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        <BusinessNameLine1Txt>CBIZ MHM LLC</BusinessNameLine1Txt>
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      <PreparerUSAddress>
        <AddressLine1Txt>700 WEST 47TH STREET SUITE 1100</AddressLine1Txt>
        <CityNm>KANSAS CITY</CityNm>
        <StateAbbreviationCd>MO</StateAbbreviationCd>
        <ZIPCd>64112</ZIPCd>
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      <PersonNm>TAMRA GRONSETH</PersonNm>
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      <PhoneNum>8138554435</PhoneNum>
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        <PersonLastNm>GRONSETH</PersonLastNm>
      </PersonFullName>
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    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
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      <PreparerPersonNm>LISA BURKE</PreparerPersonNm>
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      <PhoneNum>8169455500</PhoneNum>
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      <OfficerDirectorTrusteeEmplGrp>
        <PersonNm>CHERI O'NEIL</PersonNm>
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      <OfficerDirectorTrusteeEmplGrp>
        <PersonNm>MERIDETH NEWMAN</PersonNm>
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      <OfficerDirectorTrusteeEmplGrp>
        <PersonNm>GREG ALBERS</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
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      <ForeignOfficeInd>0</ForeignOfficeInd>
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      <OperateHospitalInd>0</OperateHospitalInd>
      <TanningServicesProvidedInd>0</TanningServicesProvidedInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
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      <PartVIOfCompOfHghstPdEmplTxt>NONE</PartVIOfCompOfHghstPdEmplTxt>
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        <ExplanationTxt>THE CHP BOARD IS SELECTED BY ITS SOLE MEMBER, THE CHILDREN'S HOME COMMUNITY, INC. (CHC) WHICH HAS THE SAME BOARD AS THE SUPPORTED ORGANIZATION. ALL THREE ORGANIZATIONS HAVE COMMON SUPERVISION AS THEY SHARE THE SAME CEO AND CFO.</ExplanationTxt>
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