﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:sfsmef="http://www.cchsfs.com/efile/mef" returnVersion="2024v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-10-07T14:06:40-06:00</ReturnTs>
    <TaxPeriodEndDt>2024-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>822362113</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>JENNIFER YOUNGS BOOKKEEPING</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>2200 SOUTH PLAZA DR STE 1</AddressLine1Txt>
        <CityNm>RAPID CITY</CityNm>
        <StateAbbreviationCd>SD</StateAbbreviationCd>
        <ZIPCd>57702</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>460417845</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>HOT SPRINGS AMBGULANCE SERVICE</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>HOTS</BusinessNameControlTxt>
      <PhoneNum>6057453651</PhoneNum>
      <USAddress>
        <AddressLine1Txt>PO BOX 927</AddressLine1Txt>
        <CityNm>HOT SPRINGS</CityNm>
        <StateAbbreviationCd>SD</StateAbbreviationCd>
        <ZIPCd>57747</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>TEX RANDY STOMBAUGH</PersonNm>
      <PersonTitleTxt>PRESIDENT</PersonTitleTxt>
      <PhoneNum>6057453651</PhoneNum>
      <SignatureDt>2025-05-14</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>JENNIFER YOUNG</PreparerPersonNm>
      <PTIN>P02034959</PTIN>
      <PhoneNum>6057873230</PhoneNum>
      <PreparationDt>2025-05-14</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="5">
    <IRS990 documentId="5" softwareId="24020071" referenceDocumentId="6 4">
      <PrincipalOfficerNm>TEX RANDY STOMBAUGH</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>PO BOX 927</AddressLine1Txt>
        <CityNm>HOT SPRINGS</CityNm>
        <StateAbbreviationCd>SD</StateAbbreviationCd>
        <ZIPCd>57747</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>1550122</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.HOTSPRINGSAMBULANCE.COM</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2008</FormationYr>
      <LegalDomicileStateCd>SD</LegalDomicileStateCd>
      <ActivityOrMissionDesc>THE AMBULANCE SERVICE PROVIDES EMERGENCY MEDICCAL SERVICE TO 8,000 PEOPLE IN FSLL RIVER COUNTY AND PARTS OF CUSTER COUNTY SOUTH DAKOTA</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>5</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>1</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>41</TotalEmployeeCnt>
      <TotalVolunteersCnt>4</TotalVolunteersCnt>
      <TotalGrossUBIAmt>925</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>99317</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>31829</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>1307505</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>1507543</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>7899</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>7460</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>15394</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>3290</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>1430115</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>1550122</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>948630</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>938180</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>812637</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>653186</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>1761267</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>1591366</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-331152</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-41244</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>5172956</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>5908991</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>2794189</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>2432365</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>2378767</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>3476626</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>THE AMBULANCE SERVICE PROVIDES EMERGENCY MEDICAL SERVICES TO 8,000 PEOPLE IN FALL RIVER COUNTY AND PARTS OF CUSTER COUNTY SOUTH DAKOTA.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>1577088</ExpenseAmt>
      <RevenueAmt>1581871</RevenueAmt>
      <Desc>PROVIDING EMERGENCY MEDICAL SERVICES TO THE COMMUNITY.</Desc>
      <ProgSrvcAccomActy2Grp>
        <Desc>N/A</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <Desc>N/A</Desc>
      </ProgSrvcAccomActy3Grp>
      <TotalProgramServiceExpensesAmt>1577088</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="1">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="2">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="3">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="3">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="3">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="3">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="3">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="3">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="3">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="3">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="3">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="3">false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="3">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="3">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="3">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <AuditedFinancialStmtAttInd referenceDocumentId="4">true</AuditedFinancialStmtAttInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>false</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>11</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>41</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <DAFExcessBusinessHoldingsInd>false</DAFExcessBusinessHoldingsInd>
      <TaxableDistributionsInd>false</TaxableDistributionsInd>
      <DistributionToDonorInd>false</DistributionToDonorInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <ExcsTaxSect4951Or4952Or4953Ind>false</ExcsTaxSect4951Or4952Or4953Ind>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>5</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>1</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>true</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>false</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>false</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>SD</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>JENNIFER YOUNGS BOOKKEEPING SE</PersonNm>
