Civic Intelligence

Initiative Foundation Impact Fund

EIN 93-3064878 • 501(c)3 • Little Falls, MN

Profile

To empower people to build thriving communities and a vibrant region across central minnesota.

405 First St SELittle Falls, MN 56345

www.ifound.org

Siviq Scores

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

Liabilities / Assets

67th percentile

0.21x

Higher debt load relative to assets than 67% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2024

Liabilities / Revenue

73rd percentile

0.28x

Higher debt load relative to revenue than 73% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2024

Net Margin

97th percentile

88%

Higher net margin than 97% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2024

Top Officer Pay

40th percentile

$0

Higher top officer pay than 40% of similar nonprofits.

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

501(c)3 • $1M-$5M nonprofits • Source year 2024

Asset Growth

99th percentile

513%

Faster asset growth than 99% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Annualized from 2023 to 2024

Revenue Growth

100th percentile

257813%

Faster revenue growth than 100% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Annualized from 2023 to 2024

Balance Sheet
Liabilities / Assets67th percentile

Assets

Up

$2,851,898

Up $2,386,550 (+513%) from 2023

Liabilities

Up

$584,889

Up $582,183 (+21515%) from 2023

Net Assets

Up

$2,267,009

Up $1,804,367 (+390%) from 2023

Operations
Liabilities / Revenue73rd percentileNet Margin97th percentile

Revenue

Up

$2,058,149

Up $2,057,351 (+257813%) from 2023

Expenses

Up

$253,782

Up $220,626 (+665%) from 2023

Net Income

Up

$1,804,367

Up $1,836,725 (+5676%) from 2023

Trend Graphs

Balance Sheet Trend

Asset Growth99th percentile

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

$3.0M$2.0M$1.0M$0Assets 2023: $465,348Liabilities 2023: $2,706Net Assets 2023: $462,6422023Assets 2024: $2,851,898Liabilities 2024: $584,889Net Assets 2024: $2,267,0092024

Highlighted filing

2024

Assets$2,851,898
Liabilities$584,889
Net Assets$2,267,009
Open 2024 Filing

Operations Trend

Revenue Growth100th percentile

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

$3.0M$2.0M$1.0M$0-$1.0MRevenue 2023: $798Expenses 2023: $33,156Net Income 2023: -$32,3582023Revenue 2024: $2,058,149Expenses 2024: $253,782Net Income 2024: $1,804,3672024

Highlighted filing

2024

Revenue$2,058,149
Expenses$253,782
Net Income$1,804,367
Open 2024 Filing

Filings

Most recent year

2024 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$2,851,898
Liabilities
$584,889
Net assets
$2,267,009
Revenue
$2,058,149
Expenses
$253,782
Net income
$1,804,367
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Detailed filing. Detailed filing data is available for this year.$2.85$0.58$2.27$2.06$0.25$1.80
2023Summary only. Only limited summary data is available for this year.$0.47$0.00$0.46$0.00$0.03$0.03
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2024 to Dec 31, 2024
Signed
Oct 21, 2025
Return Version
2024v5.2
Gross Receipts
$2,058,149
Mission and Program Overview

Mission

To empower people to build thriving communities and a vibrant region across central minnesota.

Balance Sheet Detail
LineBeginningEndChange
Assets
Other Notes and Loans Receivable, Net$45,806$433,922▲ $388,116
Cash and Non-Interest-Bearing Accounts$419,542$324,217▼ $95,325
Receivables From Officers Etc-$321,575-
Pledges and Grants Receivable-$300,000-
Accounts Receivable-$2,365-
Total Assets$465,348$2,851,898▲ $2,386,550
Other Assets Total$0$1,469,819▲ $1,469,819
Liabilities
Other Liabilities$0$298,570▲ $298,570
Deferred Revenue-$286,319-
Accounts Payable and Accrued Expenses$2,706--
Total Liabilities$2,706$584,889▲ $582,183
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$462,642$2,267,009▲ $1,804,367
Total Net Assets Fund Balance$462,642$2,267,009▲ $1,804,367
Total Liabilities and Net Assets / Fund Balance$465,348$2,851,898▲ $2,386,550

