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      <TotalRevenue>
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        <ProgramServices>314021</ProgramServices>
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        <ProgramServices>1080484</ProgramServices>
        <ManagementAndGeneral>1403387</ManagementAndGeneral>
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        <ProgramServices>97401</ProgramServices>
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        <ManagementAndGeneral>269213</ManagementAndGeneral>
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        <ProgramServices>99644</ProgramServices>
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      <FeesForServicesLegal>
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        <ProgramServices>39606</ProgramServices>
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        <ProgramServices>38779</ProgramServices>
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        <ProgramServices>287669</ProgramServices>
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        <ProgramServices>130420</ProgramServices>
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        <ProgramServices>2694</ProgramServices>
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        <ProgramServices>516274</ProgramServices>
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        <ProgramServices>15368372</ProgramServices>
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      <OtherExpenses>
        <Description>AIRCRAFT LEASE</Description>
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        <ProgramServices>2975858</ProgramServices>
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      <OtherExpenses>
        <Description>AIRCRAFT &amp; VEHICLE MAIN</Description>
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        <ProgramServices>3927894</ProgramServices>
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        <ContributorAddressUS>
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          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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        <AggregateContributions>RESTRICTED</AggregateContributions>
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      <GrantsOtherOrganizations>0</GrantsOtherOrganizations>
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        <Identifier>EXPLANATION OF LOBBYING ACTIVITIES:</Identifier>
        <ReturnReference>PART II-B, LINE 1:</ReturnReference>
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        <Description>DEPOSITS</Description>
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      <OtherAssets>
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      <OtherAssets>
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      <OtherLiabilities>
        <Description>DEFERRED COMPENSATION</Description>
        <Amount>377400</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DUE TO SIERRA MEDICAL SERVICE ALLIANCE</Description>
        <Amount>302321</Amount>
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      <OtherLiabilities>
        <Description>DUE TO MED-EXPRESS TRANSPORT, INC</Description>
        <Amount>73625</Amount>
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    <IRS990ScheduleG documentId="RetDoc1041300001">
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        <CharitableContributionsEvent1>12858</CharitableContributionsEvent1>
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        <DirectExpenseSummaryEvents>11362</DirectExpenseSummaryEvents>
        <NetIncomeSummary>-3122</NetIncomeSummary>
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    </IRS990ScheduleG>
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      <InitialContractException>0</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>PATRICK SMITH - REMSA</NamePerson>
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      <Form990ScheduleJPartII>
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    <IRS990ScheduleL documentId="RetDoc1042800001">
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        <NameOfInterestedPerson>
          <NamePerson>J RICHARD BARNARD</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>REMSA OBTAINS SERVICES FROM A FIRM THAT EMPLOYS CHAIRMAN J. RICHARD BARNARD</Relationship>
        <AmountOfTransaction>65000</AmountOfTransaction>
        <DescriptionOfTransaction>REMSA OBTAINS PROFESSIONAL ACCOUNTING AND CONSULTING SERVICES FROM THE FIRM BARNARD VOGLER &amp; CO CPA'S. THE CHAIRMAN OF REMSA'S BOARD, J. RICHARD BARNARD, IS AN EMPLOYEE OF THE FIRM.</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
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    </IRS990ScheduleL>
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      <GeneralExplanation>
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        <Explanation>THE 990 IS REVIEWED BY THE CEO AND CFO PRIOR TO BEING FILED. AT THIS TIME, THE 990 IS NOT REVIEWED BY THE BOARD.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>MANAGEMENT REGULARLY REVIEWS ANY ISSUES THAT ARISE UNDER THE CONFLICT OF INTEREST POLICY.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 15</ReturnReference>
        <Explanation>COMPENSATION FOR THE CEO, TOP MANAGEMENT AND OTHER KEY EMPLOYEES IS REVIEWED BY THE BOARD ANNUALLY WITH THE APPROVAL OF THE BUDGET.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 18</ReturnReference>
