Very truly yours, Alissa Grimm, CPA

Transcription

1 Junkermier,Clark,Campanella,Stevens PC Certified Puli Aountants & Business Advisors 60 Connery Way P.O. Box 167 Missoula, Montana 5808 July, 018 Home Health Setion of the Amerian Physial Therapy Assoiation, In. P.O. Box 55 Missoula, MT 5806 Dear Roin, Enlosed are the original and one opy of the 017 Exempt Organization returns, as follows Form Form 0 T 017 Montana Corporation Inome Tax Return Eah original should e dated, signed and filed in aordane with the filing instrutions. The opy should e retained for your files. Very truly yours, Alissa Grimm, CPA

2 Prepared for: Filing Instrutions Prepared y: HOME HEALTH SECTION OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION, INC. JUNKERMIER,CLARK,CAMPANELLA,STEVENS P P.O. BO 55 P.0. BO 167 MISSOULA, MT 5806 MISSOULA, MT FORM 0 Eletroni Filing: This return has een prepared for eletroni filing. If you wish to have it transmitted eletronially to the IRS, please sign, date, and return Form 887 EO to our offie. We will then sumit the eletroni return to the IRS. Do not mail a paper opy of the return to the IRS. 017 FORM 0-T Please sign and mail on or efore vemer 15, 018. amount is due on Form 0 T. Mail to Department of the Treasury Internal Revenue Servie Center Ogden, UT 801 7?Dtmm

3 Filing Instrutions Prepared for: HOME HEALTH SECTION OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION, INC. P.O. BO 55 MISSOULA, MT 5806 Prepared y: JUNKERMIER, CLARK, CAMPANELLA, STEVENS P.O. BO 167 MISSOULA, MT MONTANA FORM CIT You have a alane due of $ 50. Please, do NOT staple any part of the return together. The appropriate orporate offier(s) should sign and date the return. Mail y vemer 15, 018 to: Montana Department of Revenue PO Box 801 Helena, MT Enlose a hek or money order for $50., payale to Montana Department of Revenue. Inlude Form CT Corporation Inome Tax Pmt Vouher with your return

4 UNRELATED BUSINESS INCOME Name CARRYOVER DATA TO 018 HOME HEALTH SECTION OF THE AMERICAN Employer Identifiation Numer PHYSICAL THERAPY ASSOCIATION, INC Based on the information provided with this return, the following are possile arryover amounts to next year. FEDERAL NET OPERATING LOSS 5,5. FEDERAL AMT NET OPERATING LOSS 5,

5 ETENDED TO NOVEMBER 15, 018 OMB Return of Organization Exempt From Inome Tax Form 0 Under setion 501(), 57, or 7(a)(1) of the Internal Revenue Code (exept private foundations) 017 Department of the Treasury Do not enter soial seurity numers on this form as it may e made puli. Open to Puli Internal Revenue Servie Go to for instrutions and the latest information. Inspetion A For the 017 alendar year, or tax year eginning and ending B Chek if C Name of organization D Employer identifiation numer appliale: Address hange Name hange Initial return Final return/ Doing usiness as Numer and street (or P.O. ox if mail is not delivered to street address) Room/suite E terminated City or town, state or provine, ountry, and ZIP or foreign postal ode G Gross reeipts $ Telephone numer P.O. BO ,870. Amended return MISSOULA, MT 5806 H(a) Is this a group return Appliation F Name and address of prinipal offier: for suordinates? ~~ pending SAME AS C ABOVE H() Are all suordinates inluded? I Tax-exempt status: 501()() 501() ( 6 ) (insert no.) 7(a)(1) or 57 If "," attah a list. (see instrutions) J Wesite: H() Group exemption numer K Form of organization: Corporation Trust Assoiation Other L Year of formation: 156 M State of legal domiile: MT Part I Summary 1 Briefly desrie the organization s mission or most signifiant ativities: PHYSICAL THERAPIST EDUCATION Ativities & Governane Revenue Expenses Net Assets or Fund Balanes Sign Here Chek this ox Net unrelated usiness taxale inome from Form 0-T, line 16a Professional fundraising fees (Part I, olumn (A), line 11e) ~~~~~~~~~~~~~~ Total fundraising expenses (Part I, olumn (D), line 5) 0. true, orret, and omplete. Delaration of preparer (other than offier) is ased on all information of whih preparer has any knowledge. Signature of offier TREASURER Type or print name and title if the organization disontinued its operations or disposed of more than 5% of its net assets. Numer of voting memers of the governing ody (Part VI, line 1a) ~~~~~~~~~~~~~~~~~~~~ Numer of independent voting memers of the governing ody (Part VI, line 1) ~~~~~~~~~~~~~~ Total numer of individuals employed in alendar year 017 (Part V, line a) ~~~~~~~~~~~~~~~~ Total numer of volunteers (estimate if neessary) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7 a Total unrelated usiness revenue from Part VIII, olumn (C), line 1 ~~~~~~~~~~~~~~~~~~~~ Contriutions and grants (Part VIII, line 1h) ~~~~~~~~~~~~~~~~~~~~~ Program servie revenue (Part VIII, line g) ~~~~~~~~~~~~~~~~~~~~~ Investment inome (Part VIII, olumn (A), lines,, and 7d) ~~~~~~~~~~~~~ Other revenue (Part VIII, olumn (A), lines 5, 6d, 8,, 10, and 11e) ~~~~~~~~ Total revenue - add lines 8 through 11 (must equal Part VIII, olumn (A), line 1) Grants and similar amounts paid (Part I, olumn (A), lines 1-) Benefits paid to or for memers (Part I, olumn (A), line ) ~~~~~~~~~~~ ~~~~~~~~~~~~~ Salaries, other ompensation, employee enefits (Part I, olumn (A), lines 5-10) ~~~ = = HOME HEALTH SECTION OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION, INC a 7 Prior Year Current Year 7,8.,57. 5,. 110,150. 7,50. 5,. 1,5. 5,78. 16,6. 5,157. 7,0. 7, Print/Type preparer s name Preparer s signature Date Chek PTIN if Paid DREW RIEKER, CPA self-employed P01776 Preparer Firm s name JUNKERMIER,CLARK,CAMPANELLA,STEVENS PC Firm s EIN Use Only Firm s address P.O. BO 167 MISSOULA, MT 5808 Phone no May the IRS disuss this return with the preparer shown aove? (see instrutions) LHA For Paperwork Redution At tie, see the separate instrutions. Form 0 (017) Date ,750. -,1. 17 Other expenses (Part I, olumn (A), lines 11a-11d, 11f-e) ~~~~~~~~~~~~~ 7,01. 61,8. 18 Total expenses. Add lines 1-17 (must equal Part I, olumn (A), line 5) ~~~~~~~ 5,01. 68,8. 1 Revenue less expenses. Sutrat line 18 from line 1-8,68. -1,686. Beginning of Current Year End of Year 0 Total assets (Part, line 16) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1,86. 1,0. 1 Total liailities (Part, line 6) ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Net assets or fund alanes. Sutrat line 1 from line 0 1,86. 1,0. Part II Signature Blok Under penalties of perjury, I delare that I have examined this return, inluding aompanying shedules and statements, and to the est of my knowledge and elief, it is

6 HOME HEALTH SECTION OF THE AMERICAN Form 0 (017) PHYSICAL THERAPY ASSOCIATION, INC Part III Statement of Program Servie Aomplishments 1 a Chek if Shedule O ontains a response or note to any line in this Part III Briefly desrie the organization s mission: THE HOME HEALTH SECTION S PURPOSE IS TO PROVIDE A MEANS BY WHICH ASSOCIATION MEMBERS HAVING A COMMON INTEREST IN THE DELIVERY OF PHYSICAL THERAPY IN THE HOME AND OTHER ALTERNATIVE SETTINGS WITHIN THE COMMUNITY MAY MEET, CONFER, AND PROMOTE THESE INTERESTS. Did the organization undertake any signifiant program servies during the year whih were not listed on the prior Form 0 or 0-EZ? If "," desrie these new servies on Shedule O. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization ease onduting, or make signifiant hanges in how it onduts, any program servies? ~~~~~~ If "," desrie these hanges on Shedule O. Desrie the organization s program servie aomplishments for eah of its three largest program servies, as measured y expenses. Setion 501()() and 501()() organizations are required to report the amount of grants and alloations to others, the total expenses, and revenue, if any, for eah program servie reported. ( Code: ) ( Expenses $ inluding grants of $ ) ( Revenue $ ) SEMINARS AND PUBLICATIONS FOR EDUCATION OF PHYSICAL THERAPISTS. Page ( Code: ) ( Expenses $ inluding grants of $ ) ( Revenue $ ) ( Code: ) ( Expenses $ inluding grants of $ ) ( Revenue $ ) d Other program servies (Desrie in Shedule O.) ( Expenses $ inluding grants of $ ) ( Revenue $ ) e Total program servie expenses Form 0 (017)

7 HOME HEALTH SECTION OF THE AMERICAN Form 0 (017) PHYSICAL THERAPY ASSOCIATION, INC Part IV Cheklist of Required Shedules a a d e f Is the organization desried in setion 501()() or 7(a)(1) (other than a private foundation)? If "," omplete Shedule A~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Is the organization required to omplete Shedule B, Shedule of Contriutors? ~~~~~~~~~~~~~~~~~~~~~~ Did the organization engage in diret or indiret politial ampaign ativities on ehalf of or in opposition to andidates for puli offie? If "," omplete Shedule C, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Setion 501()() organizations. Did the organization engage in loying ativities, or have a setion 501(h) eletion in effet during the tax year? If "," omplete Shedule C, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Is the organization a setion 501()(), 501()(5), or 501()(6) organization that reeives memership dues, assessments, or similar amounts as defined in Revenue Proedure 8-1? If "," omplete Shedule C, Part III ~~~~~~~~~~~~~~ Did the organization maintain any donor advised funds or any similar funds or aounts for whih donors have the right to provide advie on the distriution or investment of amounts in suh funds or aounts? If "," omplete Shedule D, Part I Did the organization reeive or hold a onservation easement, inluding easements to preserve open spae, the environment, histori land areas, or histori strutures? If "," omplete Shedule D, Part II~~~~~~~~~~~~~~ Did the organization maintain olletions of works of art, historial treasures, or other similar assets? If "," omplete Shedule D, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount in Part, line 1, for esrow or ustodial aount liaility, serve as a ustodian for amounts not listed in Part ; or provide redit ounseling, det management, redit repair, or det negotiation servies? If "," omplete Shedule D, Part IV ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization, diretly or through a related organization, hold assets in temporarily restrited endowments, permanent endowments, or quasi-endowments? If "," omplete Shedule D, Part V ~~~~~~~~~~~~~~~~~~~~~~~~ If the organization s answer to any of the following questions is "," then omplete Shedule D, Parts VI, VII, VIII, I, or as appliale. Did the organization report an amount for land, uildings, and equipment in Part, line 10? If "," omplete Shedule D, Part VI ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount for investments - other seurities in Part, line 1 that is 5% or more of its total assets reported in Part, line 16? If "," omplete Shedule D, Part VII ~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount for investments - program related in Part, line 1 that is 5% or more of its total assets reported in Part, line 16? If "," omplete Shedule D, Part VIII ~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount for other assets in Part, line 15 that is 5% or more of its total assets reported in Part, line 16? If "," omplete Shedule D, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount for other liailities in Part, line 5? If "," omplete Shedule D, Part ~~~~~~ Did the organization s separate or onsolidated finanial statements for the tax year inlude a footnote that addresses the organization s liaility for unertain tax positions under FIN 8 (ASC 70)? If "," omplete Shedule D, Part ~~~~ Did the organization otain separate, independent audited finanial statements for the tax year? If "," omplete Shedule D, Parts I and II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Was the organization inluded in onsolidated, independent audited finanial statements for the tax year? If "," and if the organization answered "" to line 1a, then ompleting Shedule D, Parts I and II is optional ~~~~~ Is the organization a shool desried in setion 170()(1)(A)(ii)? If "," omplete Shedule E ~~~~~~~~~~~~~~ 1a Did the organization maintain an offie, employees, or agents outside of the United States? ~~~~~~~~~~~~~~~~ Did the organization have aggregate revenues or expenses of more than $10,0 from grantmaking, fundraising, usiness, investment, and program servie ativities outside the United States, or aggregate foreign investments valued at $1,0 or more? If "," omplete Shedule F, Parts I and IV ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report on Part I, olumn (A), line, more than $5,0 of grants or other assistane to or for any foreign organization? If "," omplete Shedule F, Parts II and IV ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report on Part I, olumn (A), line, more than $5,0 of aggregate grants or other assistane to or for foreign individuals? If "," omplete Shedule F, Parts III and IV ~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report a total of more than $15,0 of expenses for professional fundraising servies on Part I, olumn (A), lines 6 and 11e? If "," omplete Shedule G, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report more than $15,0 total of fundraising event gross inome and ontriutions on Part VIII, lines 1 and 8a? If "," omplete Shedule G, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report more than $15,0 of gross inome from gaming ativities on Part VIII, line a? If "," omplete Shedule G, Part III a d 11e 11f 1a 1 1 1a Page 1 Form 0 (017)

