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      <PreparerPersonNm>Jeffrey D Kolker</PreparerPersonNm>
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      <OfficerDirectorTrusteeEmplGrp>
        <PersonNm>Pat Lane</PersonNm>
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        <PersonNm>Lorri Mitchell</PersonNm>
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      <ForeignOfficeInd>false</ForeignOfficeInd>
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      <OperateHospitalInd>false</OperateHospitalInd>
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      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
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      <SpecialFundraisingEventsInd>X</SpecialFundraisingEventsInd>
      <AgrmtProfFundraisingActyInd>false</AgrmtProfFundraisingActyInd>
      <LicensedStatesCd>OK</LicensedStatesCd>
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        <Event2Nm>BORNRAISED</Event2Nm>
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        <GrossRevenueTotalEventsAmt>96511</GrossRevenueTotalEventsAmt>
        <NetIncomeSummaryAmt>96511</NetIncomeSummaryAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>List of grants and similar amounts paid Part I line 10</FormAndLineReferenceDesc>
        <ExplanationTxt>Activity SUPPORT FOR SPECIAL NEEDS CHILDREN Grantee HOPEKIDS Street PO BOX 28471 City, State, Zip Scottsdale, AZ 85255Relationship none Amount 10,000Activity ASSIST FAMILIES IN MAYES CO OK FIND RESOURCES Grantee PRYOR AREA RESOURCE ALLIANCE Street 3 N ADAIR City, State, Zip Pryor, OK 74361Relationship NONE Amount 2,500Activity UNIVERSITY SCHOLARSHIP Grantee RSU FOUNDATION Street 1701 W WILL ROGERS BLVD City, State, Zip Claremore, OK 74017Relationship NONE Amount 1,250Activity SUPPORT FOR VETERANS Grantee THE BARRACKS Street 4717 W OKMULGEE ST City, State, Zip Muskogee, OK 74401Relationship NONE Amount 11,000Activity SUPPORT FOR US MILITARY Grantee BLUE STAR MOMS OK CHAPTER 18 Street PO BOX 1597 City, State, Zip Pryor, OK 74362Relationship NONE Amount 1,000</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Description of other expenses Part I line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description AmountINSURANCE 1,697</ExplanationTxt>
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