﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2024v5.2" xsi:schemaLocation="http://www.irs.gov/efile">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2026-04-26T09:26:04-07:00</ReturnTs>
    <TaxPeriodEndDt>2025-06-30</TaxPeriodEndDt>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>650618157</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>PAWS 2 HELP INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>PAWS</BusinessNameControlTxt>
      <PhoneNum>5617121911</PhoneNum>
      <USAddress>
        <AddressLine1Txt>2693 Forest Hill Blvd</AddressLine1Txt>
        <CityNm>West Palm Beach</CityNm>
        <StateAbbreviationCd>FL</StateAbbreviationCd>
        <ZIPCd>33406</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Mary L Contessa</PersonNm>
      <PersonTitleTxt>President &amp; CEO</PersonTitleTxt>
      <SignatureDt>2026-04-26</SignatureDt>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="4">
    <IRS990 documentId="IRS990" referenceDocumentId="IRS990ScheduleO" softwareId="24020490" softwareVersionNum="2024v5.2">
      <PrincipalOfficerNm>Mary L Contessa</PrincipalOfficerNm>
      <GrossReceiptsAmt>7743663</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.paws2help.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1995</FormationYr>
      <LegalDomicileStateCd>FL</LegalDomicileStateCd>
      <ActivityOrMissionDesc>To provide affordable Veterinary services for all pets regardless of their owner's ability to pay for preventative, sick or emergency care.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>3</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>3</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>75</TotalEmployeeCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>56262</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>33689</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>7017375</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>7609154</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>59194</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>100820</CYInvestmentIncomeAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>7132831</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>7743663</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>3708609</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>3766148</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>7150</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>7800</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>44575</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>3157664</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>3632629</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>6873423</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>7406577</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>259408</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>337086</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>2377197</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>2699496</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>28863</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>14076</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>2348334</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>2685420</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>To provide affordable Veterinary services for all pets regardless of their owner's ability to pay for preventative, sick or emergency care.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>6582346</ExpenseAmt>
      <Desc>Provide low cost veterinary services for all pets and subsidize medical care for pets whose owners are experiencing financial hardship, temporarily or long-term.</Desc>
      <TotalProgramServiceExpensesAmt>6582346</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>false</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="IRS990ScheduleD">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="IRS990ScheduleD">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="IRS990ScheduleD">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="IRS990ScheduleD">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="IRSScheduleD">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="IRS990ScheduleD">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="IRS990ScheduleD">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="IRS990ScheduleD">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD">false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="IRS990ScheduleD">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>false</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>10</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>75</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <Form8282FiledCnt>0</Form8282FiledCnt>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>3</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>3</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>false</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>false</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>false</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>FL</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>Mary L Contessa CPA</PersonNm>
        <PhoneNum>5619063236</PhoneNum>
        <USAddress>
          <AddressLine1Txt>2693 Forest Hill Blvd</AddressLine1Txt>
          <CityNm>West Palm Beach</CityNm>
          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>33406</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mary L Contessa</PersonNm>
        <TitleTxt>President</TitleTxt>
        <AverageHoursPerWeekRt>25.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>31200</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Amy Thibodeau</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>13000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Edith Pecan</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Edward Marion</PersonNm>
        <TitleTxt>DVM</TitleTxt>
        <AverageHoursPerWeekRt>45.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kateryna Kryvonos</PersonNm>
        <TitleTxt>DVM</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Chaitanya Paturi</PersonNm>
        <TitleTxt>DVM</TitleTxt>
        <AverageHoursPerWeekRt>35.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Maria Serra DVM</PersonNm>
        <TitleTxt>DVM</TitleTxt>
        <AverageHoursPerWeekRt>45.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jef Chadwick</PersonNm>
        <TitleTxt>DVM</TitleTxt>
        <AverageHoursPerWeekRt>45.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>44200</TotalReportableCompFromOrgAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>false</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MPSVET LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>351 Garden Blvd</AddressLine1Txt>
            <CityNm>Palm Beach Gardens</CityNm>
            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>33410</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Veterinarian</ServicesDesc>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <AllOtherContributionsAmt>33689</AllOtherContributionsAmt>
      <TotalContributionsAmt>33689</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Low Cost Clinic</Desc>
        <BusinessCd>621300</BusinessCd>
        <TotalRevenueColumnAmt>7609154</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7609154</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>7609154</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>100820</TotalRevenueColumnAmt>
        <ExclusionAmt>100820</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetRentalIncomeOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetGainOrLossInvestmentsGrp>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>7743663</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7609154</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>100820</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>44200</TotalAmt>
        <ManagementAndGeneralAmt>44200</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>3423902</TotalAmt>
        <ProgramServicesAmt>3064392</ProgramServicesAmt>
        <ManagementAndGeneralAmt>342390</ManagementAndGeneralAmt>
        <FundraisingAmt>17120</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>52980</TotalAmt>
        <ProgramServicesAmt>47417</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5298</ManagementAndGeneralAmt>
        <FundraisingAmt>265</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>0</TotalAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>245066</TotalAmt>
        <ProgramServicesAmt>219334</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24507</ManagementAndGeneralAmt>
        <FundraisingAmt>1225</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>7800</TotalAmt>
        <FundraisingAmt>7800</FundraisingAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>421220</TotalAmt>