8 HOME HEALTH SECTION OF THE AMERICAN Form 0 (017) PHYSICAL THERAPY ASSOCIATION, INC Part IV Cheklist of Required Shedules (ontinued) 0a 1 a d 5a Setion 501()(), 501()(), and 501()() organizations. Did the organization engage in an exess enefit transation with a disqualified person during the year? If "," omplete Shedule L, Part I ~~~~~~~~~~~~~~~~ a Did the organization operate one or more hospital failities? If "," omplete Shedule H ~~~~~~~~~~~~~~~~ If "" to line 0a, did the organization attah a opy of its audited finanial statements to this return? ~~~~~~~~~~ Did the organization report more than $5,0 of grants or other assistane to any domesti organization or domesti government on Part I, olumn (A), line 1? If "," omplete Shedule I, Parts I and II ~~~~~~~~~~~~~~ Did the organization report more than $5,0 of grants or other assistane to or for domesti individuals on Part I, olumn (A), line? If "," omplete Shedule I, Parts I and III ~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization answer "" to Part VII, Setion A, line,, or 5 aout ompensation of the organization s urrent and former offiers, diretors, trustees, key employees, and highest ompensated employees? If "," omplete Shedule J ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization have a tax-exempt ond issue with an outstanding prinipal amount of more than $1,0 as of the last day of the year, that was issued after Deemer 1,? If "," answer lines through d and omplete Shedule K. If "", go to line 5a ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization invest any proeeds of tax-exempt onds eyond a temporary period exeption? ~~~~~~~~~~~ Did the organization maintain an esrow aount other than a refunding esrow at any time during the year to defease any tax-exempt onds? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization at as an "on ehalf of" issuer for onds outstanding at any time during the year? ~~~~~~~~~~~ Is the organization aware that it engaged in an exess enefit transation with a disqualified person in a prior year, and that the transation has not een reported on any of the organization s prior Forms 0 or 0-EZ? If "," omplete Shedule L, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report any amount on Part, line 5, 6, or for reeivales from or payales to any urrent or former offiers, diretors, trustees, key employees, highest ompensated employees, or disqualified persons? If "," omplete Shedule L, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization provide a grant or other assistane to an offier, diretor, trustee, key employee, sustantial ontriutor or employee thereof, a grant seletion ommittee memer, or to a 5% ontrolled entity or family memer of any of these persons? If "," omplete Shedule L, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Was the organization a party to a usiness transation with one of the following parties (see Shedule L, Part IV instrutions for appliale filing thresholds, onditions, and exeptions): A urrent or former offier, diretor, trustee, or key employee? If "," omplete Shedule L, Part IV ~~~~~~~~~~~ A family memer of a urrent or former offier, diretor, trustee, or key employee? If "," omplete Shedule L, Part IV ~~ An entity of whih a urrent or former offier, diretor, trustee, or key employee (or a family memer thereof) was an offier, diretor, trustee, or diret or indiret owner? If "," omplete Shedule L, Part IV~~~~~~~~~~~~~~~~~~~~~ Did the organization reeive more than $5,0 in non-ash ontriutions? If "," omplete Shedule M ~~~~~~~~~ Did the organization reeive ontriutions of art, historial treasures, or other similar assets, or qualified onservation ontriutions? If "," omplete Shedule M ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization liquidate, terminate, or dissolve and ease operations? If "," omplete Shedule N, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization sell, exhange, dispose of, or transfer more than 5% of its net assets? If "," omplete Shedule N, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization own 1% of an entity disregarded as separate from the organization under Regulations setions and ? If "," omplete Shedule R, Part I ~~~~~~~~~~~~~~~~~~~~~~~~ Was the organization related to any tax-exempt or taxale entity? If "," omplete Shedule R, Part II, III, or IV, and Part V, line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5a Did the organization have a ontrolled entity within the meaning of setion 51()(1)? ~~~~~~~~~~~~~~~~~~ If "" to line 5a, did the organization reeive any payment from or engage in any transation with a ontrolled entity within the meaning of setion 51()(1)? If "," omplete Shedule R, Part V, line ~~~~~~~~~~~~~~~~~~~ Setion 501()() organizations. Did the organization make any transfers to an exempt non-haritale related organization? If "," omplete Shedule R, Part V, line ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization ondut more than 5% of its ativities through an entity that is not a related organization and that is treated as a partnership for federal inome tax purposes? If "," omplete Shedule R, Part VI ~~~~~~~~ Did the organization omplete Shedule O and provide explanations in Shedule O for Part VI, lines 11 and 1? te. All Form 0 filers are required to omplete Shedule O 0a 0 1 a d 5a a a Page 8 Form 0 (017)

9 HOME HEALTH SECTION OF THE AMERICAN Form 0 (017) PHYSICAL THERAPY ASSOCIATION, INC Page 5 Part V Statements Regarding Other IRS Filings and Tax Compliane Chek if Shedule O ontains a response or note to any line in this Part V 1a Enter the numer reported in Box of Form 106. Enter -0- if not appliale ~~~~~~~~~~~ a Enter the numer of Forms W-G inluded in line 1a. Enter -0- if not appliale ~~~~~~~~~~ 1 Did the organization omply with akup withholding rules for reportale payments to vendors and reportale gaming If at least one is reported on line a, did the organization file all required federal employment tax returns? ~~~~~~~~~~ te. If the sum of lines 1a and a is greater than 50, you may e required to e-file (see instrutions) ~~~~~~~~~~~ 7 Organizations that may reeive dedutile ontriutions under setion 170(). a Did the organization reeive a payment in exess of $75 made partly as a ontriution and partly for goods and servies provided to the payor? d e f g h a a a 1a Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained y the Sponsoring organizations maintaining donor advised funds. Setion 501()(7) organizations. Enter: Setion 501()(1) organizations. Enter: 1a Setion 7(a)(1) non-exempt haritale trusts. Is the organization filing Form 0 in lieu of Form 101? a (gamling) winnings to prize winners? a Enter the numer of employees reported on Form W-, Transmittal of Wage and Tax Statements, filed for the alendar year ending with or within the year overed y this return ~~~~~~~~~~ Did the organization have unrelated usiness gross inome of $1,0 or more during the year? ~~~~~~~~~~~~~~ If "," has it filed a Form 0-T for this year? If "," to line, provide an explanation in Shedule O ~~~~~~~~~~ a At any time during the alendar year, did the organization have an interest in, or a signature or other authority over, a finanial aount in a foreign ountry (suh as a ank aount, seurities aount, or other finanial aount)?~~~~~~~ If "," enter the name of the foreign ountry: J See instrutions for filing requirements for FinCEN Form 11, Report of Foreign Bank and Finanial Aounts (FBAR). 5a Was the organization a party to a prohiited tax shelter transation at any time during the tax year? ~~~~~~~~~~~~ Did any taxale party notify the organization that it was or is a party to a prohiited tax shelter transation? ~~~~~~~~~ If "," to line 5a or 5, did the organization file Form 8886-T? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6a Does the organization have annual gross reeipts that are normally greater than $1,0, and did the organization soliit any ontriutions that were not tax dedutile as haritale ontriutions? If "," did the organization inlude with every soliitation an express statement that suh ontriutions or gifts were not tax dedutile? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "," did the organization notify the donor of the value of the goods or servies provided? Setion 501()() qualified nonprofit health insurane issuers. te. See the instrutions for additional information the organization must report on Shedule O. Did the organization reeive any payments for indoor tanning servies during the tax year? ~~~~~~~~~~~~~~~~ If "," has it filed a Form 70 to report these payments? If "," provide an explanation in Shedule O 1a a ~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization sell, exhange, or otherwise dispose of tangile personal property for whih it was required to file Form 88? ~~~~~~~~~~~~~~~ If "," indiate the numer of Forms 88 filed during the year ~~~~~~~~~~~~~~~~ Did the organization reeive any funds, diretly or indiretly, to pay premiums on a personal enefit ontrat? Did the organization, during the year, pay premiums, diretly or indiretly, on a personal enefit ontrat? 7d 10a 10 11a ~~~~~~~ ~~~~~~~~~ If the organization reeived a ontriution of qualified intelletual property, did the organization file Form 88 as required? ~ If the organization reeived a ontriution of ars, oats, airplanes, or other vehiles, did the organization file a Form 108-C? sponsoring organization have exess usiness holdings at any time during the year? ~~~~~~~~~~~~~~~~~~~ Did the sponsoring organization make any taxale distriutions under setion 66? Did the sponsoring organization make a distriution to a donor, donor advisor, or related person? Initiation fees and apital ontriutions inluded on Part VIII, line 1 ~~~~~~~~~~~~~~~ Gross reeipts, inluded on Form 0, Part VIII, line 1, for puli use of lu failities ~~~~~~ Gross inome from memers or shareholders ~~~~~~~~~~~~~~~~~~~~~~~~~~ Gross inome from other soures (Do not net amounts due or paid to other soures against amounts due or reeived from them.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "," enter the amount of tax-exempt interest reeived or arued during the year ~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~ Is the organization liensed to issue qualified health plans in more than one state? ~~~~~~~~~~~~~~~~~~~~~ Enter the amount of reserves the organization is required to maintain y the states in whih the organization is liensed to issue qualified health plans ~~~~~~~~~~~~~~~~~~~~~~ Enter the amount of reserves on hand~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ a a 5a 5 5 6a 6 7a 7 7 7e 7f 7g 7h 8 a 1a 1a 1a 1 Form 0 (017)