Asset Categories

AssetBook ValueDepreciationBasis
Other Assets Org$1,469,819--
Compensation and Service Providers
Top Officer Pay40th percentile

Board Members and Trustees

NameTitle
Brett AndersonTrustee/board Chair
Baabiitaw BoydTrustee/vice-chair
Rob AitkinTrustee
Shirwa AdanTrustee
Nick TietzTrustee/treasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$2,013,681
Program Service Revenue
$40,334
Investment Income
$4,134
Other Revenue
$0
All Other Contributions
$2,000,000
Change in Net Assets
$1,804,367
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$253,782
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
Other Expenses$121,801--$121,801
Fees for Services Management$90,050$3,752-$93,802
Fees for Services Other$18,932--$18,932
Occupancy$11,373--$11,373
Fees for Services Accounting$3,600--$3,600
Travel-$2,760-$2,760
Fees for Services Legal$1,460--$1,460
Office Expenses$54--$54
Total Functional Expenses$247,270$6,512$0$253,782
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
-Trustee/vice ChairField Consultant for ProgramNo$2,000

Loans and Receivables

Line ItemBeginningEndChange
Receivables from Officers, Directors, Trustees, and Key Employees-$321,575-
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to Initiative Foundation$298,570
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
Yes
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
Yes
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, Line 11B

“The form 990 is provided to the full board electronically as part of monthly board meeting materials.”

Form 990, Part VI, Section B, Line 12C

“Board meetings begin with a question asking members to disclose any potential conflicts of interest. Business finance commiteee and grant team members are required to disclose potential conflicts of interest prior to discussing grant applications and recuse themselves. Finance approves all payments and considers potential for conflicts of interest. Annually, all donation and payment transactions are reviewed by finance.”

Form 990, Part VI, Section B, Line 15

“A compensation study was conducted by an external firm in 2021. A review of market compensation for comparable foundations plus other minnesota initiative foundations is conducted annually. Market compensation studies are reviewed from the minnesota council on foundations and council of foundations. Shrm resources are also used along with temp agency compensation wage references.”

Form 990, Part VI, Section C, Line 19

“The foundation's financial statements are made available within the annual report or upon request. The foundation's governing documents and conflict of interest policy are not available to the public.”

Filing and Contact Details

Filer

Filer Name
Initiative Foundation Impact Fund
EIN
93-3064878
Phone
3206312050
Address
405 FIRST ST SE, LITTLE FALLS, MN 56345

Signing Officer

Name
Brett Anderson
Title
Chair
Phone
3206312050
Signed
2025-10-21
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Brett Anderson
Formed
2023
Legal Domicile
Mn
Voting Board Members
5
Independent Board Members
5
Employees
0
Volunteers
5

Preparer

Firm
SCHLENNER WENNER & CO CPA'S PA
Address
630 ROOSEVELT RD STE 201, ST CLOUD, MN 56301
Preparer
Shelley M Gaetz
Phone
3202510286
Supplemental Narrative

Financial Statement Notes

PART X, LINE 2:

“The foundation follows fasb asc topic 740, uncertainty in income taxes. The foundation is recognized by the internal revenue service as a not-for-profit organization under irs code section 501(c)(3). Due to the not-for-profit nature and provision of the foundation, all income and expenses attributable to the mission of the foundation are tax exempt and accordingly no provision or liability for income taxes have been made in the financial statements and contributions to the foundation are tax deductible to donors as allowed by irs regulations. However, the foundation is required to pay state and federal income taxes on unrelated business income. If the foundation were to engage in any activities that resulted in unrelated business income, a tax would be assessed on that activity. The foundation is subject to unrelated business income tax with respect to advertising income and investment in partnerships. The foundation is open and subject to examination generally for three years after the filing date.”

