<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-05-01T08:20:28-05:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>363168081</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>SIKICH LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>4020 KINROSS LAKES PARKWAY SUITE</AddressLine1Txt>
        <AddressLine2Txt>300</AddressLine2Txt>
        <CityNm>RICHFIELD</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>44286</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>454734159</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>FAITHFUL SERVANTS MISSION INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>FAIT</BusinessNameControlTxt>
      <PhoneNum>3306336380</PhoneNum>
      <USAddress>
        <AddressLine1Txt>65 COMMUNITY RD F</AddressLine1Txt>
        <CityNm>TALLMADGE</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>44278</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>MARTY HAUSER</PersonNm>
      <PersonTitleTxt>PRESIDENT</PersonTitleTxt>
      <PhoneNum>3306336380</PhoneNum>
      <SignatureDt>2024-04-27</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>MARTY</PersonFirstNm>
        <PersonLastNm>HAUSER</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>0</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>BRIDGETTE MUGGE</PreparerPersonNm>
      <PTIN>P00671418</PTIN>
      <PhoneNum>3308646661</PhoneNum>
      <PreparationDt>2024-04-27</PreparationDt>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>2</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2023</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>FAITHFUL SERVANTS CARE CENTER</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>MARTY HAUSER</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>65 COMMUNITY RD F</AddressLine1Txt>
        <CityNm>TALLMADGE</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>44278</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>184941</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.FAITHFULSERVANTSCARECENTER.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2012</FormationYr>
      <LegalDomicileStateCd>OH</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO PROVIDE FREE URGENT CARE FOR THE UNINSURED AND TO ASSIST IN IDENTIFYING CONTINUITY OF CARE.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>10</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>9</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>1</TotalEmployeeCnt>
      <TotalVolunteersCnt>86</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>212070</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>156286</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>0</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>0</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>30</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>1045</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>3074</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>11193</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>215174</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>168524</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>52736</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>31181</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>4677</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>78115</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>85329</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>130851</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>116510</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>84323</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>52014</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>447143</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>500873</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>1541</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>3259</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>445602</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>497614</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>TO PROVIDE FREE URGENT CARE FOR THE UNINSURED WHOSE INCOME IS AT OR BELOW 200% OF THE POVERTY LEVEL AND TO ASSIST IN IDENTIFYING CONTINUITY OF CARE.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>73900</ExpenseAmt>
      <Desc>UNDER-INSURED PATIENTS:# OF PATIENTS SEEN IN 2023 = 807 ON SITE VISITS; PLUS AN ADD'L 94 PHONE TRIAGE PATIENTS. OF THOSE, 53 WERE SEEN FOR MENTAL/BEHAVIORAL HEALTH CARE, 28 FOR SPECIALTY CARE, 15 FOR DENTAL CARE (ANTIBIOTIC/REFERRAL). 98 OF THOSE PATIENT VISITS WERE FOR DIABETES AND 222 OF THOSE VISITS WERE FOR HYPERTENSION. WE SERVE ALL PEOPLE WHO DO NOT HAVE INSURANCE AND WHOSE INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>2550</ExpenseAmt>
        <Desc>HYPERTENSION:28% OF PATIENTS SEEN SUFFER WITH HYPERTENSION. WE PROVIDE MEDICATION. PEOPLE WITH HYPERTENSION HAVE COMPLEX MEDICAL ISSUES REQUIRING CLOSE MONITORING-WE ARE ABLE TO PROVIDE THIS TO THOSE WHO OTHERWISE WOULD LET THEIR HYPERTENSION GO UNMANAGED BECAUSE OF THE COST OF OTHER NECESSARY LIVING REQUIREMENTS.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>1093</ExpenseAmt>
        <Desc>DIABETES:DIABETES PATIENTS HAVE COMPLEX MEDICAL ISSUES REQUIRING CLOSE MONITORING. WE PROVIDE MEDICATION AND FOLLOW UP VISITS TO MONITOR THEIR LEVELS.</Desc>
      </ProgSrvcAccomActy3Grp>
      <TotalProgramServiceExpensesAmt>77543</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd referenceDocumentId="RetDoc1041300001">0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd referenceDocumentId="RetDoc1041300001">1</FundraisingActivitiesInd>
      <GamingActivitiesInd referenceDocumentId="RetDoc1041300001">0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>0</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>2</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>1</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>1</QuidProQuoContributionsInd>
      <QuidProQuoContriDisclInd>1</QuidProQuoContriDisclInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>10</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>9</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>OH</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>ZACH MEYER</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>3306336380</PhoneNum>
        <USAddress>
          <AddressLine1Txt>65 COMMUNITY RD F</AddressLine1Txt>
          <CityNm>TALLMADGE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44278</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <NoListedPersonsCompensatedInd>X</NoListedPersonsCompensatedInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARTIN HAUSER</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHLEEN KOSTELNICK</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ZACHARY MEYER</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GAYLE GRATER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>T RANDALL FAIRFAX</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JUDGE TODD MCKENNEY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES PACHEL</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EMILY GALE SCOTT MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID WEYRICH</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID HOFF MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TITUS SHEERS MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>0</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>0</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <FundraisingAmt>89159</FundraisingAmt>