10 HOME HEALTH SECTION OF THE AMERICAN Form 0 (017) PHYSICAL THERAPY ASSOCIATION, INC Page 6 Part VI Governane, Management, and Dislosure For eah "" response to lines through 7 elow, and for a "" response to line 8a, 8, or 10 elow, desrie the irumstanes, proesses, or hanges in Shedule O. See instrutions. Chek if Shedule O ontains a response or note to any line in this Part VI Setion A. Governing Body and Management 1a Enter the numer of voting memers of the governing ody at the end of the tax year ~~~~~~ If there are material differenes in voting rights among memers of the governing ody, or if the governing a Is there any offier, diretor, trustee, or key employee listed in Part VII, Setion A, who annot e reahed at the organization s mailing address? If "," provide the names and addresses in Shedule O Setion B. Poliies (This Setion B requests information aout poliies not required y the Internal Revenue Code.) 1a a 16a exempt status with respet to suh arrangements? Setion C. Dislosure 17 List the states with whih a opy of this Form 0 is required to e filed J NONE ody delegated road authority to an exeutive ommittee or similar ommittee, explain in Shedule O. Enter the numer of voting memers inluded in line 1a, aove, who are independent ~~~~~~ persons other than the governing ody? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization ontemporaneously doument the meetings held or written ations undertaken during the year y the following: Desrie in Shedule O the proess, if any, used y the organization to review this Form 0. Did the organization have a written onflit of interest poliy? If "," go to line 1 ~~~~~~~~~~~~~~~~~~~~ Were offiers, diretors, or trustees, and key employees required to dislose annually interests that ould give rise to onflits? ~~~~~~ Did the organization regularly and onsistently monitor and enfore ompliane with the poliy? If "," desrie in Shedule O how this was done ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ for puli inspetion. Indiate how you made these availale. Chek all that apply. Own wesite Another s wesite Upon request Other (explain in Shedule O) Did any offier, diretor, trustee, or key employee have a family relationship or a usiness relationship with any other offier, diretor, trustee, or key employee? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization delegate ontrol over management duties ustomarily performed y or under the diret supervision of offiers, diretors, or trustees, or key employees to a management ompany or other person? ~~~~~~~~~~~~~~ Did the organization make any signifiant hanges to its governing douments sine the prior Form 0 was filed? ~~~~~ Did the organization eome aware during the year of a signifiant diversion of the organization s assets? ~~~~~~~~~ Did the organization have memers or stokholders? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7a Did the organization have memers, stokholders, or other persons who had the power to elet or appoint one or more memers of the governing ody? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Are any governane deisions of the organization reserved to (or sujet to approval y) memers, stokholders, or The governing ody? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Eah ommittee with authority to at on ehalf of the governing ody? 1a 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~ 10a Did the organization have loal hapters, ranhes, or affiliates? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "," did the organization have written poliies and proedures governing the ativities of suh hapters, affiliates, and ranhes to ensure their operations are onsistent with the organization s exempt purposes? ~~~~~~~~~~~~~ 11a Has the organization provided a omplete opy of this Form 0 to all memers of its governing ody efore filing the form? Did the organization have a written whistlelower poliy? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization have a written doument retention and destrution poliy? ~~~~~~~~~~~~~~~~~~~~~~ Did the proess for determining ompensation of the following persons inlude a review and approval y independent persons, omparaility data, and ontemporaneous sustantiation of the delieration and deision? The organization s CEO, Exeutive Diretor, or top management offiial Other offiers or key employees of the organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "" to line 15a or 15, desrie the proess in Shedule O (see instrutions). ~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization invest in, ontriute assets to, or partiipate in a joint venture or similar arrangement with a taxale entity during the year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "," did the organization follow a written poliy or proedure requiring the organization to evaluate its partiipation in joint venture arrangements under appliale federal tax law, and take steps to safeguard the organization s Setion 610 requires an organization to make its Forms 10 (or 10 if appliale), 0, and 0-T (Setion 501()()s only) availale Desrie in Shedule O whether (and if so, how) the organization made its governing douments, onflit of interest poliy, and finanial statements availale to the puli during the tax year. State the name, address, and telephone numer of the person who possesses the organization s ooks and reords: ROBIN CHILDERS PO BO 55, MISSOULA, MT a 7 8a 8 10a 10 11a 1a a 15 16a 16 Form 0 (017)

11 HOME HEALTH SECTION OF THE AMERICAN Form 0 (017) PHYSICAL THERAPY ASSOCIATION, INC Page 7 Part VII Compensation of Offiers, Diretors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contrators Chek if Shedule O ontains a response or note to any line in this Part VII Setion A. Offiers, Diretors, Trustees, Key Employees, and Highest Compensated Employees 1a Complete this tale for all persons required to e listed. Report ompensation for the alendar year ending with or within the organization s tax year. List all of the organization s urrent offiers, diretors, trustees (whether individuals or organizations), regardless of amount of ompensation. Enter -0- in olumns (D), (E), and (F) if no ompensation was paid. List all of the organization s urrent key employees, if any. See instrutions for definition of "key employee." List the organization s five urrent highest ompensated employees (other than an offier, diretor, trustee, or key employee) who reeived reportale ompensation (Box 5 of Form W- and/or Box 7 of Form 10-MISC) of more than $1,0 from the organization and any related organizations. List all of the organization s former offiers, key employees, and highest ompensated employees who reeived more than $1,0 of reportale ompensation from the organization and any related organizations. List all of the organization s former diretors or trustees that reeived, in the apaity as a former diretor or trustee of the organization, more than $10,0 of reportale ompensation from the organization and any related organizations. List persons in the following order: individual trustees or diretors; institutional trustees; offiers; key employees; highest ompensated employees; and former suh persons. Chek this ox if neither the organization nor any related organization ompensated any urrent offier, diretor, or trustee. (A) (B) (C) (D) (E) (F) Name and Title Average hours per week (list any hours for related organizations elow line) Position (do not hek more than one ox, unless person is oth an offier and a diretor/trustee) Individual trustee or diretor Institutional trustee Offier Key employee Highest ompensated employee Former Reportale ompensation from the organization (W-/10-MISC) Reportale ompensation from related organizations (W-/10-MISC) Estimated amount of other ompensation from the organization and related organizations (1) DIANA KORNETTI 1. PRESIDENT () ARLYNN HANSELL (THRU MARCH 017) 1. VICE PRESIDENT () CHRISTOPHER CHIMENTI 1. VICE PRESIDENT () MATT JANES 1. SECRETARY (5) PHILIP GOLDSMITH 1. TREASURER Form 0 (017)

12 HOME HEALTH SECTION OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION, INC Form 0 (017) Page 8 Part VII Setion A. Offiers, Diretors, Trustees, Key Employees, and Highest Compensated Employees (ontinued) (A) (B) (C) (D) (E) (F) Name and title Average Position (do not hek more than one Reportale Reportale Estimated hours per ox, unless person is oth an ompensation ompensation amount of week offier and a diretor/trustee) from from related other (list any the organizations ompensation hours for organization (W-/10-MISC) from the related (W-/10-MISC) organization organizations and related elow organizations line) Individual trustee or diretor Institutional trustee Offier Key employee Highest ompensated employee Former 1 d Su-total~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total from ontinuation sheets to Part VII, Setion A ~~~~~~~~~~ Total (add lines 1 and 1) Did the organization list any former offier, diretor, or trustee, key employee, or highest ompensated employee on line 1a? If "," omplete Shedule J for suh individual ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 Did any person listed on line 1a reeive or arue ompensation from any unrelated organization or individual for servies rendered to the organization? If "," omplete Shedule J for suh person Setion B. Independent Contrators 1 Total numer of individuals (inluding ut not limited to those listed aove) who reeived more than $1,0 of reportale ompensation from the organization For any individual listed on line 1a, is the sum of reportale ompensation and other ompensation from the organization and related organizations greater than $150,0? If "," omplete Shedule J for suh individual~~~~~~~~~~~~~ Complete this tale for your five highest ompensated independent ontrators that reeived more than $1,0 of ompensation from the organization. Report ompensation for the alendar year ending with or within the organization s tax year (A) (B) (C) Name and usiness address NONE Desription of servies Compensation 5 0 Total numer of independent ontrators (inluding ut not limited to those listed aove) who reeived more than $1,0 of ompensation from the organization Form 0 (017)

13 HOME HEALTH SECTION OF THE AMERICAN Form 0 (017) PHYSICAL THERAPY ASSOCIATION, INC Part VIII Statement of Revenue Contriutions, Gifts, Grants and Other Similar Amounts Program Servie Revenue Other Revenue 1 a d e f g nash ontriutions inluded in lines 1a-1f: $ h 1a 1 1 1d 1e e Total. Add lines 11a-11d ~~~~~~~~~~~~~~~ 1 Total revenue. See instrutions. 1f Total. Add lines 1a-1f Business Code a REGISTRATION FEES ,. 107,. OTHER PROGRAMS 6110,817., d e f g 6 a d d 8 a a 10 a Total. Add lines a-f a a a Misellaneous Revenue Business Code 11 a ADVERTISING 518,750.,750. d Government grants (ontriutions) All other ontriutions, gifts, grants, and similar amounts not inluded aove ~~ Page Chek if Shedule O ontains a response or note to any line in this Part VIII (A) (B) (C) (D) Total revenue Related or Unrelated Revenue exluded exempt funtion usiness from tax under setions revenue revenue Federated ampaigns Memership dues ~~~~~~ ~~~~~~~~ Fundraising events ~~~~~~~~ Related organizations ~~~~~~ All other program servie revenue ~~~~~ Investment inome (inluding dividends, interest, and other similar amounts) ~~~~~~~~~~~~~~~~~ Inome from investment of tax-exempt ond proeeds Royalties Gross rents ~~~~~~~ Less: rental expenses~~~ Rental inome or (loss) ~~ Net rental inome or (loss) 7 a Gross amount from sales of assets other than inventory Less: ost or other asis and sales expenses ~~~ Gain or (loss) ~~~~~~~ (i) Real (ii) Personal (i) Seurities 6,0. (ii) Other Net gain or (loss) Gross inome from fundraising events (not inluding $ of ontriutions reported on line 1). See Part IV, line 18 ~~~~~~~~~~~~~ Less: diret expenses~~~~~~~~~~ Net inome or (loss) from fundraising events Gross inome from gaming ativities. See Part IV, line 1 ~~~~~~~~~~~~~ Less: diret expenses ~~~~~~~~~ Net inome or (loss) from gaming ativities Gross sales of inventory, less returns and allowanes ~~~~~~~~~~~~~ Less: ost of goods sold 1,71. 1,87. ~~~~~~~~ Net inome or (loss) from sales of inventory All other revenue ~~~~~~~~~~~~~ 8,88.,068., , ,05. 11,05. 1,78. 1,78. 1,87. 1,87.,750. 5, ,150.,750. 7,. Form 0 (017)

