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        <StateAbbreviationCd>NJ</StateAbbreviationCd>
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      <USAddress>
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        <CityNm>WOODBINE</CityNm>
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      <PreparerPersonNm>Cheryl Ward</PreparerPersonNm>
      <PTIN>P00914779</PTIN>
      <PhoneNum>6093900600</PhoneNum>
      <PreparationDt>2020-11-16</PreparationDt>
      <SelfEmployedInd>X</SelfEmployedInd>
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