitive services, using new mexican resources.

Balance Sheet Detail
LineBeginningEndChange
Assets
Savings and Temporary Cash Investments$1,089,817$774,842▼ $314,975
Accounts Receivable$206,623$242,191▲ $35,568
Cash and Non-Interest-Bearing Accounts$201,663$69,854▼ $131,809
Prepaid Expenses and Deferred Charges$59,218$53,550▼ $5,668
Land, Buildings, and Equipment, Net$40,747$14,240▼ $26,507
Total Assets$1,598,068$1,154,677▼ $443,391
Liabilities
Mortgage Notes Payable Secured by Investment Property$1,040,858$788,626▼ $252,232
Accounts Payable and Accrued Expenses$89,587$131,022▲ $41,435
Total Liabilities$1,130,445$919,648▼ $210,797
Net Assets / Fund Balance
Unrestricted Net Assets$467,623$235,029▼ $232,594
Total Net Assets Fund Balance$467,623$235,029▼ $232,594
Total Liabilities and Net Assets / Fund Balance$1,598,068$1,154,677▼ $443,391

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$14,240$453,574$467,814
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseTotal
Connie FiorenzioExecutive DiFT$83,763$83,763

Board Members and Trustees

NameTitle
David AntlePresident
Arthur KaufmanBoard Member
Bob DefeliceBoard Member
Gayle SumnerBoard Member
Sam HowarthBoard Member
Cheryl LopezSecretary
Robert HorwitzTreasurer
Michael MarchiVice Preside
Revenue and Support

Revenue Composition

Contributions and Grants
$581,121
Program Service Revenue
$1,575,749
Investment Income
$1,285
Other Revenue
$3,645
Change in Net Assets
$-232,594
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$1,865,619
Other Expenses$528,775
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$1,531,318$15,362-$1,546,680
Occupancy$216,615$29,584-$246,199
Payroll Taxes$123,354$1,247-$124,601
Other Employee Benefits$107,874$2,701-$110,575
Fees for Services Other$59,620$26,645-$86,265
Current Officers, Directors, Trustees, and Key Employees$82,925$838-$83,763
Depreciation Depletion$22,532$3,976-$26,508
Insurance-$25,934-$25,934
Interest$14,909--$14,909
Other Expenses$6,140$5,715-$5,715
All Other Expenses-$4,337-$4,337
Office Expenses$2,763$421-$3,184
Advertising$1,179--$1,179
Travel-$742-$742
Information Technology$693--$693
Conferences and Meetings-$314-$314
Total Functional Expenses$2,276,578$117,816$0$2,394,394
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
Bob DefeliceBoard MemberBob Is CEO of FirstNo$8,303
Dave AntleBoard MemberDave Is CEO of PueblNo$8,036
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
No
Other officer compensation reviewed
No
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, Page 6, Part VI, Line 7A

The organization elects officers and an audit committee.

Form 990, Page 6, Part VI, Line 11B

The form 990 is provided to the board of directors who review it with the internal accountant prior to signing and filing the tax return.

Form 990, Page 6, Part VI, Line 12C

1)all board members must review and attest by signature annually regarding matters of conflict of interest, and this is usually done at the annual meeting in the fall (oct or nov meeting). 2)the board president reviews and signs off on each attestation. 3)if, at any time during the year, a members situation changes that materially impacts his/her conflict of interest situation, that member has a duty to report it and submit a new attestation.

Form 990, Page 6, Part VI, Line 19

Governing documents and financial statements are made available to the public upon request.

Filing and Contact Details

Filer

Filer Name
Nurseadvice New Mexico
EIN
71-0924113
Phone
5058737461
Address
PO BOX 37437, ALBUQUERQUE, NM 87176

Signing Officer

Name
David Antle
Title
President
Phone
0050587374
Signed
2016-11-14
Discuss with paid preparer
Yes

Organization Details

Principal Officer
David Antle
Formed
2003
Legal Domicile
Nm
Voting Board Members
8
Independent Board Members
8
Employees
62

Preparer

Firm
Hinkle Landers Pc
Address
2500 9TH ST NW, ALBUQUERQUE, NM 87102-1055
Preparer
Farley Vener
Phone
5058838788
Supplemental Narrative

Additional Explanations

FORM 990 - ORGANIZATION'S MISSION

The mission of nurseadvice new mexico is to offer every new mexican an opportunity to access healthcare whether insured or not, by providing quality, cost effective and culturally sensitive services, using new mexican resources.