14 HOME HEALTH SECTION OF THE AMERICAN Form 0 (017) PHYSICAL THERAPY ASSOCIATION, INC Part I Statement of Funtional Expenses Setion 501()() and 501()() organizations must omplete all olumns. All other organizations must omplete olumn (A). Chek if Shedule O ontains a response or note to any line in this Part I Do not inlude amounts reported on lines 6, (A) (B) (C) (D) 7, 8,, and 10 of Part VIII. Total expenses Program servie Management and Fundraising expenses general expenses expenses 1 Grants and other assistane to domesti organizations and domesti governments. See Part IV, line 1 ~ 7, a d e f g a d Grants and other assistane to domesti individuals. See Part IV, line ~~~~~~~ Grants and other assistane to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ~~~ Benefits paid to or for memers ~~~~~~~ Compensation of urrent offiers, diretors, trustees, and key employees ~~~~~~~~ Compensation not inluded aove, to disqualified persons (as defined under setion 58(f)(1)) and persons desried in setion 58()()(B) Other salaries and wages ~~~~~~~~~~ Pension plan aruals and ontriutions (inlude setion 01(k) and 0() employer ontriutions) Loying ~~~~~~~~~~~~~~~~~~ Professional fundraising servies. See Part IV, line 17 Investment management fees ~~~~~~~~ Other. (If line 11g amount exeeds 10% of line 5, olumn (A) amount, list line 11g expenses on Sh O.) Insurane ~~~~~~~~~~~~~~~~~ Other expenses. Itemize expenses not overed aove. (List misellaneous expenses in line e. If line e amount exeeds 10% of line 5, olumn (A) amount, list line e expenses on Shedule O.) WEBSITE,0. DUES AND SUBSCRIPTIONS 1,1. STATE TAES 50. LICENSE AND PERMITS 0. e All other expenses 5 Total funtional expenses. Add lines 1 through e 6 Joint osts. Complete this line only if the organization reported in olumn (B) joint osts from a omined eduational ampaign and fundraising soliitation. Chek here if following SOP 8- (ASC 58-70) ~~~ Other employee enefits ~~~~~~~~~~ Payroll taxes ~~~~~~~~~~~~~~~~ Fees for servies (non-employees): Management ~~~~~~~~~~~~~~~~ Legal ~~~~~~~~~~~~~~~~~~~~ Aounting ~~~~~~~~~~~~~~~~~ Advertising and promotion ~~~~~~~~~ Offie expenses~~~~~~~~~~~~~~~ Information tehnology ~~~~~~~~~~~ Royalties ~~~~~~~~~~~~~~~~~~ Oupany ~~~~~~~~~~~~~~~~~ Travel ~~~~~~~~~~~~~~~~~~~ Payments of travel or entertainment expenses for any federal, state, or loal puli offiials Conferenes, onventions, and meetings ~~ Interest ~~~~~~~~~~~~~~~~~~ Payments to affiliates ~~~~~~~~~~~~ Depreiation, depletion, and amortization ~~,170. 1,1.,10.,6. 6,05.,86. 85, ,8. Page 10 Form 0 (017)

15 HOME HEALTH SECTION OF THE AMERICAN Form 0 (017) PHYSICAL THERAPY ASSOCIATION, INC Part Balane Sheet Assets Liailities Net Assets or Fund Balanes Chek if Shedule O ontains a response or note to any line in this Part Cash - non-interest-earing ~~~~~~~~~~~~~~~~~~~~~~~~~ Savings and temporary ash investments ~~~~~~~~~~~~~~~~~~ Pledges and grants reeivale, net Total assets. Add lines 1 through 15 (must equal line ) Total liailities. Add lines 17 through 5 Organizations that follow SFAS 117 (ASC 58), hek here and 10a 10 omplete lines 7 through, and lines and. Organizations that do not follow SFAS 117 (ASC 58), hek here and omplete lines 0 through. ~~~~~~~~~~~~~~~~~~~~~ Aounts reeivale, net ~~~~~~~~~~~~~~~~~~~~~~~~~~ Loans and other reeivales from urrent and former offiers, diretors, trustees, key employees, and highest ompensated employees. Complete Part II of Shedule L ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Loans and other reeivales from other disqualified persons (as defined under setion 58(f)(1)), persons desried in setion 58()()(B), and ontriuting employers and sponsoring organizations of setion 501()() voluntary employees enefiiary organizations (see instr). Complete Part II of Sh L ~~ tes and loans reeivale, net ~~~~~~~~~~~~~~~~~~~~~~~ Inventories for sale or use ~~~~~~~~~~~~~~~~~~~~~~~~~~ Prepaid expenses and deferred harges 10a Land, uildings, and equipment: ost or other asis. Complete Part VI of Shedule D Less: aumulated depreiation ~~~~~~~~~~~~~~~~~~ ~~~ ~~~~~~ Investments - pulily traded seurities ~~~~~~~~~~~~~~~~~~~ Investments - other seurities. See Part IV, line 11 ~~~~~~~~~~~~~~ Investments - program-related. See Part IV, line 11 ~~~~~~~~~~~~~ Intangile assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other assets. See Part IV, line 11 ~~~~~~~~~~~~~~~~~~~~~~ Aounts payale and arued expenses ~~~~~~~~~~~~~~~~~~ Grants payale ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Deferred revenue ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax-exempt ond liailities ~~~~~~~~~~~~~~~~~~~~~~~~~ Esrow or ustodial aount liaility. Complete Part IV of Shedule D ~~~~ Loans and other payales to urrent and former offiers, diretors, trustees, key employees, highest ompensated employees, and disqualified persons. Complete Part II of Shedule L ~~~~~~~~~~~~~~~~~~~~~~~ Seured mortgages and notes payale to unrelated third parties ~~~~~~ Unseured notes and loans payale to unrelated third parties ~~~~~~~~ Other liailities (inluding federal inome tax, payales to related third parties, and other liailities not inluded on lines 17-). Complete Part of Shedule D ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unrestrited net assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Temporarily restrited net assets Permanently restrited net assets ~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~ Capital stok or trust prinipal, or urrent funds ~~~~~~~~~~~~~~~ Paid-in or apital surplus, or land, uilding, or equipment fund ~~~~~~~~ Retained earnings, endowment, aumulated inome, or other funds ~~~~ Total net assets or fund alanes ~~~~~~~~~~~~~~~~~~~~~~ Total liailities and net assets/fund alanes (A) (B) Beginning of year End of year 0, , , , , , , , Page 11 1,86. 1,0. 1,86. 1,0. Form 0 (017)

16 HOME HEALTH SECTION OF THE AMERICAN Form 0 (017) PHYSICAL THERAPY ASSOCIATION, INC Page 1 Part I Reoniliation of Net Assets Chek if Shedule O ontains a response or note to any line in this Part I a Total revenue (must equal Part VIII, olumn (A), line 1) Total expenses (must equal Part I, olumn (A), line 5) ~~~~~~~~~~~~~~~~~~~~~~~~~~ Revenue less expenses. Sutrat line from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Net assets or fund alanes at eginning of year (must equal Part, line, olumn (A)) ~~~~~~~~~~ Net unrealized gains (losses) on investments Donated servies and use of failities Investment expenses Prior period adjustments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other hanges in net assets or fund alanes (explain in Shedule O) ~~~~~~~~~~~~~~~~~~~ 10 Net assets or fund alanes at end of year. Comine lines through (must equal Part, line, olumn (B)) 10 1,0. Part II Finanial Statements and Reporting Chek if Shedule O ontains a response or note to any line in this Part II 1 Aounting method used to prepare the Form 0: Cash Arual Other If the organization hanged its method of aounting from a prior year or heked "Other," explain in Shedule O. Were the organization s finanial statements ompiled or reviewed y an independent aountant? ~~~~~~~~~~~~ If "," hek a ox elow to indiate whether the finanial statements for the year were ompiled or reviewed on a separate asis, onsolidated asis, or oth: Separate asis Consolidated asis Both onsolidated and separate asis Were the organization s finanial statements audited y an independent aountant? ~~~~~~~~~~~~~~~~~~~ If "," hek a ox elow to indiate whether the finanial statements for the year were audited on a separate asis, onsolidated asis, or oth: Separate asis Consolidated asis Both onsolidated and separate asis If "" to line a or, does the organization have a ommittee that assumes responsiility for oversight of the audit, review, or ompilation of its finanial statements and seletion of an independent aountant?~~~~~~~~~~~~~~~ If the organization hanged either its oversight proess or seletion proess during the tax year, explain in Shedule O. a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit At and OMB Cirular A-1? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Shedule O and desrie any steps taken to undergo suh audits , ,8. -1,686. 1, a a 0. Form 0 (017)

17 SCHEDULE C (Form 0 or 0-EZ) Department of the Treasury Internal Revenue Servie For Organizations Exempt From Inome Tax Under setion 501() and setion 57 J Complete if the organization is desried elow. J Attah to Form 0 or Form 0-EZ. Go to for instrutions and the latest information. OMB Open to Puli Inspetion If the organization answered "," on Form 0, Part IV, line, or Form 0-EZ, Part V, line 6 (Politial Campaign Ativities), then Setion 501()() organizations: Complete Parts I-A and B. Do not omplete Part I-C. Setion 501() (other than setion 501()()) organizations: Complete Parts I-A and C elow. Do not omplete Part I-B. Setion 57 organizations: Complete Part I-A only. Politial Campaign and Loying Ativities If the organization answered "," on Form 0, Part IV, line, or Form 0-EZ, Part VI, line 7 (Loying Ativities), then Setion 501()() organizations that have filed Form 5768 (eletion under setion 501(h)): Complete Part II-A. Do not omplete Part II-B. 017 Setion 501()() organizations that have NOT filed Form 5768 (eletion under setion 501(h)): Complete Part II-B. Do not omplete Part II-A. If the organization answered "," on Form 0, Part IV, line 5 (Proxy Tax) (see separate instrutions) or Form 0-EZ, Part V, line 5 (Proxy Tax) (see separate instrutions), then Setion 501()(), (5), or (6) organizations: Complete Part III. Name of organization HOME HEALTH SECTION OF THE AMERICAN Employer identifiation numer PHYSICAL THERAPY ASSOCIATION, INC Part I-A Complete if the organization is exempt under setion 501() or is a setion 57 organization. 1 Provide a desription of the organization s diret and indiret politial ampaign ativities in Part IV. Politial ampaign ativity expenditures ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ J $ Volunteer hours for politial ampaign ativities ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Part I-B Complete if the organization is exempt under setion 501()(). 1 Enter the amount of any exise tax inurred y the organization under setion 55 ~~~~~~~~~~~~~ J $ Enter the amount of any exise tax inurred y organization managers under setion 55 ~~~~~~~~~~ J $ a Was a orretion made? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "," desrie in Part IV. Part I-C Complete if the organization is exempt under setion 501(), exept setion 501()(). 1 Enter the amount diretly expended y the filing organization for setion 57 exempt funtion ativities ~~~~ J $ 5 If the organization inurred a setion 55 tax, did it file Form 70 for this year? ~~~~~~~~~~~~~~~~~~~ Enter the amount of the filing organization s funds ontriuted to other organizations for setion 57 exempt funtion ativities ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ J $ Total exempt funtion expenditures. Add lines 1 and. Enter here and on Form 110-POL, line 17 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ J $ Did the filing organization file Form 110-POL for this year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter the names, addresses and employer identifiation numer (EIN) of all setion 57 politial organizations to whih the filing organization made payments. For eah organization listed, enter the amount paid from the filing organization s funds. Also enter the amount of politial ontriutions reeived that were promptly and diretly delivered to a separate politial organization, suh as a separate segregated fund or a politial ation ommittee (PAC). If additional spae is needed, provide information in Part IV. (a) Name () Address () EIN (d) Amount paid from (e) Amount of politial filing organization s ontriutions reeived and funds. If none, enter -0-. promptly and diretly delivered to a separate politial organization. If none, enter -0-. For Paperwork Redution At tie, see the Instrutions for Form 0 or 0-EZ. Shedule C (Form 0 or 0-EZ) 017 LHA

