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      <PreparerPersonNm>Melissa Lessner</PreparerPersonNm>
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      <PhoneNum>7245451040</PhoneNum>
      <PreparationDt>2022-09-15</PreparationDt>
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    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
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      <InfoInScheduleOPartIInd>X</InfoInScheduleOPartIInd>
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      <ProgramServiceRevenueAmt>6144</ProgramServiceRevenueAmt>
      <MembershipDuesAmt>473</MembershipDuesAmt>
      <GamingGrossIncomeAmt>12398</GamingGrossIncomeAmt>
      <FundraisingGrossIncomeAmt referenceDocumentId="1">3368</FundraisingGrossIncomeAmt>
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        <EOYAmt>2273</EOYAmt>
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      <OfficerDirectorTrusteeEmplGrp>
        <PersonNm>MICHAEL GILL</PersonNm>
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      <OfficerDirectorTrusteeEmplGrp>
        <PersonNm>DEBORAH LEMLEY</PersonNm>
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      <OfficerDirectorTrusteeEmplGrp>
        <PersonNm>RUTH BEHRENDT</PersonNm>
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      <ChgMadeToOrgnzngDocNotRptInd>false</ChgMadeToOrgnzngDocNotRptInd>
      <OrganizationHadUBIInd>false</OrganizationHadUBIInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <OrganizationDissolvedEtcInd>false</OrganizationDissolvedEtcInd>
      <MadeLoansToFromOfficersInd>false</MadeLoansToFromOfficersInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
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      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <DonorAdvisedFndsInd>false</DonorAdvisedFndsInd>
      <OperateHospitalInd>false</OperateHospitalInd>
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      <TransactionWithControlEntInd>false</TransactionWithControlEntInd>
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      <PartVIOfCompOfHghstPdEmplTxt>NONE</PartVIOfCompOfHghstPdEmplTxt>
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        <VolunteerLaborOtherGamingInd>false</VolunteerLaborOtherGamingInd>
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      <GamingWithNonmembersInd>false</GamingWithNonmembersInd>
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      <CntrctWith3rdPrtyForGameRevInd>false</CntrctWith3rdPrtyForGameRevInd>
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        <ExplanationTxt>DONATIONS TO MOOSE CHARITIES</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>LINE 16</FormAndLineReferenceDesc>
        <ExplanationTxt>DONATIONS TO OTHER CHARITIES</ExplanationTxt>
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        <ExplanationTxt>MISC GENERAL SUPPLIES NOT IN INVENTORY</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>SALES TAX PAID</ExplanationTxt>
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