        <PhoneNum>6057873230</PhoneNum>
        <USAddress>
          <AddressLine1Txt>2200 SOUTH PLAZ</AddressLine1Txt>
          <CityNm>RAPID CITY</CityNm>
          <StateAbbreviationCd>SD</StateAbbreviationCd>
          <ZIPCd>57702</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>JACKI CONLIN</PersonNm>
        <TitleTxt>DIRECTOR OF OP</TitleTxt>
        <AverageHoursPerWeekRt>40</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>81237</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SEAN LEIN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>56617</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATT RAMSEY</PersonNm>
        <TitleTxt>CREW CHIEF</TitleTxt>
        <AverageHoursPerWeekRt>49</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>70192</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JUSTIN RICHARD</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>41</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>45690</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHEYENNE ERWIN</PersonNm>
        <TitleTxt>SECRETARTY</TitleTxt>
        <AverageHoursPerWeekRt>14</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>49794</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICK ROGERS</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>19492</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TEX RANDY STOM</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>323022</TotalReportableCompFromOrgAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>false</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>31829</GovernmentGrantsAmt>
      <TotalContributionsAmt>31829</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>AMBULANCE SERVICE</Desc>
        <BusinessCd>621910</BusinessCd>
        <TotalRevenueColumnAmt>1297596</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1297596</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONTRACTS</Desc>
        <BusinessCd>621910</BusinessCd>
        <TotalRevenueColumnAmt>209947</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>209947</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>1507543</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>7460</TotalRevenueColumnAmt>
        <ExclusionAmt>7460</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>925</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>925</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>925</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>925</UnrelatedBusinessRevenueAmt>
      </NetRentalIncomeOrLossGrp>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISC INCOME</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>499</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>499</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>REIMBURSEMENT</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>910</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>910</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>REFUNDS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>956</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>956</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>2365</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>1550122</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1509908</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>925</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>7460</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>323022</TotalAmt>
        <ProgramServicesAmt>323022</ProgramServicesAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>536325</TotalAmt>
        <ProgramServicesAmt>536325</ProgramServicesAmt>
      </OtherSalariesAndWagesGrp>
      <PayrollTaxesGrp>
        <TotalAmt>78833</TotalAmt>
        <ProgramServicesAmt>78833</ProgramServicesAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>85528</TotalAmt>
        <ProgramServicesAmt>85528</ProgramServicesAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>5756</TotalAmt>
        <ProgramServicesAmt>5756</ProgramServicesAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>6519</TotalAmt>
        <ManagementAndGeneralAmt>6519</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>12971</TotalAmt>
        <ProgramServicesAmt>11165</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1806</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>56771</TotalAmt>
        <ProgramServicesAmt>56771</ProgramServicesAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>68141</TotalAmt>
        <ProgramServicesAmt>68141</ProgramServicesAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>212217</TotalAmt>
        <ProgramServicesAmt>197939</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>135745</TotalAmt>
        <ProgramServicesAmt>135745</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>45000</TotalAmt>
        <ProgramServicesAmt>37481</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7519</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>EVENTS</Desc>
        <TotalAmt>11730</TotalAmt>
        <ProgramServicesAmt>11730</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>TRAINING</Desc>
        <TotalAmt>6776</TotalAmt>
        <ProgramServicesAmt>6776</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PHONE</Desc>
        <TotalAmt>6032</TotalAmt>
        <ProgramServicesAmt>6032</ProgramServicesAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>1591366</TotalAmt>
        <ProgramServicesAmt>1561244</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15844</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>-2424</BOYAmt>
        <EOYAmt>392109</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>411855</BOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>673485</BOYAmt>
        <EOYAmt>1071362</EOYAmt>
      </AccountsReceivableGrp>
      <LandBldgEquipCostOrOtherBssAmt>6149531</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>1704011</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>4090040</BOYAmt>
        <EOYAmt>4445520</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <TotalAssetsGrp>