18 HOME HEALTH SECTION OF THE AMERICAN Shedule C (Form 0 or 0-EZ) 017 PHYSICAL THERAPY ASSOCIATION, INC Page Part II-A Complete if the organization is exempt under setion 501()() and filed Form 5768 (eletion under setion 501(h)). A Chek J if the filing organization elongs to an affiliated group (and list in Part IV eah affiliated group memer s name, address, EIN, B Chek J expenses, and share of exess loying expenditures). if the filing organization heked ox A and "limited ontrol" provisions apply. Limits on Loying Expenditures (The term "expenditures" means amounts paid or inurred.) (a) Filing organization s totals () Affiliated group totals 1a d e f Total loying expenditures to influene puli opinion (grass roots loying) ~~~~~~~~~~ Total loying expenditures to influene a legislative ody (diret loying) ~~~~~~~~~~~ Total loying expenditures (add lines 1a and 1) ~~~~~~~~~~~~~~~~~~~~~~~~ Other exempt purpose expenditures ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total exempt purpose expenditures (add lines 1 and 1d) ~~~~~~~~~~~~~~~~~~~~ Loying nontaxale amount. Enter the amount from the following tale in oth olumns. If the amount on line 1e, olumn (a) or () is: The loying nontaxale amount is: t over $5,0 0% of the amount on line 1e. Over $5,0 ut not over $1,0,0 $1,0 plus 15% of the exess over $5,0. Over $1,0,0 ut not over $1,5,0 $175,0 plus 10% of the exess over $1,0,0. Over $1,5,0 ut not over $17,0,0 $5,0 plus 5% of the exess over $1,5,0. Over $17,0,0 $1,0,0. g h i j Grassroots nontaxale amount (enter 5% of line 1f) Sutrat line 1g from line 1a. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~ Sutrat line 1f from line 1. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~~~~~ If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 70 reporting setion 11 tax for this year? -Year Averaging Period Under setion 501(h) (Some organizations that made a setion 501(h) eletion do not have to omplete all of the five olumns elow. See the separate instrutions for lines a through f.) Loying Expenditures During -Year Averaging Period Calendar year (or fisal year eginning in) (a) 01 () 015 () 016 (d) 017 (e) Total a Loying nontaxale amount Loying eiling amount (150% of line a, olumn(e)) Total loying expenditures d e Grassroots nontaxale amount Grassroots eiling amount (150% of line d, olumn (e)) f Grassroots loying expenditures Shedule C (Form 0 or 0-EZ)

19 HOME HEALTH SECTION OF THE AMERICAN Shedule C (Form 0 or 0-EZ) 017 PHYSICAL THERAPY ASSOCIATION, INC Part II-B Complete if the organization is exempt under setion 501()() and has NOT filed Form 5768 (eletion under setion 501(h)). Page For eah "," response on lines 1a through 1i elow, provide in Part IV a detailed desription of the loying ativity. (a) () Amount 1 a d e f g h i j d If the filing organization inurred a setion 1 tax, did it file Form 70 for this year? Part III-A Complete if the organization is exempt under setion 501()(), setion 501()(5), or setion 501()(6). 1 Were sustantially all (0% or more) dues reeived nondedutile y memers? ~~~~~~~~~~~~~~~~~ 1 Did the organization make only in-house loying expenditures of $,0 or less? ~~~~~~~~~~~~~~~~ Did the organization agree to arry over loying and politial ampaign ativity expenditures from the prior year? Part III-B Complete if the organization is exempt under setion 501()(), setion 501()(5), or setion 501()(6) and if either (a) BOTH Part III-A, lines 1 and, are answered "," OR () Part III-A, line, is answered "." 1 a During the year, did the filing organization attempt to influene foreign, national, state or loal legislation, inluding any attempt to influene puli opinion on a legislative matter or referendum, through the use of: Volunteers? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Paid staff or management (inlude ompensation in expenses reported on lines 1 through 1i)? Media advertisements? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Mailings to memers, legislators, or the puli? ~~~~~~~~~~~~~~~~~~~~~~~~~ Puliations, or pulished or roadast statements? Grants to other organizations for loying purposes? ~~~~~~~~~~~~~~~~~~~~~~ Setion 16(e) nondedutile loying and politial expenditures (do not inlude amounts of politial expenses for whih the setion 57(f) tax was paid). ~~~~~~~~~~~~~~~~~~~~~~ Diret ontat with legislators, their staffs, government offiials, or a legislative ody? ~~~~~~ Rallies, demonstrations, seminars, onventions, speehes, letures, or any similar means? ~~~~ Other ativities? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total. Add lines 1 through 1i ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ a Did the ativities in line 1 ause the organization to e not desried in setion 501()()? ~~~~ If "," enter the amount of any tax inurred under setion 1 ~~~~~~~~~~~~~~~~ If "," enter the amount of any tax inurred y organization managers under setion 1 ~~~ Dues, assessments and similar amounts from memers ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Current year Carryover from last year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Aggregate amount reported in setion 60(e)(1)(A) noties of nondedutile setion 16(e) dues If noties were sent and the amount on line exeeds the amount on line, what portion of the exess does the organization agree to arryover to the reasonale estimate of nondedutile loying and politial expenditure next year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 Taxale amount of loying and politial expenditures (see instrutions) 5 Part IV Supplemental Information Provide the desriptions required for Part I-A, line 1; Part I-B, line ; Part I-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and (see instrutions); and Part II-B, line 1. Also, omplete this part for any additional information. ~ ~~~~~~~~ 1 a Shedule C (Form 0 or 0-EZ) 017

20 SCHEDULE D (Form 0) Complete if the organization answered "" on Form 0, Part IV, line 6, 7, 8,, 10, 11a, 11, 11, 11d, 11e, 11f, 1a, or 1. Department of the Treasury Attah to Form 0. Internal Revenue Servie Go to for instrutions and the latest information. Name of the organization HOME HEALTH SECTION OF THE AMERICAN Part I a d a OMB Open to Puli Inspetion Employer identifiation numer PHYSICAL THERAPY ASSOCIATION, INC Organizations Maintaining Donor Advised Funds or Other Similar Funds or Aounts. Complete if the organization answered "" on Form 0, Part IV, line 6. (a) Donor advised funds () Funds and other aounts Total numer at end of year ~~~~~~~~~~~~~~~ Aggregate value of ontriutions to (during year) Aggregate value of grants from (during year) Aggregate value at end of year Complete lines a through d if the organization held a qualified onservation ontriution in the form of a onservation easement on the last day of the tax year. Held at the End of the Tax Year (i) (ii) ~~~~ ~~~~~~ ~~~~~~~~~~~~~ Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization s property, sujet to the organization s exlusive legal ontrol?~~~~~~~~~~~~~~~~~~ Did the organization inform all grantees, donors, and donor advisors in writing that grant funds an e used only for haritale purposes and not for the enefit of the donor or donor advisor, or for any other purpose onferring impermissile private enefit? Part II Conservation Easements. Complete if the organization answered "" on Form 0, Part IV, line 7. Purpose(s) of onservation easements held y the organization (hek all that apply). Preservation of land for puli use (e.g., rereation or eduation) Protetion of natural haitat Preservation of open spae Preservation of a historially important land area Preservation of a ertified histori struture Total numer of onservation easements ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total areage restrited y onservation easements ~~~~~~~~~~~~~~~~~~~~~~~~~~ Numer of onservation easements on a ertified histori struture inluded in (a) ~~~~~~~~~~~~ Numer of onservation easements inluded in () aquired after 7/5/06, and not on a histori struture listed in the National Register ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Numer of onservation easements modified, transferred, released, extinguished, or terminated y the organization during the tax year Numer of states where property sujet to onservation easement is loated Does the organization have a written poliy regarding the periodi monitoring, inspetion, handling of violations, and enforement of the onservation easements it holds? ~~~~~~~~~~~~~~~~~~~~~~~~~ Staff and volunteer hours devoted to monitoring, inspeting, handling of violations, and enforing onservation easements during the year Amount of expenses inurred in monitoring, inspeting, handling of violations, and enforing onservation easements during the year $ Does eah onservation easement reported on line (d) aove satisfy the requirements of setion 170(h)()(B)(i) and setion 170(h)()(B)(ii)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ In Part III, desrie how the organization reports onservation easements in its revenue and expense statement, and alane sheet, and inlude, if appliale, the text of the footnote to the organization s finanial statements that desries the organization s aounting for onservation easements. Part III Organizations Maintaining Colletions of Art, Historial Treasures, or Other Similar Assets. Complete if the organization answered "" on Form 0, Part IV, line 8. 1a If the organization eleted, as permitted under SFAS 116 (ASC 58), not to report in its revenue statement and alane sheet works of art, LHA historial treasures, or other similar assets held for puli exhiition, eduation, or researh in furtherane of puli servie, provide, in Part III, the text of the footnote to its finanial statements that desries these items. If the organization eleted, as permitted under SFAS 116 (ASC 58), to report in its revenue statement and alane sheet works of art, historial treasures, or other similar assets held for puli exhiition, eduation, or researh in furtherane of puli servie, provide the following amounts relating to these items: Revenue inluded on Form 0, Part VIII, line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ $ Assets inluded in Form 0, Part ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If the organization reeived or held works of art, historial treasures, or other similar assets for finanial gain, provide the following amounts required to e reported under SFAS 116 (ASC 58) relating to these items: Revenue inluded on Form 0, Part VIII, line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ $ Assets inluded in Form 0, Part Supplemental Finanial Statements For Paperwork Redution At tie, see the Instrutions for Form 0. Shedule D (Form 0) 017 a d $ $ 017

21 HOME HEALTH SECTION OF THE AMERICAN Shedule D (Form 0) 017 PHYSICAL THERAPY ASSOCIATION, INC Page Part III Organizations Maintaining Colletions of Art, Historial Treasures, or Other Similar Assets (ontinued) Using the organization s aquisition, aession, and other reords, hek any of the following that are a signifiant use of its olletion items 5 a d e f d e If "," explain the arrangement in Part III. Chek here if the explanation has een provided on Part III Part V Endowment Funds. Complete if the organization answered "" on Form 0, Part IV, line 10. d e f g a (i) (ii) (a) Current year () Prior year () Two years ak (d) Three years ak (e) Four years ak Desrie in Part III the intended uses of the organization s endowment funds. Part VI Land, Buildings, and Equipment. Complete if the organization answered "" on Form 0, Part IV, line 11a. See Form 0, Part, line 10. 1a d (hek all that apply): Puli exhiition Sholarly researh Preservation for future generations Loan or exhange programs Provide a desription of the organization s olletions and explain how they further the organization s exempt purpose in Part III. During the year, did the organization soliit or reeive donations of art, historial treasures, or other similar assets to e sold to raise funds rather than to e maintained as part of the organization s olletion? Part IV Esrow and Custodial Arrangements. Complete if the organization answered "" on Form 0, Part IV, line, or reported an amount on Form 0, Part, line 1. 1a Is the organization an agent, trustee, ustodian or other intermediary for ontriutions or other assets not inluded on Form 0, Part? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 1d 1e 1f a(i) a(ii) (a) Cost or other () Cost or other () Aumulated (d) Book value asis (investment) asis (other) depreiation e Other Total. Add lines 1a through 1e. (Column (d) must equal Form 0, Part, olumn (B), line 10.) Other If "," explain the arrangement in Part III and omplete the following tale: Beginning alane Additions during the year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Distriutions during the year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Ending alane ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ a Did the organization inlude an amount on Form 0, Part, line 1, for esrow or ustodial aount liaility? ~~~~~ 1a Beginning of year alane Contriutions ~~~~~~~~~~~~~~ Net investment earnings, gains, and losses Grants or sholarships Other expenditures for failities and programs Administrative expenses End of year alane ~~~~~~~ ~~~~~~~~~ ~~~~~~~~~~~~~ ~~~~~~~~ ~~~~~~~~~~ Provide the estimated perentage of the urrent year end alane (line 1g, olumn (a)) held as: Board designated or quasi-endowment % Permanent endowment % Temporarily restrited endowment % The perentages on lines a,, and should equal 1%. a Are there endowment funds not in the possession of the organization that are held and administered for the organization y: unrelated organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ related organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "" on line a(ii), are the related organizations listed as required on Shedule R? ~~~~~~~~~~~~~~~~~~~~ Desription of property Land ~~~~~~~~~~~~~~~~~~~~ Buildings ~~~~~~~~~~~~~~~~~~ Leasehold improvements ~~~~~~~~~~ Equipment ~~~~~~~~~~~~~~~~~ Amount 0. Shedule D (Form 0)

