SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public
Inspection
Name of the organization
DAVIESS COUNTY MEDICAL SOCIETY ALLIANCE
 
Employer identification number

61-1131478
Return Reference Explanation
PART I LINE 10 SCHOLARSHIPS: AUGENTSTEIN $2000.00, NELSON $2000.00, SIMS $2000.00, ARNOLD $ 2000.00, SANGOI $2000.00 TOTAL SCHOLARSHIPS: $ 10,000.00
PART 1 LINE 16: OTHER EXPENSES: PO BOX RENT $70, STATE DUES $270, TOTAL $340.00
PART 1 LINE 8: SQUARE CARD USAGE $1.00
PART 1 LINE 20: ASSET ACCT WITHDRAWAL, ASSET VALUE CHNGES, ASSET INCOME
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2016


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