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        <AddressLine1>1400 PARKMOOR AVENUE NO 130</AddressLine1>
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        <State>CA</State>
        <ZIPCode>95126</ZIPCode>
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      <DateSigned>2011-11-17</DateSigned>
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      <DatePrepared>2011-11-17</DatePrepared>
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    <BuildTS>2016-02-24 21:20:13Z</BuildTS>
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        <PersonName>EDIE KIRKWOOD</PersonName>
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          <City>SAN JOSE</City>
          <State>CA</State>
          <ZIPCode>95126</ZIPCode>
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        <PersonName>JEANNE LABOZETTA</PersonName>
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          <State>CA</State>
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      <TaxImposedUnderIRC4911>0</TaxImposedUnderIRC4911>
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      <StatesWhereCopyOfReturnIsFiled>CA</StatesWhereCopyOfReturnIsFiled>
      <TheBooksAreInCareOf>
        <NameBusiness>
          <BusinessNameLine1>THE HEALTH TRUST</BusinessNameLine1>
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          <City>CAMPBELL</City>
          <State>CA</State>
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        <CurrentTaxYearMinus1Year>5000</CurrentTaxYearMinus1Year>
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      <GeneralExplanation>
        <Identifier>OTHER ASSETS</Identifier>
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      <GeneralExplanation>
        <Identifier>OTHER LIABILITIES</Identifier>
        <ReturnReference>FORM 990-EZ, PART II, LINE 26</ReturnReference>
        <Explanation>DESCRIPTION: ACCRUED EXPENSES. BEG. OF YEAR AMOUNT: 9,013. END OF YEAR AMOUNT: 10,983. DESCRIPTION: DEFERRED REVENUE. BEG. OF YEAR AMOUNT: 7,170. END OF YEAR AMOUNT: 26,950. DESCRIPTION: NOTES PAYABLE. BEG. OF YEAR AMOUNT: 31,291. END OF YEAR AMOUNT: 23,458. DESCRIPTION: ACCOUNTS PAYABLE. BEG. OF YEAR AMOUNT: 9,999. END OF YEAR AMOUNT: 4,820. DESCRIPTION: PASS THROUGH FUNDS. BEG. OF YEAR AMOUNT: 3,685. END OF YEAR AMOUNT: 0.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <TransferPrsnlBnftContractsDecl documentId="RetDoc10046300000">
      <Declaration>THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.</Declaration>
    </TransferPrsnlBnftContractsDecl>
  </ReturnData>
</Return>