        <ProgramServicesAmt>376992</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42122</ManagementAndGeneralAmt>
        <FundraisingAmt>2106</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>30532</TotalAmt>
        <ProgramServicesAmt>27326</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3053</ManagementAndGeneralAmt>
        <FundraisingAmt>153</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>11778</TotalAmt>
        <ProgramServicesAmt>10541</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1178</ManagementAndGeneralAmt>
        <FundraisingAmt>59</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>10162</TotalAmt>
        <ProgramServicesAmt>9095</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1016</ManagementAndGeneralAmt>
        <FundraisingAmt>51</FundraisingAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>287591</TotalAmt>
        <ProgramServicesAmt>257394</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28759</ManagementAndGeneralAmt>
        <FundraisingAmt>1438</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>11904</TotalAmt>
        <ProgramServicesAmt>10654</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1190</ManagementAndGeneralAmt>
        <FundraisingAmt>60</FundraisingAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>0</TotalAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>26141</TotalAmt>
        <ProgramServicesAmt>23396</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2614</ManagementAndGeneralAmt>
        <FundraisingAmt>131</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>186111</TotalAmt>
        <ProgramServicesAmt>166569</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18611</ManagementAndGeneralAmt>
        <FundraisingAmt>931</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>2584826</TotalAmt>
        <ProgramServicesAmt>2313419</ProgramServicesAmt>
        <ManagementAndGeneralAmt>258483</ManagementAndGeneralAmt>
        <FundraisingAmt>12924</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Miscellaneous</Desc>
        <TotalAmt>17420</TotalAmt>
        <ProgramServicesAmt>15591</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1742</ManagementAndGeneralAmt>
        <FundraisingAmt>87</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Continuing Education</Desc>
        <TotalAmt>12538</TotalAmt>
        <ProgramServicesAmt>11222</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1253</ManagementAndGeneralAmt>
        <FundraisingAmt>63</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Payroll Service</Desc>
        <TotalAmt>11323</TotalAmt>
        <ProgramServicesAmt>10134</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1132</ManagementAndGeneralAmt>
        <FundraisingAmt>57</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>21083</TotalAmt>
        <ProgramServicesAmt>18870</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2108</ManagementAndGeneralAmt>
        <FundraisingAmt>105</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>7406577</TotalAmt>
        <ProgramServicesAmt>6582346</ProgramServicesAmt>
        <ManagementAndGeneralAmt>779656</ManagementAndGeneralAmt>
        <FundraisingAmt>44575</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>644784</BOYAmt>
        <EOYAmt>623489</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1374006</BOYAmt>
        <EOYAmt>1729412</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <EOYAmt>0</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>74089</BOYAmt>
        <EOYAmt>29919</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>537299</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>278277</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>249492</BOYAmt>
        <EOYAmt>259022</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>34826</BOYAmt>
        <EOYAmt>57654</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>2377197</BOYAmt>
        <EOYAmt>2699496</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>28863</BOYAmt>
        <EOYAmt>14076</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>28863</BOYAmt>
        <EOYAmt>14076</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrgDoesNotFollowFASB117Ind>X</OrgDoesNotFollowFASB117Ind>
      <CapStkTrPrinCurrentFundsGrp>
        <BOYAmt>2632</BOYAmt>
        <EOYAmt>2632</EOYAmt>
      </CapStkTrPrinCurrentFundsGrp>
      <RtnEarnEndowmentIncmOthFndsGrp>
        <BOYAmt>2345702</BOYAmt>
        <EOYAmt>2682788</EOYAmt>
      </RtnEarnEndowmentIncmOthFndsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2348334</BOYAmt>
        <EOYAmt>2685420</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>2377197</BOYAmt>
        <EOYAmt>2699496</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>337086</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingCashInd>X</MethodOfAccountingCashInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="24020490" softwareVersionNum="2024v5.2">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>17086</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>393206</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>112190</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>56262</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>13689</CurrentTaxYearAmt>
        <TotalAmt>592433</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>5060953</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>5291325</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5950536</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7017375</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7629154</CurrentTaxYearAmt>
        <TotalAmt>30949343</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <GrossReceiptsNonUnrltBusGrp>
        <TotalAmt>0</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <TaxRevLeviedOrgnztnlBnft509Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft509Grp>
      <GovtFurnSrvcFcltsVl509Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl509Grp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>5078039</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>5684531</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>6062726</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7073637</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7642843</CurrentTaxYearAmt>
        <TotalAmt>31541776</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <PublicSupportTotal509Amt>31541776</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>15605</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>15953</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8988</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>56288</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>100820</CurrentTaxYearAmt>
        <TotalAmt>197654</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <Post1975UBTIGrp>
        <TotalAmt>0</TotalAmt>
      </Post1975UBTIGrp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>15605</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>15953</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8988</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>56288</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>100820</CurrentTaxYearAmt>
        <TotalAmt>197654</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <TotalAmt>0</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <OtherIncome509Grp>
        <TotalAmt>0</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>5093644</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>5700484</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>6071714</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7129925</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7743663</CurrentTaxYearAmt>
        <TotalAmt>31739430</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99380</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99650</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00620</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00350</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="24020490" softwareVersionNum="2024v5.2">
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>295094</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>77994</DepreciationAmt>
        <BookValueAmt>217100</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>242205</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>200283</DepreciationAmt>
        <BookValueAmt>41922</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>259022</TotalBookValueLandBuildingsAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="24020490" softwareVersionNum="2024v5.2">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Governing body reviews the Form 990 before it is filed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABLE UPON REQUEST</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>