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        <ListedByNameGoverningDocInd>true</ListedByNameGoverningDocInd>
        <SuprtOrgNoIRSDeterminationInd>false</SuprtOrgNoIRSDeterminationInd>
        <SupportedOrgSectionC456Ind>false</SupportedOrgSectionC456Ind>
        <SupportedOrgNotOrganizedUSInd>false</SupportedOrgNotOrganizedUSInd>
        <OrganizationChangeSuprtOrgInd>false</OrganizationChangeSuprtOrgInd>
        <SupportNonSupportedOrgInd>false</SupportNonSupportedOrgInd>
        <PaymentSubstantialContribtrInd>false</PaymentSubstantialContribtrInd>
        <LoanDisqualifiedPersonInd>false</LoanDisqualifiedPersonInd>
        <ControlledDisqualifiedPrsnInd>false</ControlledDisqualifiedPrsnInd>
        <DisqualifiedPrsnControllIntInd>false</DisqualifiedPrsnControllIntInd>
        <DisqualifiedPrsnOwnrIntInd>false</DisqualifiedPrsnOwnrIntInd>
        <ExcessBusinessHoldingsRulesInd>false</ExcessBusinessHoldingsRulesInd>
        <ContributionControllerInd>false</ContributionControllerInd>
        <ContributionFamilyInd>false</ContributionFamilyInd>
        <Contribution35ControlledInd>false</Contribution35ControlledInd>
      </Form990SchASupportingOrgGrp>
      <Form990SchAType3SprtOrgAllGrp>
        <TimelyProvidedDocumentsInd>false</TimelyProvidedDocumentsInd>
        <OfficersCloseRelationshipInd>true</OfficersCloseRelationshipInd>
        <SupportedOrgVoiceInvestmentInd>false</SupportedOrgVoiceInvestmentInd>
      </Form990SchAType3SprtOrgAllGrp>
      <Form990SchAType3FuncIntGrp>
        <ActivitiesTestInd>X</ActivitiesTestInd>
        <ActivitiesFurtherExemptPrpsInd>true</ActivitiesFurtherExemptPrpsInd>
        <ActivitiesEngagedOrgInvlmntInd>true</ActivitiesEngagedOrgInvlmntInd>
      </Form990SchAType3FuncIntGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART IV, SECTION E, LINE 2A</FormAndLineReferenceDesc>
        <ExplanationTxt>THROUGH FUNDRAISING AND THE OPERATION OF THE GIFT SHOP LOCATED WITHIN THE HOSPITAL, THE MAJORITY OF THE FUNDS GENERATED WERE GIVEN TO THE HOSPITAL TO BE USED FOR CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES THAT THE HOSPITAL WOULD HAVE OTHERWISE HAD TO EXPEND FUNDS FOR.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART IV, SECTION E, LINE 2B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SUPPORTING ORGANIZATION PROVIDED FUNDS TO THE HOSPITAL FOR CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES THAT THE HOSPITAL WOULD HAVE EXPANDED FUNDS FOR HAD IT NOT RECEIVED SUPPORT.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleG documentId="RetDoc3">
      <FundraisingEventInformationGrp>
        <Event1Nm>GOLF TOURNAMENT</Event1Nm>
        <GrossReceiptsEvent1Amt>32277</GrossReceiptsEvent1Amt>
        <GrossRevenueEvent1Amt>32277</GrossRevenueEvent1Amt>
        <NonCashPrizesEvent1Amt>600</NonCashPrizesEvent1Amt>
        <RentFacilityCostsEvent1Amt>4000</RentFacilityCostsEvent1Amt>
        <FoodAndBeverageEvent1Amt>1843</FoodAndBeverageEvent1Amt>
        <OtherDirectExpensesEvent1Amt>587</OtherDirectExpensesEvent1Amt>
        <GrossReceiptsTotalAmt>32277</GrossReceiptsTotalAmt>
        <GrossRevenueTotalEventsAmt>32277</GrossRevenueTotalEventsAmt>
        <NonCashPrizesTotalEventsAmt>600</NonCashPrizesTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>4000</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>1843</FoodAndBeverageTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>587</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>7030</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>25247</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleI documentId="RetDoc4">
      <GrantRecordsMaintainedInd>false</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>CANTON-POTSDAM HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>29 GROVE STREET</AddressLine1Txt>
          <CityNm>POTSDAM</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13676</ZIPCd>
        </USAddress>
        <RecipientEIN>161279472</RecipientEIN>
        <IRCSectionDesc>(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <PurposeOfGrantTxt>CAPITAL PROJECTS</PurposeOfGrantTxt>
      </RecipientTable>
    </IRS990ScheduleI>
    <IRS990ScheduleO documentId="RetDoc5">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 - ORGANIZATION'S MISSION</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PURPOSE OF THE ORGANIZATION IS TO: PROVIDE SERVICE TO CANTON-POTSDAM HOSPITAL AND ITS PATIENTS ASSIST IN PROMOTING THE HEALTH AND WELFARE OF THE COMMUNITY IN ACCORDANCE WITH THE GOALS OF THE HOSPITAL OPERATE A GIFT SHOP AND OTHER BUSINESS ACTIVITIES SPONSOR FUNDRAISING EVENTS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 1, PART I, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE VOLUNTEERS FOR THE ORGANIZATION PROVIDE SUPPORT FOR FUNDRAISING EVENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>COPY OF FORM 990 PROVIDED TO TREASURER FOR REVIEW AND COMMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>NO DOCUMENTS AVAILABLE TO THE PUBLIC</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
