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        <AddressLine1Txt>302 S Lynn Riggs Blvd</AddressLine1Txt>
        <CityNm>Claremore</CityNm>
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      <PreparerPersonNm>Michael Stanley</PreparerPersonNm>
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      <InfoInScheduleOPartIInd>X</InfoInScheduleOPartIInd>
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      <MembershipDuesAmt>165</MembershipDuesAmt>
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        <PersonNm>CINDY BAKER</PersonNm>
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        <PersonNm>SANDI WILLIAMS</PersonNm>
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        <PersonNm>MARY LYONS</PersonNm>
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        <PersonNm>CONNIE JESINA</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
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        <PersonNm>SANDI WILLIAMS</PersonNm>
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          <AddressLine1Txt>1202 N MUSKOGEE PLACE</AddressLine1Txt>
          <CityNm>Claremore</CityNm>
          <StateAbbreviationCd>OK</StateAbbreviationCd>
          <ZIPCd>74017</ZIPCd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>List of grants and similar amounts paid Part I line 10</FormAndLineReferenceDesc>
        <ExplanationTxt>Activity DEPARTMENTAL NEEDS Grantee CLAREMORE HOSPITAL Amount 5,028Activity CHARITABLE DONATIONS Grantee VARIOUS CHARITABLE ORGANIZATIONS Amount 7,982</ExplanationTxt>
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        <FormAndLineReferenceDesc>Description of other expenses Part I line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description AmountFEES AND DUES 1,230HOSPITAL RELATIONS 24MEMBERSHIP RELATIONS 226OPERATIONS 399OTHER FUNDRAISING EXPENSES 2,440SALES TAX PAID 5,381SCHOLARSHIPS NTC 1,500SCHOLARSHIPS RSU 3,750TRAVEL AND MEETING EXPENSES 69BAGS AND BATTERIES FOR GS 96</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Description of other assets Part II line 24</FormAndLineReferenceDesc>
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