22 HOME HEALTH SECTION OF THE AMERICAN Shedule D (Form 0) 017 PHYSICAL THERAPY ASSOCIATION, INC Page Part VII Investments - Other Seurities. Complete if the organization answered "" on Form 0, Part IV, line 11. See Form 0, Part, line 1. (a) Desription of seurity or ategory (inluding name of seurity) () Book value () Method of valuation: Cost or end-of-year market value (1) Finanial derivatives ~~~~~~~~~~~~~~~ () Closely-held equity interests ~~~~~~~~~~~ () Other (A) WELLINGTON FUND ADMIRAL 17,056. END-OF-YEAR MARKET VALUE (B) (C) (D) (E) (F) (G) (H) Total. (Col. () must equal Form 0, Part, ol. (B) line 1.) 17,056. Part VIII Investments - Program Related. Complete if the organization answered "" on Form 0, Part IV, line 11. See Form 0, Part, line 1. (a) Desription of investment () Book value () Method of valuation: Cost or end-of-year market value (1) () () () (5) (6) (7) (8) () Total. (Col. () must equal Form 0, Part, ol. (B) line 1.) Part I Other Assets. Complete if the organization answered "" on Form 0, Part IV, line 11d. See Form 0, Part, line 15. (a) Desription () Book value (1) () () () (5) (6) (7) (8) () Total. (Column () must equal Form 0, Part, ol. (B) line 15.) Part Other Liailities. Complete if the organization answered "" on Form 0, Part IV, line 11e or 11f. See Form 0, Part, line (a) Desription of liaility () Book value (1) Federal inome taxes () () () (5) (6) (7) (8) () Total. (Column () must equal Form 0, Part, ol. (B) line 5.). Liaility for unertain tax positions. In Part III, provide the text of the footnote to the organization s finanial statements that reports the organization s liaility for unertain tax positions under FIN 8 (ASC 70). Chek here if the text of the footnote has een provided in Part III Shedule D (Form 0)

23 HOME HEALTH SECTION OF THE AMERICAN Shedule D (Form 0) 017 PHYSICAL THERAPY ASSOCIATION, INC Page Part I Reoniliation of Revenue per Audited Finanial Statements With Revenue per Return. Complete if the organization answered "" on Form 0, Part IV, line 1a. 1 Total revenue, gains, and other support per audited finanial statements Amounts inluded on line 1 ut not on Form 0, Part VIII, line 1: ~~~~~~~~~~~~~~~~~~~ 1 a Net unrealized gains (losses) on investments ~~~~~~~~~~~~~~~~~~ a Donated servies and use of failities ~~~~~~~~~~~~~~~~~~~~~~ Reoveries of prior year grants ~~~~~~~~~~~~~~~~~~~~~~~~~ d Other (Desrie in Part III.) ~~~~~~~~~~~~~~~~~~~~~~~~~~ d e Add lines a through d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ e Sutrat line e from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Amounts inluded on Form 0, Part VIII, line 1, ut not on line 1: a Investment expenses not inluded on Form 0, Part VIII, line 7 ~~~~~~~~ a Other (Desrie in Part III.) ~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines a and ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 Total revenue. Add lines and. (This must equal Form 0, Part I, line 1.) 5 Part II Reoniliation of Expenses per Audited Finanial Statements With Expenses per Return. Complete if the organization answered "" on Form 0, Part IV, line 1a. 1 Total expenses and losses per audited finanial statements ~~~~~~~~~~~~~~~~~~~~~~~~~~ Amounts inluded on line 1 ut not on Form 0, Part I, line 5: 1 a Donated servies and use of failities ~~~~~~~~~~~~~~~~~~~~~~ a Prior year adjustments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other losses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ d Other (Desrie in Part III.) ~~~~~~~~~~~~~~~~~~~~~~~~~~ d e Add lines a through d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ e Sutrat line e from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Amounts inluded on Form 0, Part I, line 5, ut not on line 1: a Investment expenses not inluded on Form 0, Part VIII, line 7 ~~~~~~~~ a Other (Desrie in Part III.) ~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines a and ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 Total expenses. Add lines and. (This must equal Form 0, Part I, line 18.) 5 Part III Supplemental Information. Provide the desriptions required for Part II, lines, 5, and ; Part III, lines 1a and ; Part IV, lines 1 and ; Part V, line ; Part, line ; Part I, lines d and ; and Part II, lines d and. Also omplete this part to provide any additional information Shedule D (Form 0) 017

24 SCHEDULE I (Form 0) Department of the Treasury Internal Revenue Servie Name of the organization Part I 1 Complete if the organization answered "" on Form 0, Part IV, line 1 or. Attah to Form 0. Go to for the latest information. HOME HEALTH SECTION OF THE AMERICAN OMB Open to Puli Inspetion Employer identifiation numer PHYSICAL THERAPY ASSOCIATION, INC General Information on Grants and Assistane Grants and Other Assistane to Organizations, Governments, and Individuals in the United States 017 Does the organization maintain reords to sustantiate the amount of the grants or assistane, the grantees eligiility for the grants or assistane, and the seletion riteria used to award the grants or assistane? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Desrie in Part IV the organization s proedures for monitoring the use of grant funds in the United States. Part II Grants and Other Assistane to Domesti Organizations and Domesti Governments. Complete if the organization answered "" on Form 0, Part IV, line 1, for any reipient that reeived more than $5,0. Part II an e dupliated if additional spae is needed. 1 (a) Name and address of organization () EIN () IRC setion (d) Amount of (e) Amount of (f) Method of (g) Desription of (h) Purpose of grant valuation (ook, or government (if appliale) ash grant non-ash nonash assistane or assistane FMV, appraisal, assistane other) FOUNDATION FOR PT 1111 N FAIRFA ST ALEANDRIA, VA C 7,0. 0. PHYSICAL THERAPY RESEARCH LHA Enter total numer of setion 501()() and government organizations listed in the line 1 tale ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Enter total numer of other organizations listed in the line 1 tale For Paperwork Redution At tie, see the Instrutions for Form 0. Shedule I (Form 0) (017)

25 HOME HEALTH SECTION OF THE AMERICAN Shedule I (Form 0) (017) PHYSICAL THERAPY ASSOCIATION, INC Part III Grants and Other Assistane to Domesti Individuals. Complete if the organization answered "" on Form 0, Part IV, line. Part III an e dupliated if additional spae is needed. Page (a) Type of grant or assistane () Numer of () Amount of (d) Amount of nonash (e) Method of valuation (f) Desription of nonash assistane reipients ash grant assistane (ook, FMV, appraisal, other) Part IV Supplemental Information. Provide the information required in Part I, line ; Part III, olumn (); and any other additional information Shedule I (Form 0) (017)

26 SCHEDULE O (Form 0 or 0-EZ) Department of the Treasury Internal Revenue Servie Name of the organization Supplemental Information to Form 0 or 0-EZ Complete to provide information for responses to speifi questions on Form 0 or 0-EZ or to provide any additional information. Attah to Form 0 or 0-EZ. Go to for the latest information. HOME HEALTH SECTION OF THE AMERICAN 017 OMB Open to Puli Inspetion Employer identifiation numer PHYSICAL THERAPY ASSOCIATION, INC FORM 0, PART VI, SECTION A, LINE 6: MEMBERS JOIN VOLUNTARILY, BUT MUST MEET PROFESSIONAL QUALIFICATIONS SINCE THIS ORGANIZATION SERVES PHYSICAL THERAPISTS, PHYSICAL THERAPIST ASSISTANTS, AND PHYSICAL THERAPY STUDENTS. FORM 0, PART VI, SECTION A, LINE 7A: VOTING MEMBERS ELECT THE GOVERNING OFFICERS. FORM 0, PART VI, SECTION B, LINE 11B: THE EECUTIVE DIRECTOR AND TREASURER REVIEW THE FORM 0 PRIOR TO FILING AND A COPY IS CIRCULATED TO THE GOVERNING BODY AND THE FINANCE COMMITTEE MEMBERS PRIOR TO FILING. FORM 0, PART VI, SECTION B, LINE 1C: THE POLICY IS REVIEWED AND DISCUSSED ANNUALLY AND SIGNED DISCLOSURES ARE REQUIRED ANNUALLY. POTENTIAL CONFLICTS ARE IDENTIFIED AND DISCUSSED ON AN ONGOING BASIS AS IDENTIFIED AND DISCLOSURES UPDATED AS NEEDED. FORM 0, PART VI, SECTION B, LINE 15A: THE ORGANIZATION CONTRACTS WITH AN ASSOCIATION MANAGEMENT COMPANY FOR MANAGEMENT. THE CONTRACT AND PROPOSED FEES ARE REVIEWED ANNUALLY BY THE GOVERNING BODY, NEGOTIATED, AND APPROVED BY THE GOVERNING BODY. AS NEEDED, THE GOVERNING BODY REVIEWS DATA FOR COMPARABLE ORGANIZATIONS AND MAY, AT ITS DISCRETION, SOLICIT PROPOSALS FROM OTHER MANAGEMENT ENTITIES. FORM 0, PART VI, SECTION C, LINE 1: LHA For Paperwork Redution At tie, see the Instrutions for Form 0 or 0-EZ. Shedule O (Form 0 or 0-EZ) (017)

27 Shedule O (Form 0 or 0-EZ) (017) Page Name of the organization HOME HEALTH SECTION OF THE AMERICAN Employer identifiation numer PHYSICAL THERAPY ASSOCIATION, INC GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE TO ORGANIZATION MEMBERS THROUGH THE WEBSITE. FINANCIAL STATEMENTS ARE MADE AVAILABLE TO MEMBERS ANNUALLY AT THE MEMBERSHIP MEETING AND POSTED TO THE WEBSITE FOR MEMBER ACCESS PRIOR TO THE MEETING Shedule O (Form 0 or 0-EZ) (017)