        <Explanation>REMSA'S 990 IS LOCATED ON GUIDESTAR AS WELL AS MADE AVAILABLE UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>REMSA'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ALL OTHER FUNCTIONAL EXPENSES</Identifier>
        <ReturnReference>FORM 990, PART X, LINE 24E</ReturnReference>
        <Explanation>FUEL: PROGRAM SERVICE EXPENSES 614,198. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 614,198. EQUIPMENT RENTAL AND MAINTENANCE: PROGRAM SERVICE EXPENSES 565,630. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 565,630. INSURANCE: PROGRAM SERVICE EXPENSES 560,011. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 560,011. EDUCATION: PROGRAM SERVICE EXPENSES 393,408. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 393,408. AIRCRAFT FUEL: PROGRAM SERVICE EXPENSES 300,574. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 300,574. TELEPHONE: PROGRAM SERVICE EXPENSES 276,242. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 276,242. AIRCRAFT FLIGHT TIME: PROGRAM SERVICE EXPENSES 261,051. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 261,051. PUBLIC RELATIONS: PROGRAM SERVICE EXPENSES 227,084. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 227,084. FACILITY MAINT./JANITORIAL: PROGRAM SERVICE EXPENSES 222,742. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 222,742. UTILITIES: PROGRAM SERVICE EXPENSES 165,145. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 165,145. POSTAGE AND PRINTING: PROGRAM SERVICE EXPENSES 117,191. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 117,191. EMPLOYEE UNIFORMS: PROGRAM SERVICE EXPENSES 105,379. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 105,379. CHILD SAFETY SEAT PROGRAM: PROGRAM SERVICE EXPENSES 84,374. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,374. TAXES/LICENSES/FEES: PROGRAM SERVICE EXPENSES 73,536. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,536. LDT COORDINATION SERVICES: PROGRAM SERVICE EXPENSES 67,896. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 67,896. COLLECTION: PROGRAM SERVICE EXPENSES 51,444. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 51,444. SILVER SAVER SUBSCRIPTION: PROGRAM SERVICE EXPENSES 34,096. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,096. DUES/SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 24,789. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,789. EMPLOYEE WELFARE: PROGRAM SERVICE EXPENSES 17,189. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,189. MEALS AND ENTERTAINMENT: PROGRAM SERVICE EXPENSES 10,431. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,431. AIRCRAFT/MISC.: PROGRAM SERVICE EXPENSES 4,384. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,384. RECRUITING: PROGRAM SERVICE EXPENSES 100. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 100. COST REIMBURSEMENT FROM RELATED PARTIES: PROGRAM SERVICE EXPENSES -249,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -249,000.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART XII, LINE 2C:</ReturnReference>
        <Explanation>THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>SIERRA MEDICAL SERVICES ALLIANCE</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>450 EDISON WAY</AddressLine1>
          <City>RENO</City>
          <State>NV</State>
          <ZIPCode>89502</ZIPCode>
        </AddressUS>
        <EIN>680459931</EIN>
        <PrimaryActivities>SEMSA IS AN INDEPENDENT, NONPROFIT ORG THAT EXPANDS HEALTHCARE SERVICES</PrimaryActivities>
        <LegalDomicileState>NV</LegalDomicileState>
        <PublicCharityStatus>509(A)(2) 33 1/3%</PublicCharityStatus>
        <ControlledOrg>0</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>REGIONAL AMBULANCE SERVICES INC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>450 EDISON WAY</AddressLine1>
          <City>RENO</City>
          <State>NV</State>
          <ZIPCode>89502</ZIPCode>
        </AddressUS>
        <EIN>880355913</EIN>
        <PrimaryActivity>PROVIDES EMPLOYEE SERVICES TO REMSA</PrimaryActivity>
        <LegalDomicileState>NV</LegalDomicileState>
        <TypeOfEntity>C</TypeOfEntity>
        <ShareOfTotalIncome>17612750</ShareOfTotalIncome>
        <ShareOfEOYAssets>3094812</ShareOfEOYAssets>
        <PercentageOwnership>1.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>0</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>0</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>0</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>0</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>0</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>0</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>0</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>0</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>0</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>0</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>0</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>0</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>0</SharingOfFacilities>
      <SharingOfPaidEmployees>0</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>0</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>0</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>0</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>0</OtherTransferFromOtherOrg>
    </IRS990ScheduleR>
  </ReturnData>
</Return>