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        <AddressLine1>710 EAST 24TH STREET NO 100</AddressLine1>
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        <State>MN</State>
        <ZIPCode>554043810</ZIPCode>
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      <Name>JEREMY KIEVAL MD</Name>
      <Title>TREASURER</Title>
      <Phone>6128133692</Phone>
      <DateSigned>2013-08-09</DateSigned>
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    <Preparer>
      <Name>KIM HUNWARDSEN CPA</Name>
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          <BusinessNameLine1>JEREMY KIEVAL MD</BusinessNameLine1>
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          <AddressLine1>710 EAST 24TH STREET</AddressLine1>
          <City>MINNEAPOLIS</City>
          <State>MN</State>
          <ZIPCode>55404</ZIPCode>
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          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
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          <ZIPCode>RESTRICTED</ZIPCode>
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        <Identifier>GRANTS AND SIMILAR AMOUNTS PAID</Identifier>
        <ReturnReference>FORM 990-EZ, PART I, LINE 10</ReturnReference>
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        <Identifier>OTHER EXPENSES</Identifier>
        <ReturnReference>FORM 990-EZ, PART I, LINE 16</ReturnReference>
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