28 Form Department of the Treasury Internal Revenue Servie For alendar year 017 or other tax year eginning, and ending. Go to for instrutions and the latest information. Do not enter SSN numers on this form as it may e made puli if your organization is a 501()(). OMB Open to Puli Inspetion for 501()() Organizations Only Employer identifiation numer A Chek ox if Name of organization ( Chek ox if name hanged and see instrutions.) D (Employees trust, see address hanged HOME HEALTH SECTION OF THE AMERICAN instrutions.) B Exempt under setion Print PHYSICAL THERAPY ASSOCIATION, INC ( )( 6 ) or E Unrelated usiness ativity odes Numer, street, and room or suite no. If a P.O. ox, see instrutions. (See instrutions.) Type 08(e) 0(e) P.O. BO 55 Book value of all assets C F Group exemption numer (See instrutions.) at end of year 1,0. G Chek organization type 501() orporation 501() trust 01(a) trust Other trust H Desrie the organization s primary unrelated usiness ativity. NEWSLETTER AND WEBSITE ADVERTISING I During the tax year, was the orporation a susidiary in an affiliated group or a parent-susidiary ontrolled group? ~~~~~~ If "," enter the name and identifying numer of the parent orporation. J The ooks are in are of ROBIN CHILDERS Telephone numer Part I Unrelated Trade or Business Inome (A) Inome (B) Expenses (C) Net Less returns and allowanes Balane ~~~ 1 Other inome (See instrutions; attah shedule) ~~~~~~~~~~~~ 1 1 Total. Comine lines through 1 1,750., Part II Dedutions t Taken Elsewhere (See instrutions for limitations on dedutions.) (Exept for ontriutions, dedutions must e diretly onneted with the unrelated usiness inome.) T 08A 50(a) City or town, state or provine, ountry, and ZIP or foreign postal ode 5(a) MISSOULA, MT a Gross reeipts or sales Cost of goods sold (Shedule A, line 7) ~~~~~~~~~~~~~~~~~ Gross profit. Sutrat line from line 1 ~~~~~~~~~~~~~~~~ a Capital gain net inome (attah Shedule D) ~~~~~~~~~~~~~~~ Net gain (loss) (Form 77, Part II, line 17) (attah Form 77) ~~~~~~ Capital loss dedution for trusts ~~~~~~~~~~~~~~~~~~~~ Inome (loss) from partnerships and S orporations (attah statement) ~~~ Rent inome (Shedule C) ~~~~~~~~~~~~~~~~~~~~~~ Unrelated det-finaned inome (Shedule E) ~~~~~~~~~~~~~~ Interest, annuities, royalties, and rents from ontrolled organizations (Sh. F)~ Investment inome of a setion 501()(7), (), or (17) organization (Shedule G) Exploited exempt ativity inome (Shedule I) ~~~~~~~~~~~~~~ Advertising inome (Shedule J) ~~~~~~~~~~~~~~~~~~~~ Compensation of offiers, diretors, and trustees (Shedule K) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Salaries and wages ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Repairs and maintenane Bad dets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Interest (attah shedule) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Taxes and lienses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Charitale ontriutions (See instrutions for limitation rules) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Depreiation (attah Form 56) Less depreiation laimed on Shedule A and elsewhere on return Depletion Contriutions to deferred ompensation plans ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total dedutions. Add lines 1 through 8 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unrelated usiness taxale inome. Sutrat line from line. If line is greater than line, enter the smaller of zero or line For Paperwork Redution At tie, see instrutions. 1 a ~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Employee enefit programs ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Exess exempt expenses (Shedule I) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Exess readership osts (Shedule J) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other dedutions (attah shedule) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unrelated usiness taxale inome efore net operating loss dedution. Sutrat line from line 1 ~~~~~~~~~~~~ Net operating loss dedution (limited to the amount on line 0) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE STATEMENT 1 Unrelated usiness taxale inome efore speifi dedution. Sutrat line 1 from line 0 ~~~~~~~~~~~~~~~~~ Speifi dedution (Generally $1,0, ut see line instrutions for exeptions) ~~~~~~~~~~~~~~~~~~~~~ LHA ETENDED TO NOVEMBER 15, 018 Exempt Organization Business Inome Tax Return (and proxy tax under setion 60(e)) 1 a ,0.,1. -,1., ,86. 1,86. 1,86. -,1. -,1. 1,0. -,1. Form 0-T (017)

29 HOME HEALTH SECTION OF THE AMERICAN Form 0-T (017) PHYSICAL THERAPY ASSOCIATION, INC Part III Tax Computation 5 Organizations Taxale as Corporations. See instrutions for tax omputation a Controlled group memers (setions 1561 and 156) hek here See instrutions and: (1) $ () $ () $ Enter organization s share of: (1) Additional 5% tax (not more than $11,750) $ () Additional % tax (not more than $1,0) ~~~~~~~~~~~~~ $ Trusts Taxale at Trust Rates. See instrutions for tax omputation. Inome tax on the amount on line from: Proxy tax. See instrutions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 0 Tax on n-compliant Faility Inome. See instrutions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total. Add lines 7, 8 and to line 5 or 6, whihever applies Part IV Tax and Payments 1a Foreign tax redit (orporations attah Form 1118; trusts attah Form 1116) ~~~~~~~~ 1a d e Total redits. Add lines 1a through 1d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other taxes. Chek if from: Form 55 Form 8611 Form 867 Form 8866 Other (attah shedule) Total tax. Add lines and ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 a Payments: A 016 overpayment redited to 017 ~~~~~~~~~~~~~~~~~~~ estimated tax payments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax deposited with Form 8868 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ d Foreign organizations: Tax paid or withheld at soure (see instrutions) ~~~~~~~~~~ f g Other redits and payments: Total payments. Add lines 5a through 5g ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6 Tax due. If line 6 is less than the total of lines and 7, enter amount owed ~~~~~~~~~~~~~~~~~~~ Overpayment. If line 6 is larger than the total of lines and 7, enter amount overpaid ~~~~~~~~~~~~~~ 50 Enter the amount of line you want: Credited to 018 estimated tax Refunded Part V Statements Regarding Certain Ativities and Other Information (see instrutions) 51 At any time during the 017 alendar year, did the organization have an interest in or a signature or other authority 5 5 Sign Here Enter your share of the $50,0, $5,0, and $,5,0 taxale inome rakets (in that order): Inome tax on the amount on line ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax rate shedule or Shedule D (Form 101) ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Alternative minimum tax Other redits (see instrutions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~ General usiness redit. Attah Form 8 ~~~~~~~~~~~~~~~~~~~~~~ Credit for prior year minimum tax (attah Form 8801 or 887) ~~~~~~~~~~~~~~ Sutrat line 1e from line 0 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ e Bakup withholding (see instrutions) ~~~~~~~~~~~~~~~~~~~~~~~~ Credit for small employer health insurane premiums (Attah Form 81) Form ~~~~~~~~ Form 16 Other Total Estimated tax penalty (see instrutions). Chek if Form 0 is attahed ~~~~~~~~~~~~~~~~~~~ over a finanial aount (ank, seurities, or other) in a foreign ountry? If YES, the organization may have to file FinCEN Form 11, Report of Foreign Bank and Finanial Aounts. If YES, enter the name of the foreign ountry here During the tax year, did the organization reeive a distriution from, or was it the grantor of, or transferor to, a foreign trust? ~~~~~~~~~ If YES, see instrutions for other forms the organization may have to file. Enter the amount of tax-exempt interest reeived or arued during the tax year $ Under penalties of perjury, I delare that I have examined this return, inluding aompanying shedules and statements, and to the est of my knowledge and elief, it is true, orret, and omplete. Delaration of preparer (other than taxpayer) is ased on all information of whih preparer has any knowledge. = = TREASURER Signature of offier Date Title Print/Type preparer s name Preparer s signature Date Chek 1 1 1d 5a 5 5 5d 5e 5f 5g e Page May the IRS disuss this return with the preparer shown elow (see instrutions)? self- employed Paid DREW RIEKER, CPA P01776 Preparer Firm s name JUNKERMIER,CLARK,CAMPANELLA,STEVENS PC Firm s EIN Use Only P.O. BO 167 Firm s address MISSOULA, MT 5808 Phone no Form 0-T (017) if PTIN

30 Form 0-T (017) HOME HEALTH SECTION OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION, INC Page Shedule A - Cost of Goods Sold. Enter method of inventory valuation N/A 1 Inventory at eginning of year ~~~ 1 6 Inventory at end of year ~~~~~~~~~~~~ 6 Purhases ~~~~~~~~~~~ 7 Cost of goods sold. Sutrat line 6 Cost of laor~~~~~~~~~~~ from line 5. Enter here and in Part I, a Additional setion 6A osts line ~~~~~~~~~~~~~~~~~~~~ 7 (attah shedule) ~~~~~~~~ a 8 Do the rules of setion 6A (with respet to Other osts (attah shedule) ~~~ property produed or aquired for resale) apply to 5 Total. Add lines 1 through 5 the organization? Shedule C - Rent Inome (From Real Property and Personal Property Leased With Real Property) (see instrutions) 1. Desription of property (1) () () () (1) () () (a). From personal property (if the perentage of rent for personal property is more than 10% ut not more than 50%) Rent reeived or arued () From real and personal property (if the perentage of rent for personal property exeeds 50% or if the rent is ased on profit or inome) (a) Dedutions diretly onneted with the inome in olumns (a) and () (attah shedule) () Total 0. Total 0. () Total inome. Add totals of olumns (a) and (). Enter () Total dedutions. Enter here and on page 1, here and on page 1, Part I, line 6, olumn (A) 0. Part I, line 6, olumn (B) 0. Shedule E - Unrelated Det-Finaned Inome (see instrutions). Dedutions diretly onneted with or alloale. Gross inome from to det-finaned property 1. Desription of det-finaned property or alloale to detfinaned property (a) Straight line depreiation () Other dedutions (attah shedule) (attah shedule) (1) () () () (1) () () (). Amount of average aquisition 5. Average adjusted asis 6. Column divided 7. Gross inome 8. Alloale dedutions det on or alloale to det-finaned of or alloale to y olumn 5 reportale (olumn (olumn 6 x total of olumns property (attah shedule) det-finaned property x olumn 6) (a) and ()) (attah shedule) Enter here and on page 1, Part I, line 7, olumn (A). Enter here and on page 1, Part I, line 7, olumn (B). Totals ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total dividends-reeived dedutions inluded in olumn 8 0. % % % % Form 0-T (017)

31 HOME HEALTH SECTION OF THE AMERICAN Form 0-T (017) PHYSICAL THERAPY ASSOCIATION, INC Shedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations (see instrutions) Exempt Controlled Organizations 1. Name of ontrolled organization. Employer. Net unrelated inome. Total of speified 5. Part of olumn that is 6. Dedutions diretly identifiation (loss) (see instrutions) payments made inluded in the ontrolling onneted with inome numer organization s gross inome in olumn 5 Page (1) () () () nexempt Controlled Organizations 7. Taxale Inome 8. Net unrelated inome (loss). Total of speified payments 10. Part of olumn that is inluded 11. Dedutions diretly onneted (see instrutions) made in the ontrolling organization s with inome in olumn 10 gross inome (1) () () () Totals J Shedule G - Investment Inome of a Setion 501()(7), (), or (17) Organization (see instrutions) (1) () () () 1. Desription of inome. Amount of inome Enter here and on page 1, Part I, line 10, ol. (A). Enter here and on page 1, Part I, line 10, ol. (B). Enter here and on page 1, Part I, line, olumn (A). Add olumns 5 and 10. Enter here and on page 1, Part I, line 8, olumn (A). Add olumns 6 and 11. Enter here and on page 1, Part I, line 8, olumn (B).. Dedutions Total dedutions diretly onneted. Set-asides 5. and set-asides (attah shedule) (attah shedule) (ol. plus ol. ) 5. Gross inome 6. Expenses from ativity that attriutale to is not unrelated olumn 5 usiness inome Enter here and on page 1, Part I, line, olumn (B). Totals Shedule I - Exploited Exempt Ativity Inome, Other Than Advertising Inome (see instrutions) Net inome (loss) Expenses... Gross from unrelated trade or diretly onneted 1. Desription of unrelated usiness usiness (olumn with prodution exploited ativity inome from minus olumn ). If a of unrelated trade or usiness gain, ompute ols. 5 usiness inome STMT through 7. (1) WEBSITE () ADVERTISING 1,0.,1. -,1. () () Exess exempt expenses (olumn 6 minus olumn 5, ut not more than olumn ). Enter here and on page 1, Part II, line 6. Totals 1,0.,1. 0. Shedule J - Advertising Inome (see instrutions) Part I Inome From Periodials Reported on a Consolidated Basis Name of periodial Totals (arry to Part II, line (5)). Gross. Diret advertising advertising osts inome. Advertising gain or (loss) (ol. minus ol. ). If a gain, ompute ols. 5 through Cirulation 6. Readership inome osts (1) THE QUARTERLY () REPORT, ,61. 6,15. () () 7. Exess readership osts (olumn 6 minus olumn 5, ut not more than olumn )., ,86.,61. 6,15. 1,86. Form 0-T (017)

