2024-02-07T13:05:55-06:00 2023-09-30 205857627 TMH P O DRAWER 15099 HATTIESBURG MS 394045099 990 2022-11-17 921090610 PINE GROVE PUBLIC BENEFIT CORPORATION PINE 6012881078 PO BOX 17649 HATTIESBURG MS 394047649 JEFFREY COOK JR PRESIDENT 6012881078 2024-02-07 1 JEFFREY COOK JR 999009999 0 RICHARD G TOPP CPA P00144777 6012643519 2024-01-23 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z X JEFFREY COOK JR PO BOX 17649 HATTIESBURG MS 394047649 0 0 X N/A X 2022 MS AS A SUPPORTING ORGANIZATION WITHIN THE MEANING OF SECTION 509(A)(3) OF THE CODE AND RELATED REGULATIONS, PINE GROVE PUBLIC BENEFIT CORPORATION'S PURPOSE IS TO ASSIST FORREST COUNTY GENERAL HOSPITAL IN THE ADMINISTRATION AND PROVISION OF ITS CHARITABLE PROGRAMS AND SERVICES BY UNDERTAKING THE (A)ACQUISITION OF A LEASEHOLD INTEREST IN CERTAIN REAL PROPERTY LOCATED AT 2115 BROADWAY DRIVE, HATTIESBURG, MS, (B)CONSTRUCTION AND DEVELOPMENT OF A NEW MEDICAL OFFICE BUILDING AND CARE FACILITY ON THE LAND, AND (C)LEASING OF THE PROPERTY TO THE HOSPITAL FOR OPERATION TO THE EXTENT OF ITS CHARITABLE PURPOSES. 5 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 988658 988658 -988658 15597912 16586570 -988658 X AS A SUPPORTING ORGANIZATION WITHIN THE MEANING OF SECTION 509(A)(3) OF THE CODE AND RELATED REGULATIONS, PINE GROVE PUBLIC BENEFIT CORPORATION'S PURPOSE IS TO ASSIST FORREST COUNTY GENERAL HOSPITAL IN THE ADMINISTRATION AND PROVISION OF ITS CHARITABLE PROGRAMS AND SERVICES BY UNDERTAKING THE (A)ACQUISITION OF A LEASEHOLD INTEREST IN CERTAIN REAL PROPERTY LOCATED AT 2115 BROADWAY DRIVE, HATTIESBURG, MS, (B)CONSTRUCTION AND DEVELOPMENT OF A NEW MEDICAL OFFICE BUILDING AND CARE FACILITY ON THE LAND, AND (C)LEASING OF THE PROPERTY TO THE HOSPITAL FOR OPERATION TO THE EXTENT OF ITS CHARITABLE PURPOSES. 0 0 988658 0 BEGAN CONSTRUCTION AND DEVELOPMENT OF A MEDICAL OFFICE BUILDING AS DESCRIBED IN THE ORGANIZATION'S MISSION STATEMENT. CONSTRUCTION REMAINS IN PROCESS AT THE END OF THE CURRENT FISCAL YEAR. 988658 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X KRISTIE HOLLAND CPA 6012881078 125 SOUTH 28TH AVENUE HATTIESBURG MS 39401 X JEFFREY COOK JR PRESIDENT 0.00 X X 0 0 0 BILL OLIVER VICE PRESIDENT 0.00 X X 0 0 0 DEBBIE SANFORD SECRETARY 0.00 X X 0 0 0 LACEY MILLER TREASURER 0.00 X X 0 0 0 PETER KAMP DIRECTOR 0.00 X 0 0 0 0 0 0 0 0 0 0 BAKER TILLY 4807 INNOVATE LN MADISON WI 53737 BUSINESS CONSULTING 470000 BUTLER SNOW 1020 HIGHLKAND COLONY PKWY STE 1400 RIDGELAND MS 39157 LEGAL SERVICES 161450 JONES WALKER 190 E CAPITAL ST STE 800 JACKSON MS 39201 LEGAL SERVICES 148380 3 0 0 0 0 X 324830 324830 499399 499399 127208 127208 9713 9713 27508 27508 988658 988658 0 0 5092747 0 10505165 0 15597912 0 16570 16570000 0 0 0 16586570 X -988658 0 -988658 0 15597912 -988658 0 X 0 1 X 1 0 X X 1 FORREST GENERAL HEALTH 640219645 3 1 0 16570000 1 0 16570000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 PREPAID INSURANCE 4857 CONSTRUCTION IN PROGRESS 10500308 10505165 FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, SECTION C, LINE 18 DOCUMENTS ARE AVAILABLE FOR INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE FOR INSPECTION UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL SERVICES : PROGRAM SERVICE EXPENSES 499,399. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 499,399. FORREST GENERAL HEALTH SERVICES POST OFFICE BOX 16389 HATTIESBURG MS 394046389 646001587 MS 501(C)(3) 170(B)(1)(A)(III) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 FORREST GENERAL HEALTH P 4235163 INVOICES FORREST GENERAL HEALTH Q 16570 INVOICES