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          <State>NY</State>
          <ZIPCode>11050</ZIPCode>
        </USAddress>
      </SubstantialContributor>
    </SubstantialContributorsSch>
    <TaxesSchedule documentId="RetDoc2002500001">
      <Taxes>
        <Category>PAYROLL TAXES</Category>
        <Amount>2818</Amount>
        <NetInvestmentIncome>0</NetInvestmentIncome>
        <DisbursementsCharitablePrps>2818</DisbursementsCharitablePrps>
      </Taxes>
    </TaxesSchedule>
  </ReturnData>
</Return>