      <AllOtherContributionsAmt>67127</AllOtherContributionsAmt>
      <TotalContributionsAmt>156286</TotalContributionsAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1045</TotalRevenueColumnAmt>
        <ExclusionAmt>1045</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>13406</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>13406</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>13406</TotalRevenueColumnAmt>
        <ExclusionAmt>13406</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <FundraisingGrossIncomeAmt>8150</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>89159</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>16417</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-8267</TotalRevenueColumnAmt>
        <ExclusionAmt>-8267</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>6054</TotalRevenueColumnAmt>
        <ExclusionAmt>6054</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>6054</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>168524</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>12238</ExclusionAmt>
      </TotalRevenueGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>31181</TotalAmt>
        <ProgramServicesAmt>23386</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3118</ManagementAndGeneralAmt>
        <FundraisingAmt>4677</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>16011</TotalAmt>
        <ManagementAndGeneralAmt>16011</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>6558</TotalAmt>
        <ManagementAndGeneralAmt>6558</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>564</TotalAmt>
        <ProgramServicesAmt>465</ProgramServicesAmt>
        <ManagementAndGeneralAmt>99</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>35883</TotalAmt>
        <ProgramServicesAmt>29603</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6280</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>169</TotalAmt>
        <ManagementAndGeneralAmt>169</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InsuranceGrp>
        <TotalAmt>5808</TotalAmt>
        <ProgramServicesAmt>4792</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1016</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PHARMACEUTICALS, MEDICA</Desc>
        <TotalAmt>14401</TotalAmt>
        <ProgramServicesAmt>14401</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS EXPENSE</Desc>
        <TotalAmt>5935</TotalAmt>
        <ProgramServicesAmt>4896</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1039</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>116510</TotalAmt>
        <ProgramServicesAmt>77543</ProgramServicesAmt>
        <ManagementAndGeneralAmt>34290</ManagementAndGeneralAmt>
        <FundraisingAmt>4677</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>341719</BOYAmt>
        <EOYAmt>393704</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>101357</BOYAmt>
        <EOYAmt>102402</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <LandBldgEquipCostOrOtherBssAmt>129916</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>129916</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>4067</BOYAmt>
        <EOYAmt>4767</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>447143</BOYAmt>
        <EOYAmt>500873</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>915</BOYAmt>
        <EOYAmt>2423</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>626</BOYAmt>
        <EOYAmt>836</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>1541</BOYAmt>
        <EOYAmt>3259</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrgDoesNotFollowFASB117Ind>X</OrgDoesNotFollowFASB117Ind>
      <CapStkTrPrinCurrentFundsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </CapStkTrPrinCurrentFundsGrp>
      <PdInCapSrplsLandBldgEqpFundGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PdInCapSrplsLandBldgEqpFundGrp>
      <RtnEarnEndowmentIncmOthFndsGrp>
        <BOYAmt>445602</BOYAmt>
        <EOYAmt>497614</EOYAmt>
      </RtnEarnEndowmentIncmOthFndsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>445602</BOYAmt>
        <EOYAmt>497614</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>447143</BOYAmt>
        <EOYAmt>500873</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>52014</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingCashInd>X</MethodOfAccountingCashInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>0</FSAuditedInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>9439</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>9439</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>120477</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>120477</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>0</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>PAYROLL LIABILITIES</Desc>
        <Amt>836</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>836</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="RetDoc1041300001">
      <FundraisingEventInformationGrp>
        <Event1Nm>BLACK TIE &amp; BLUE JEAN</Event1Nm>
        <GrossReceiptsEvent1Amt>97309</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>89159</CharitableContriEvent1Amt>
        <GrossRevenueEvent1Amt>8150</GrossRevenueEvent1Amt>
        <NonCashPrizesEvent1Amt>4475</NonCashPrizesEvent1Amt>
        <RentFacilityCostsEvent1Amt>2400</RentFacilityCostsEvent1Amt>
        <FoodAndBeverageEvent1Amt>7993</FoodAndBeverageEvent1Amt>
        <EntertainmentEvent1Amt>630</EntertainmentEvent1Amt>
        <OtherDirectExpensesEvent1Amt>919</OtherDirectExpensesEvent1Amt>
        <GrossReceiptsTotalAmt>97309</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>89159</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>8150</GrossRevenueTotalEventsAmt>
        <NonCashPrizesTotalEventsAmt>4475</NonCashPrizesTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>2400</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>7993</FoodAndBeverageTotalEventsAmt>
        <EntertainmentTotalEventsAmt>630</EntertainmentTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>919</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>16417</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-8267</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>A COMPLETE COPY OF THE FORM 990 IS E-MAILED TO ALL MEMBERS OF THE GOVERNING BODY BEFORE FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>AT THE BEGINNING OF EACH YEAR, WE HOLD A RETREAT WITH BOARD AND DIRECTORS. AT THE MEETING WE DISCUSS CONFLICTS OF INTEREST AND EACH MEMBER IS ASKED TO SIGN A LETTER DECLARING THEY HAVE NONE. LETTERS ARE KEPT ON FILE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS STEP IS NOT APPLICABLE AS THE ORGANIZATION DOES NOT HAVE PAID OFFICERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
