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          <PersonName referenceDocumentId="RetDoc3">SUSAN CLARK</PersonName>
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          <PersonName referenceDocumentId="RetDoc3">MATTHEW CLARK</PersonName>
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          <Title>DIRECTOR</Title>
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      <SumOfProgramRelatedInvestments>
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            <State>NC</State>
            <ZIPCode>27262</ZIPCode>
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          <FormAndInfoAndMaterials>LETTER OF REQUEST AND PURPOSE OF CHARITABLE REQUEST ALONG WITH A COPY OF 501(C)(3) DETERMINATION LETTER</FormAndInfoAndMaterials>
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            <State>NC</State>
            <ZIPCode>27262</ZIPCode>
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          <PurposeOfGrantOrContribution>OPERATIONS</PurposeOfGrantOrContribution>
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        <GrantOrContriPaidDuringYear>
          <RecipientBusinessName>
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          <RecipientUSAddress>
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            <State>NC</State>
            <ZIPCode>27293</ZIPCode>
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          <RecipientRelationship>NONE</RecipientRelationship>
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        <GrantOrContriPaidDuringYear>
          <RecipientBusinessName>
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            <ZIPCode>27262</ZIPCode>
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          <RecipientRelationship>NONE</RecipientRelationship>
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        <GrantOrContriPaidDuringYear>
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            <BusinessNameLine1>WESLEY MEMORIAL UNITED ME</BusinessNameLine1>
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