HALIFAX STAFFING INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
HALIFAX STAFFING INC (EIN 59-3222299)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-08-17
IRS object ID
201502299349303940
Schema version
2013v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-08-17T15:37:35-05:00ReturnTs
Tax Period End2014-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN592425904PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1OLIVARI & ASSOCIATES CPA'SBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1141 SAGE BRUSH TRAIL SUITE DAddressLine1
CityORMOND BEACHCity
StateFLState
ZIP Code32174ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN593222299EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HALIFAX STAFFING INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlHALIBusinessNameControlTxt
Phone3862264560PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1303 NORTH CLYDE MORRIS BLVDAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32114ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKATHLEEN DULKOPersonNm
Person TitleCONTROLLERPersonTitleTxt
Phone3862264560PhoneNum
Signature2015-08-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHNNY SVAJKO CPAPreparerPersonNm
PTINP00201386PTIN
Phone3866720775PhoneNum
Preparation2015-08-17PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJEFF FEASELPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1303 NORTH CLYDE MORRIS BLVDAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32114ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$214,044,028GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionHALIFAX STAFFING PROVIDES PAYROLL AND PAYROLL RELATED FUNCTIONS ON BEHALF OF ITS SUPPORTED ORGANIZATION, HALIFAX HOSPITAL MEDICAL CENTER D/B/A HALIFAX HEALTH (59-6001217)ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee3656TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$208,450,851PYProgramServiceRevenueAmt
CY Program Service Revenue$214,044,028CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$208,450,851PYTotalRevenueAmt
CY Total Revenue$214,044,028CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$208,450,851PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$214,044,028CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
CY Other Expenses$0CYOtherExpensesAmt
PY Total Expenses$208,450,851PYTotalExpensesAmt
CY Total Expenses$214,044,028CYTotalExpensesAmt
CY Revenues Less Expenses$0CYRevenuesLessExpensesAmt
Total Assets EOY$0TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
MissionHALIFAX STAFFING PROVIDES PAYROLL AND PAYROLL RELATED FUNCTIONS ON BEHALF OF ITS SUPPORTED ORGANIZATION, HALIFAX HOSPITAL MEDICAL CENTER D/B/A HALIFAX HEALTH (59-6001217)MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$214,044,028ExpenseAmt
Revenue$214,044,028RevenueAmt
DescPROVIDE PAYROLL AND STAFFING FOR SUPPORTED ORGANIZATION, HALIFAX HOSPITAL MEDICAL CENTER.Desc
Total Program Service Expenses$214,044,028TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee3656EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKATHLEEN DULKOPersonNm
Phone3862264560PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1303 N CLYDE MORRIS BLVDAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32114ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
DAN FRANCATTI
COMMISSIONER1.00Yes (X)$0$0$0
HAROLD GOODEMOTE
COMMISSIONER1.00Yes (X)$0$0$0
KAREN JANS
SECRETARY1.00Yes (X)$0$0$0
JOHN JOHNSON
CHAIRMAN1.00Yes (X)$0$0$0
GLENN RITCHEY
VICE CHAIRMA1.00Yes (X)$0$0$0
SUSAN SCHANDEL
TREASURER1.00Yes (X)$0$0$0
JEFF FEASEL
CHIEF EXEC.40.00$586,527$0$17,345Yes (X)
ERIC PEBURN
CHIEF FINANC40.00$367,949$0$16,081Yes (X)
ROHIT KHANNA
PHYSICIAN40.00$1,057,220$0$16,091Yes (X)
WILLIAM KUHN
PHYSICIAN40.00$973,598$0$23,388Yes (X)
CHUNI KWONG
PHYSICIAN40.00$594,679$0$26,975Yes (X)
ABDUL SORATHIA
PHYSICIAN40.00$529,699$0$16,518Yes (X)
FEDERICO VINAS
PHYSICIAN40.00$1,015,396$0$8,786Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,125,068TotalReportableCompFromOrgAmt
Total Other Compensation$125,184TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K206IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescEXPENSE REIMBURSEMENTDesc
Total Revenue Column$214,044,028TotalRevenueColumnAmt
Related Or Exempt Func Income$214,044,028RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$214,044,028TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$214,044,028TotalRevenueColumnAmt
Related Or Exempt Func Income$214,044,028RelatedOrExemptFuncIncomeAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$936,200TotalAmt
Program Services$936,200ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$163,597,141TotalAmt
Program Services$163,597,141ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$24,653,746TotalAmt
Program Services$24,653,746ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$14,094,094TotalAmt
Program Services$14,094,094ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$10,762,847TotalAmt
Program Services$10,762,847ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$214,044,028TotalAmt
Program Services$214,044,028ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$0ReconcilationRevenueExpnssAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
CertificationYes (X)CertificationInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HALIFAX HOSPITAL MEDICAL CENTER DBA HALIFAX HEALTHBusinessNameLine1
FieldValueIRS element (for citing)
EIN596001217EIN
Organization Type6OrganizationTypeDesc
Governing Document ListedYes (true)GoverningDocumentListedInd
Supported Org NotifiedYes (true)SupportedOrgNotifiedInd
US OrganizedYes (true)USOrganizedInd
Support$0SupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmt
JEFF FEASEL
CHIEF EXEC. OFFICER$586,527$4,034$13,311$603,872
ERIC PEBURN
CHIEF FINANCIAL OFF.$367,949$4,054$12,027$384,030
ROHIT KHANNA
PHYSICIAN$325,000$6,510$9,581$1,073,311$599,925$132,295
WILLIAM KUHN
PHYSICIAN$325,000$23,000$388$996,986$509,379$139,219
CHUNI KWONG
PHYSICIAN$312,800$17,500$9,475$621,654$8,107$273,772
ABDUL SORATHIA
PHYSICIAN$135,012$7,212$9,306$546,217$394,243$444
FEDERICO VINAS
PHYSICIAN$250,000$3,103$5,683$1,024,182$631,636$133,760

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BFORM 990 IS PROVIDED TO THE ORGANIZATION'S CONTROLLER FOR REVIEW PRIOR TO FILING.
FORM 990, PAGE 6, PART VI, LINE 12CTHE ORGANIZATION FOLLOWS THE POLICIES AND PROCEDURES OF ITS SUPPORTED ORGANIZATION, HALIFAX HEALTH.
FORM 990, PAGE 6, PART VI, LINE 15ATHE ORGANIZATION FOLLOWS THE POLICIES AND PROCEDURES OF ITS SUPPORTED ORGANIZATION, HALIFAX HEALTH.
FORM 990, PAGE 6, PART VI, LINE 15BTHE ORGANIZATION FOLLOWS THE POLICIES AND PROCEDURES OF ITS SUPPORTED ORGANIZATION, HALIFAX HEALTH.
FORM 990, PAGE 6, PART VI, LINE 19UPON REQUEST

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1HALIFAX HOSPITAL MEDICAL CENTERBusinessNameLine1
Business Name Line2D/B/A HALIFAX HEALTHBusinessNameLine2

US Address USAddress

FieldValueIRS element (for citing)
Address Line1303 N CLYDE MORRIS BLVDAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32114ZIPCode
FieldValueIRS element (for citing)
EIN596001217EIN
Primary ActivitiesHOSPITALPrimaryActivitiesTxt
Legal Domicile StateFLLegalDomicileStateCd
Exempt Code Section170BExemptCodeSectionTxt
Public Charity Status6PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HALIFAX HEALTHBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeOTransactionTypeTxt
Method Of Amount DeterminationACTUAL AMOUNT PAIDMethodOfAmountDeterminationTxt

Comments

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