Financial Statement Notes

Schedule D, Page 3, Part X

Nanm has adopted accounting principles generally accepted in the united states of america as they relate to uncertain tax positions. Any interest and penalties recognized associated with a tax position are classified as current in the nanm financial statements. Currently, the prior three tax years are open and subject to examination by the internal revenue service and new mexico taxation and revenue department. However, the organization is not currently under audit nor has the organization been contacted by any of these jurisdictions. Management believes that they are operating within their tax-exempt purpose. Therefore, no provision for the effects of uncertain tax positions has been recorded for the year.

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IRS990/SavingsAndTempCashInvstGrp/BOYAmt01089817
IRS990/SavingsAndTempCashInvstGrp/EOYAmt0774842
IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt0462
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc0PART II, LINE 10
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearAmt0581121
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus1YearAmt0520247
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus2YearsAmt0559088
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus3YearsAmt0529244
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus4YearsAmt0478912
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/TotalAmt02668612
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearAmt01285
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus1YearAmt01559
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus2YearsAmt01569
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus3YearsAmt02659
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus4YearsAmt01837
IRS990ScheduleA/GrossInvestmentIncome170Grp/TotalAmt08909
IRS990ScheduleA/GrossReceiptsRltdActivitiesAmt01579394
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus1YearAmt0462
IRS990ScheduleA/OtherIncome170Grp/TotalAmt0462
IRS990ScheduleA/PublicOrganization170Ind0X
IRS990ScheduleA/PublicSupportCY170Pct00.99650
IRS990ScheduleA/PublicSupportPY170Pct00.99650
IRS990ScheduleA/PublicSupportTotal170Amt02668612
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY170Ind0X
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearAmt0581121
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus1YearAmt0520247
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus2YearsAmt0559088
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus3YearsAmt0529244
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus4YearsAmt0478912
IRS990ScheduleA/TotalCalendarYear170Grp/TotalAmt02668612
IRS990ScheduleA/TotalSupportAmt02677983
IRS990/ScheduleBRequiredInd0false
IRS990ScheduleD/EquipmentGrp/BookValueAmt014240
IRS990ScheduleD/EquipmentGrp/DepreciationAmt0453574
IRS990ScheduleD/EquipmentGrp/OtherCostOrOtherBasisAmt0467814
IRS990ScheduleD/FootnoteTextInd0X
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0NANM HAS ADOPTED ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA AS THEY RELATE TO UNCERTAIN TAX POSITIONS. ANY INTEREST AND PENALTIES RECOGNIZED ASSOCIATED WITH A TAX POSITION ARE CLASSIFIED AS CURRENT IN THE NANM FINANCIAL STATEMENTS. CURRENTLY, THE PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE AND NEW MEXICO TAXATION AND REVENUE DEPARTMENT. HOWEVER, THE ORGANIZATION IS NOT CURRENTLY UNDER AUDIT NOR HAS THE ORGANIZATION BEEN CONTACTED BY ANY OF THESE JURISDICTIONS. MANAGEMENT BELIEVES THAT THEY ARE OPERATING WITHIN THEIR TAX-EXEMPT PURPOSE. THEREFORE, NO PROVISION FOR THE EFFECTS OF UNCERTAIN TAX POSITIONS HAS BEEN RECORDED FOR THE YEAR.
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE D, PAGE 3, PART X
IRS990ScheduleD/TotalBookValueLandBuildingsAmt014240
IRS990/ScheduleJRequiredInd0false
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/NameOfInterested/PersonNm0BOB DEFELICE
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/NameOfInterested/PersonNm1DAVE ANTLE
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/RelationshipDescriptionTxt0BOARD MEMBER
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/RelationshipDescriptionTxt1BOARD MEMBER
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/SharingOfRevenuesInd0false
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/SharingOfRevenuesInd1false
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionAmt08303
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionAmt18036
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionDesc0BOB IS CEO OF FIRST
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionDesc1DAVE IS CEO OF PUEBL
IRS990ScheduleL/SupplementalInformationDetail/ExplanationTxt0(A) NAME OF PERSON: BOB DEFELICE (D) DESCRIPTION OF TRANSACTION: BOB IS CEO OF FIRST CHOICE COMMUNITY HEALTH WITH WHOM NANM IS CONTRACTED (A) NAME OF PERSON: DAVE ANTLE (D) DESCRIPTION OF TRANSACTION: DAVE IS CEO OF PUEBLO OF ISLETAS DEPARTMENT OF HEALTH SERVICES WITH WHOM NANM IS CONTRACTED
