2025-12-05T09:31:08-06:00 2025-09-30 205857627 TMH P O DRAWER 15099 HATTIESBURG MS 394045099 990 2024-10-01 921090610 PINE GROVE PUBLIC BENEFIT CORPORATION PINE 6012881078 PO BOX 17649 HATTIESBURG MS 394047649 JEFFREY COOK JR PRESIDENT 6012881078 2025-12-05 1 1 RICHARD G TOPP CPA P00144777 6012643519 2025-12-05 2024 2025-03-06 01:10:19Z JEFFREY COOK JR PO BOX 17649 HATTIESBURG MS 394047649 778962 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 447679 778962 0 0 0 0 447679 778962 0 0 0 0 0 0 0 0 0 574502 810314 574502 810314 -126823 -31352 16765476 15862966 17880957 17009799 -1115481 -1146833 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 808229 778962 LEASED A MEDICAL OFFICE BUILDING TO FORREST COUNTY GENERAL HOSPITAL TO ASSIST IN THE ADMINISTRATION AND PROVISION OF ITS CHARITABLE PROGRAMS AND SERVICES. 808229 1 0 0 0 0 0 0 0 0 0 1 0 0 0 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 0 LEASE REVENUE 531120 778962 778962 778962 778962 778962 0 0 2085 2085 196543 196543 542180 542180 3797 3797 65709 65709 810314 808229 2085 0 1124092 704281 16014248 855563 15641384 15158685 16765476 15862966 1310957 439799 16570000 16570000 17880957 17009799 X -1115481 -1146833 -1115481 -1146833 16765476 15862966 -31352 0 X X 0 1 X 1 0 X X 1 FORREST COUNTY GENERAL HOSPITAL 646001587 3 1 0 16014248 1 0 16014248 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART I, LN. 12G(VI) USE OF BUILDING, EQUIPMENT, AND LAND IS PROVIDED TO FORREST GENERAL HEALTH. 14482841 573089 13909752 1101646 217840 883806 429761 64634 365127 15158685 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 XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORREST COUNTY GENERAL HOSPITAL POST OFFICE BOX 16389 HATTIESBURG MS 394046389 646001587 MS 501(C)(3) 170(B)(1)(A)(III) 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 FORREST COUNTY GENERAL HOSPITAL J 778962 INVOICES FORREST COUNTY GENERAL HOSPITAL E 439799 INVOICES