        <BOYAmt>5172956</BOYAmt>
        <EOYAmt>5908991</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>257870</BOYAmt>
        <EOYAmt>189898</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>2536319</BOYAmt>
        <EOYAmt>2242467</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>2794189</BOYAmt>
        <EOYAmt>2432365</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>2378767</BOYAmt>
        <EOYAmt>3476626</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2378767</BOYAmt>
        <EOYAmt>3476626</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>5172956</BOYAmt>
        <EOYAmt>5908991</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-41244</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingCashInd>X</MethodOfAccountingCashInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="1" softwareId="24020071">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <SupportSumAmt>0</SupportSumAmt>
      <OtherSupportSumAmt>0</OtherSupportSumAmt>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>71213</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>524981</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>30695</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>99317</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>31829</CurrentTaxYearAmt>
        <TotalAmt>758035</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>1194876</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1455745</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1758750</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1321849</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1541657</CurrentTaxYearAmt>
        <TotalAmt>7272877</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>1266089</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1980726</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1789445</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1421166</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1573486</CurrentTaxYearAmt>
        <TotalAmt>8030912</TotalAmt>
      </Total509Grp>
      <PublicSupportTotal509Amt>8030912</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>2180</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>75</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3502</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2799</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7460</CurrentTaxYearAmt>
        <TotalAmt>16016</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <Post1975UBTIGrp>
        <CurrentTaxYearMinus2YearsAmt>85</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1050</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>925</CurrentTaxYearAmt>
        <TotalAmt>2060</TotalAmt>
      </Post1975UBTIGrp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>2180</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>75</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3587</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3849</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>8385</CurrentTaxYearAmt>
        <TotalAmt>18076</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>1268269</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1980801</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1793032</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1425015</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1581871</CurrentTaxYearAmt>
        <TotalAmt>8048988</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99780</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99820</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00220</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00220</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="2" softwareId="24020071">
      <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="3" softwareId="24020071">
      <InclEscrowCustodialAcctLiabInd>false</InclEscrowCustodialAcctLiabInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>211639</OtherCostOrOtherBasisAmt>
        <BookValueAmt>211639</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>4050999</OtherCostOrOtherBasisAmt>
        <BookValueAmt>4050999</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>148849</OtherCostOrOtherBasisAmt>
        <BookValueAmt>148849</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1608975</OtherCostOrOtherBasisAmt>
        <BookValueAmt>1608975</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>6020462</TotalBookValueLandBuildingsAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="6" softwareId="24020071">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>2023 FORM 990 PART II SCH B</FormAndLineReferenceDesc>
        <ExplanationTxt>ORIGINALLY REPORTED 15 CARDIAC MONITORS DONATED BUT THEIR WAS ONLY 5 THAT WERE DONATED, THE VALUE OF 97367 STAYS THE SAME.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART VI LINE 11B ORGANIZATIONS PROCESS TO REVIEW</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPLETED COPIES OF THE FORM 990 ARE GIVEN TO THE AMBULANCE SERVICE PRESIDENT AND ARE PRESENTED AT THEIR BOARD MEETING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART VI LINE 12C ENFORCEMENT OF CONFLICT POLICY</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATION REQUIRES ALL BOARD MEMBERS, FULL MEMBERS, ASSOC MEMBERS, PAID EMPLOYEES ADHERE TO THE CONFLICT OF INTERST POLICY BY MAKING CONFLICT KNOWN AS SOON AS THEY OCCUR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART VI LINE 15A COMPENSATION PROCESS FOR TOP OFFIC</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS OF THE ORGANIZATION RECEIVE COMPENSATION FOR PROVIDING EMERGENCY MEDICAL SERVICES TO THE COMMUNITY WHICH IS PAID ACCORDING TO STATE BASED ON TRAINING</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART VI LINE 15B COMPENSATION PROCESS FOR OFFICERS</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS OF THE ORGANIZATION RECEIVE COMPENSATION FOR PROVIDING EMERGENCY MEDICAL SERVICES WHICH IS PAID ACCORDING TO AMOUNTS PRESCRIBED BY THE STATE BASED ON TRAINING</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART VI LINE 19 GOVERNING DOCUMENTS DISCLOSURE</FormAndLineReferenceDesc>
        <ExplanationTxt>A COPY OF THE TAX RETURN AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>