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IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/RelationshipDescriptionTxt0TRUSTEE/VICE CHAIR
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/SharingOfRevenuesInd00
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionAmt02000
IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionDesc0FIELD CONSULTANT FOR PROGRAM
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/BalanceDueAmt0196579
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/BalanceDueAmt199996
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/BalanceDueAmt225000
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/BoardOrCommitteeApprovalInd01
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/BoardOrCommitteeApprovalInd11
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/BoardOrCommitteeApprovalInd21
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/DefaultInd00
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/DefaultInd10
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/DefaultInd20
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/LoanFromOrganizationInd0X
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/LoanFromOrganizationInd1X
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/LoanFromOrganizationInd2X
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/OriginalPrincipalAmt0200000
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/OriginalPrincipalAmt1100000
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/OriginalPrincipalAmt225000
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/PersonNm0SHIRWA ADANCREDENT CARE LLC
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/PersonNm1SHIRWA ADANCREDENT CARE LLC
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/PersonNm2NICK TIETZ
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/RelationshipWithOrgTxt0TRUSTEE
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/RelationshipWithOrgTxt1TRUSTEE
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/RelationshipWithOrgTxt2TRUSTEE/TREASURER
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/WrittenAgreementInd01
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/WrittenAgreementInd11
IRS990ScheduleL/LoansBtwnOrgInterestedPrsnGrp/WrittenAgreementInd21
IRS990ScheduleL/TotalBalanceDueAmt0321575
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0THE FORM 990 IS PROVIDED TO THE FULL BOARD ELECTRONICALLY AS PART OF MONTHLY BOARD MEETING MATERIALS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1BOARD MEETINGS BEGIN WITH A QUESTION ASKING MEMBERS TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. BUSINESS FINANCE COMMITEEE AND GRANT TEAM MEMBERS ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST PRIOR TO DISCUSSING GRANT APPLICATIONS AND RECUSE THEMSELVES. FINANCE APPROVES ALL PAYMENTS AND CONSIDERS POTENTIAL FOR CONFLICTS OF INTEREST. ANNUALLY, ALL DONATION AND PAYMENT TRANSACTIONS ARE REVIEWED BY FINANCE.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2A COMPENSATION STUDY WAS CONDUCTED BY AN EXTERNAL FIRM IN 2021. A REVIEW OF MARKET COMPENSATION FOR COMPARABLE FOUNDATIONS PLUS OTHER MINNESOTA INITIATIVE FOUNDATIONS IS CONDUCTED ANNUALLY. MARKET COMPENSATION STUDIES ARE REVIEWED FROM THE MINNESOTA COUNCIL ON FOUNDATIONS AND COUNCIL OF FOUNDATIONS. SHRM RESOURCES ARE ALSO USED ALONG WITH TEMP AGENCY COMPENSATION WAGE REFERENCES.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3THE FOUNDATION'S FINANCIAL STATEMENTS ARE MADE AVAILABLE WITHIN THE ANNUAL REPORT OR UPON REQUEST. THE FOUNDATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION B, LINE 15
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleR/AssetExchangeInd00
IRS990ScheduleR/AssetPurchaseFromOtherOrgInd00
IRS990ScheduleR/AssetSaleToOtherOrgInd00
IRS990ScheduleR/DivRelatedOrganizationInd00
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd01
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd00
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd00
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt0INITIATIVE FOUNDATION
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN0363451562
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt0501(C)(3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd0MN
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt0COMMUNITY FOUNDATION
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PublicCharityStatusTxt0LINE 7
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt0405 FIRST STREET
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm0LITTLE FALLS
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd0MN