IRS990ScheduleL/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE L, PART V
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0THE MISSION OF NURSEADVICE NEW MEXICO IS TO OFFER EVERY NEW MEXICAN AN OPPORTUNITY TO ACCESS HEALTHCARE WHETHER INSURED OR NOT, BY PROVIDING QUALITY, COST EFFECTIVE AND CULTURALLY SENSITIVE SERVICES, USING NEW MEXICAN RESOURCES.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1THE ORGANIZATION ELECTS OFFICERS AND AN AUDIT COMMITTEE.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS WHO REVIEW IT WITH THE INTERNAL ACCOUNTANT PRIOR TO SIGNING AND FILING THE TAX RETURN.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt31)ALL BOARD MEMBERS MUST REVIEW AND ATTEST BY SIGNATURE ANNUALLY REGARDING MATTERS OF CONFLICT OF INTEREST, AND THIS IS USUALLY DONE AT THE ANNUAL MEETING IN THE FALL (OCT OR NOV MEETING). 2)THE BOARD PRESIDENT REVIEWS AND SIGNS OFF ON EACH ATTESTATION. 3)IF, AT ANY TIME DURING THE YEAR, A MEMBERS SITUATION CHANGES THAT MATERIALLY IMPACTS HIS/HER CONFLICT OF INTEREST SITUATION, THAT MEMBER HAS A DUTY TO REPORT IT AND SUBMIT A NEW ATTESTATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990 - ORGANIZATION'S MISSION
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PAGE 6, PART VI, LINE 7A
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PAGE 6, PART VI, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PAGE 6, PART VI, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PAGE 6, PART VI, LINE 19
IRS990/SchoolOperatingInd0false
IRS990/SignificantChangeInd0false
IRS990/SignificantNewProgramSrvcInd0false
IRS990/StatesWhereCopyOfReturnIsFldCd0NM
IRS990/SubjectToProxyTaxInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TempOrPermanentEndowmentsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt01598068
IRS990/TotalAssetsEOYAmt01154677
IRS990/TotalAssetsGrp/BOYAmt01598068
IRS990/TotalAssetsGrp/EOYAmt01154677
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt0581121
IRS990/TotalEmployeeCnt062
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt0117816
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt02276578
IRS990/TotalFunctionalExpensesGrp/TotalAmt02394394
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt01130445
IRS990/TotalLiabilitiesEOYAmt0919648
IRS990/TotalLiabilitiesGrp/BOYAmt01130445
IRS990/TotalLiabilitiesGrp/EOYAmt0919648
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0467623
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0235029
IRS990/TotalProgramServiceExpensesAmt02276578
IRS990/TotalProgramServiceRevenueAmt01575749
IRS990/TotalReportableCompFromOrgAmt083763
IRS990/TotalRevenueGrp/ExclusionAmt01285
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt01579394
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt02161800
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt01598068
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt01154677
IRS990/TravelGrp/ManagementAndGeneralAmt0742
IRS990/TravelGrp/TotalAmt0742
IRS990/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UnrestrictedNetAssetsGrp/BOYAmt0467623
IRS990/UnrestrictedNetAssetsGrp/EOYAmt0235029
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0PO BOX 37437
IRS990/USAddress/CityNm0ALBUQUERQUE
IRS990/USAddress/StateAbbreviationCd0NM
IRS990/USAddress/ZIPCd087176
IRS990/VotingMembersGoverningBodyCnt08
IRS990/VotingMembersIndependentCnt08
IRS990/WebsiteAddressTxt0WWW.NURSEADVICE.ORG
IRS990/WhistleblowerPolicyInd0true
ReturnHeader/BuildTS02017-02-10 21:41:12Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0DAVID ANTLE
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0PRESIDENT
ReturnHeader/BusinessOfficerGrp/PhoneNum00050587374
ReturnHeader/BusinessOfficerGrp/SignatureDt02016-11-14
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0NURSEADVICE NEW MEXICO
ReturnHeader/Filer/BusinessNameControlTxt0NURS
ReturnHeader/Filer/EIN0710924113
ReturnHeader/Filer/PhoneNum05058737461
ReturnHeader/Filer/USAddress/AddressLine1Txt0PO BOX 37437
ReturnHeader/Filer/USAddress/CityNm0ALBUQUERQUE
ReturnHeader/Filer/USAddress/StateAbbreviationCd0NM
ReturnHeader/Filer/USAddress/ZIPCd087176
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0850232815
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0HINKLE LANDERS PC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt02500 9TH ST NW
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0ALBUQUERQUE
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0NM
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0871021055
ReturnHeader/PreparerPersonGrp/PhoneNum05058838788
ReturnHeader/PreparerPersonGrp/PreparationDt02016-11-14
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0FARLEY VENER
ReturnHeader/ReturnTs02016-11-14T14:23:07-06:00
ReturnHeader/ReturnTypeCd0990

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