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd056345
IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd00
IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd00
IRS990ScheduleR/PaidEmployeesSharingInd00
IRS990ScheduleR/PerformOfServicesByOtherOrgInd00
IRS990ScheduleR/PerformOfServicesForOthOrgInd00
IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd00
IRS990ScheduleR/ReimbursementPaidByOtherOrgInd00
IRS990ScheduleR/ReimbursementPaidToOtherOrgInd01
IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd00
IRS990ScheduleR/RentalOfFcltsFromOthOrgInd00
IRS990ScheduleR/SharingOfFacilitiesInd00
IRS990ScheduleR/TransactionsRelatedOrgGrp/InvolvedAmt02000000
IRS990ScheduleR/TransactionsRelatedOrgGrp/InvolvedAmt193802
IRS990ScheduleR/TransactionsRelatedOrgGrp/MethodOfAmountDeterminationTxt0INCOME STATEMENT
IRS990ScheduleR/TransactionsRelatedOrgGrp/MethodOfAmountDeterminationTxt1INCOME STATEMENT
IRS990ScheduleR/TransactionsRelatedOrgGrp/OtherOrganizationName/BusinessNameLine1Txt0INITIATIVE FOUNDATION
IRS990ScheduleR/TransactionsRelatedOrgGrp/OtherOrganizationName/BusinessNameLine1Txt1INITIATIVE FOUNDATION
IRS990ScheduleR/TransactionsRelatedOrgGrp/TransactionTypeTxt0C
IRS990ScheduleR/TransactionsRelatedOrgGrp/TransactionTypeTxt1P
IRS990ScheduleR/TransferFromOtherOrgInd00
IRS990ScheduleR/TransferToOtherOrgInd00
IRS990/SchoolOperatingInd00
IRS990/SignificantChangeInd00
IRS990/SignificantNewProgramSrvcInd00
IRS990/StatesWhereCopyOfReturnIsFldCd0MN
IRS990/SubjectToExcsTaxNetInvstIncInd00
IRS990/SubjectToProxyTaxInd00
IRS990/SubjToTaxRmnrtnExPrchtPymtInd00
IRS990/TaxablePartyNotificationInd00
IRS990/TaxExemptBondsInd00
IRS990/TerminateOperationsInd00
IRS990/TotalAssetsBOYAmt0465348
IRS990/TotalAssetsEOYAmt02851898
IRS990/TotalAssetsGrp/BOYAmt0465348
IRS990/TotalAssetsGrp/EOYAmt02851898
IRS990/TotalCompGreaterThan150KInd00
IRS990/TotalContributionsAmt02013681
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt06512
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0247270
IRS990/TotalFunctionalExpensesGrp/TotalAmt0253782
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt02706
IRS990/TotalLiabilitiesEOYAmt0584889
IRS990/TotalLiabilitiesGrp/BOYAmt02706
IRS990/TotalLiabilitiesGrp/EOYAmt0584889
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0462642
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt02267009
IRS990/TotalOtherCompensationAmt00
IRS990/TotalProgramServiceExpensesAmt0247270
IRS990/TotalProgramServiceRevenueAmt040334
IRS990/TotalReportableCompFromOrgAmt00
IRS990/TotalRevenueGrp/ExclusionAmt04134
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt040334
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt02058149
IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt00
IRS990/TotalVolunteersCnt05
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0465348
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt02851898
IRS990/TotReportableCompRltdOrgAmt00
IRS990/TravelGrp/ManagementAndGeneralAmt02760
IRS990/TravelGrp/TotalAmt02760
IRS990/TrnsfrExmptNonChrtblRltdOrgInd00
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd00
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0405 FIRST ST SE
IRS990/USAddress/CityNm0LITTLE FALLS
IRS990/USAddress/StateAbbreviationCd0MN
IRS990/USAddress/ZIPCd056345
IRS990/VotingMembersGoverningBodyCnt05
IRS990/VotingMembersIndependentCnt05
IRS990/WebsiteAddressTxt0WWW.IFOUND.ORG
IRS990/WhistleblowerPolicyInd01
ReturnHeader/BuildTS02025-03-06 01:10:19Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0BRETT ANDERSON
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0CHAIR
ReturnHeader/BusinessOfficerGrp/PhoneNum03206312050
ReturnHeader/BusinessOfficerGrp/SignatureDt02025-10-21
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0INITIATIVE FOUNDATION IMPACT FUND
ReturnHeader/Filer/BusinessNameControlTxt0INIT
ReturnHeader/Filer/EIN0933064878
ReturnHeader/Filer/PhoneNum03206312050
ReturnHeader/Filer/USAddress/AddressLine1Txt0405 FIRST ST SE
ReturnHeader/Filer/USAddress/CityNm0LITTLE FALLS
ReturnHeader/Filer/USAddress/StateAbbreviationCd0MN
ReturnHeader/Filer/USAddress/ZIPCd056345
ReturnHeader/IRSResponsiblePrtyInfoCurrInd01
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0411656121
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0SCHLENNER WENNER & CO CPA'S PA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0630 ROOSEVELT RD STE 201
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0ST CLOUD
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0MN
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd056301

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