32 HOME HEALTH SECTION OF THE AMERICAN Form 0-T (017) PHYSICAL THERAPY ASSOCIATION, INC Part II Inome From Periodials Reported on a Separate Basis (For eah periodial listed in Part II, fill in olumns through 7 on a line-y-line asis.) (1) () () () Totals from Part I 1. Name of periodial. Gross. Diret advertising advertising osts inome Enter here and on page 1, Part I, line 11, ol. (A). Enter here and on page 1, Part I, line 11, ol. (B).. Advertising gain or (loss) (ol. minus ol. ). If a gain, ompute ols. 5 through Cirulation 6. Readership inome osts 7. Exess readership osts (olumn 6 minus olumn 5, ut not more than olumn ). Enter here and on page 1, Part II, line 7. Totals, Part II (lines 1-5), ,86. Shedule K - Compensation of Offiers, Diretors, and Trustees (see instrutions). Perent of. Compensation attriutale Title time devoted to 1. Name. to unrelated usiness usiness (1) () (), ,86. () Total. Enter here and on page 1, Part II, line 1 % % % % Page 5 0. Form 0-T (017)

33 HOME HEALTH SECTION OF THE AMERICAN PHYS }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-T NET OPERATING LOSS DEDUCTION STATEMENT 1 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} LOSS PREVIOUSLY LOSS AVAILABLE TA YEAR LOSS SUSTAINED APPLIED REMAINING THIS YEAR }}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} 1/1/16,. 0.,. }}}}}}}}}}}}}},. }}}}}}}}}}}}}} NOL CARRYOVER AVAILABLE THIS YEAR,.,. ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-T SCHEDULE I - EPENSES DIRECTLY CONNECTED WITH STATEMENT PRODUCTION OF UNRELATED BUSINESS INCOME }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} ACTIVITY DESCRIPTION NUMBER AMOUNT TOTAL }}}}}}}}}}} }}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}} , COMMISIONS, STAFF TIME, ETC.,1. - SUBTOTAL - 1,1. }}}}}}}}}}}}} TOTAL OF FORM 0-T, SCHEDULE I, COLUMN,1. ~~~~~~~~~~~~~ STATEMENT(S) 1,

34 Form (Rev. January 017) Department of the Treasury Internal Revenue Servie Type or print File y the due date for filing your return. See instrutions. Appliation Is For a File a separate appliation for eah return. Information aout Form 8868 and its instrutions is at Eletroni filing (e-file). You an eletronially file Form 8868 to request a 6-month automati extension of time to file any of the forms listed elow with the exeption of Form 8870, Information Return for Transfers Assoiated With Certain Personal Benefit Contrats, for whih an extension request must e sent to the IRS in paper format (see instrutions). For more details on the eletroni filing of this form, visit lik on Charities & n-profits, and lik on e-file for Charities and n-profits. All orporations required to file an inome tax return other than Form 0-T (inluding 110-C filers), partnerships, REMICs, and trusts must use Form 7 to request an extension of time to file inome tax returns. Return Code Appliation Is For Balane due. Sutrat line from line a. Inlude your payment with this form, if required, Enter filer s identifying numer Caution: If you are going to make an eletroni funds withdrawal (diret deit) with this Form 8868, see Form 85-EO and Form 887-EO for payment instrutions. LHA For Privay At and Paperwork Redution At tie, see instrutions. Form 8868 (Rev ) a $ $ $ OMB Name of exempt organization or other filer, see instrutions. Employer identifiation numer (EIN) or HOME HEALTH SECTION OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION, INC Numer, street, and room or suite no. If a P.O. ox, see instrutions. P.O. BO 55 City, town or post offie, state, and ZIP ode. For a foreign address, see instrutions. MISSOULA, MT 5806 Soial seurity numer (SSN) Enter the Return Code for the return that this appliation is for (file a separate appliation for eah return) Form 0 or Form 0-EZ Form 0-BL Form 70 (individual) Form 0-PF 8868 Appliation for Automati Extension of Time To File an Exempt Organization Return Automati 6-Month Extension of Time. Only sumit original (no opies needed). Form 0-T (se. 01(a) or 08(a) trust) Form 0-T (trust other than aove) 06 Form 8870 ROBIN CHILDERS The ooks are in the are of PO BO 55 - MISSOULA, MT 5806 Telephone Fax Return Code Form 0-T (orporation) 07 Form 101-A Form 70 (other than individual) Form 57 Form 606 If the organization does not have an offie or plae of usiness in the United States, hek this ox~~~~~~~~~~~~~~~~~ If this is for a Group Return, enter the organization s four digit Group Exemption Numer (GEN). If this is for the whole group, hek this ox. If it is for part of the group, hek this ox and attah a list with the names and EINs of all memers the extension is for. 1 I request an automati 6-month extension of time until NOVEMBER 15, 018, to file the exempt organization return for the organization named aove. The extension is for the organization s return for: alendar year017 or tax year eginning, and ending. If the tax year entered in line 1 is for less than 1 months, hek reason: Initial return Final return Change in aounting period If this appliation is for Forms 0-BL, 0-PF, 0-T, 70, or 606, enter the tentative tax, less any nonrefundale redits. See instrutions. If this appliation is for Forms 0-PF, 0-T, 70, or 606, enter any refundale redits and estimated tax payments made. Inlude any prior year overpayment allowed as a redit. y using EFTPS (Eletroni Federal Tax Payment System). See instrutions MAIL TO: DEPARTMENT OF THE TREASURY INTERNAL REVENUE SERVICE CENTER OGDEN, UT

35 Form (Rev. January 017) Department of the Treasury Internal Revenue Servie Type or print File y the due date for filing your return. See instrutions. Appliation Is For a File a separate appliation for eah return. Information aout Form 8868 and its instrutions is at Eletroni filing (e-file). You an eletronially file Form 8868 to request a 6-month automati extension of time to file any of the forms listed elow with the exeption of Form 8870, Information Return for Transfers Assoiated With Certain Personal Benefit Contrats, for whih an extension request must e sent to the IRS in paper format (see instrutions). For more details on the eletroni filing of this form, visit lik on Charities & n-profits, and lik on e-file for Charities and n-profits. All orporations required to file an inome tax return other than Form 0-T (inluding 110-C filers), partnerships, REMICs, and trusts must use Form 7 to request an extension of time to file inome tax returns. Return Code Appliation Is For Balane due. Sutrat line from line a. Inlude your payment with this form, if required, Enter filer s identifying numer Caution: If you are going to make an eletroni funds withdrawal (diret deit) with this Form 8868, see Form 85-EO and Form 887-EO for payment instrutions. LHA For Privay At and Paperwork Redution At tie, see instrutions. Form 8868 (Rev ) a $ $ $ OMB Name of exempt organization or other filer, see instrutions. Employer identifiation numer (EIN) or HOME HEALTH SECTION OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION, INC Numer, street, and room or suite no. If a P.O. ox, see instrutions. P.O. BO 55 City, town or post offie, state, and ZIP ode. For a foreign address, see instrutions. MISSOULA, MT 5806 Soial seurity numer (SSN) Enter the Return Code for the return that this appliation is for (file a separate appliation for eah return) Form 0 or Form 0-EZ Form 0-BL Form 70 (individual) Form 0-PF 8868 Appliation for Automati Extension of Time To File an Exempt Organization Return Automati 6-Month Extension of Time. Only sumit original (no opies needed). Form 0-T (se. 01(a) or 08(a) trust) Form 0-T (trust other than aove) 06 Form 8870 ROBIN CHILDERS The ooks are in the are of PO BO 55 - MISSOULA, MT 5806 Telephone Fax Return Code Form 0-T (orporation) 07 Form 101-A Form 70 (other than individual) Form 57 Form 606 If the organization does not have an offie or plae of usiness in the United States, hek this ox~~~~~~~~~~~~~~~~~ If this is for a Group Return, enter the organization s four digit Group Exemption Numer (GEN). If this is for the whole group, hek this ox. If it is for part of the group, hek this ox and attah a list with the names and EINs of all memers the extension is for. 1 I request an automati 6-month extension of time until NOVEMBER 15, 018, to file the exempt organization return for the organization named aove. The extension is for the organization s return for: alendar year017 or tax year eginning, and ending. If the tax year entered in line 1 is for less than 1 months, hek reason: Initial return Final return Change in aounting period If this appliation is for Forms 0-BL, 0-PF, 0-T, 70, or 606, enter the tentative tax, less any nonrefundale redits. See instrutions. If this appliation is for Forms 0-PF, 0-T, 70, or 606, enter any refundale redits and estimated tax payments made. Inlude any prior year overpayment allowed as a redit. y using EFTPS (Eletroni Federal Tax Payment System). See instrutions MAIL TO: DEPARTMENT OF THE TREASURY INTERNAL REVENUE SERVICE CENTER OGDEN, UT

36 Form CIT Staples! 017 Montana Corporate Inome Tax Return Inlude a opy of federal Form 110 as filed with the Internal Revenue Servie C Name For alendar year 017 or tax year eginning and ending HOME HEALTH SECTION OF THE AMERICAN PHYSICA FEIN Mailing Address Federal Business Code/NAICS 518 PO BO State Inorporated in on City State ZIP + Date Qualified in Montana 1117 MISSOULA MT 5806 D MT Seretary of State ID Mark all that apply: Offie Use Only Initial Return Final Return Amended Return Refund Return Part I - Filing Method Mark this ox if you are exempt from tax under the provision of Puli Law If marked, Shedule K must e ompleted and inluded with your tax return; skip questions through 5 of this part. Are you a memer (parent or susidiary) of a onsolidated group for federal purposes? ~~~~~~~~~~~~~~ Are you filing a omined return for Montana purposes? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "," enter the numer of entities with Montana ativity inluded in this tax return. If you answered "" to questions or aove, then mark one of the following filing methods and inlude Shedule M: a. Separate Company d. Domesti Comination. Separate Aounting e. Limited Comination. Worldwide Comination f. Water's Edge (You must have a valid eletion and Shedule WE must e inluded.) If you answered "" to questions or aove, you must inlude pages 1 through 5 of the parent's onsolidated federal Form 110 that you filed with the Internal Revenue Servie, and enter: a. Ultimate U.S. parent's name as reported on federal tax return. Ultimate U.S. parent's FEIN Part II - Amended Return Only. Mark all that apply. a. Federal Revenue Agent Report; inlude a omplete opy of this report.. NOL arryak/arryforward; list year(s) of loss.. Apportionment fator hanges; inlude a statement explaining all adjustments in detail. d. Amended federal tax return (Form 110); inlude a omplete opy of the federal Form 110. e. Appliation and/or hange in tax redit; list type of redit eing laimed. f. Other; inlude a statement explaining all adjustments in detail. Part III - General Questions. All questions must e answered. a.. Desrie in detail the nature and loation(s) of your Montana ativities (if neessary, provide the desription on an additional page). Is this your orporation's first Montana tax return? MISSOULA - PHYSCIAL THERAPY ASSOCIATION ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If this orporation is a suessor to a previously existing usiness, enter the predeessor's information: Name FEIN MONTANA e-file File online at revenue.mt.gov CCH A1

37 HOME HEALTH SECTION OF THE AMERICAN PHYS Form CIT, Page Period End Date FEIN Part III - ontinued. Is this your orporation's final Montana tax return? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "," please inlude detailed statement and indiate whether your orporation has: Withdrawn Merged Dissolved Reorganized Date of withdrawal, dissolution, merger, or reorganization If appliale, enter the suessor's name FEIN d. e. For any tax period(s), has the Internal Revenue Servie issued an offiial notie of hange or orretion that you have not filed with the Montana Department of Revenue? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "," indiate what period(s) Are any statute of limitation waivers urrently in fore that have een exeuted with the Internal Revenue Servie? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "," whih taxale year(s) is overed and what is the expiration date(s) of the waiver(s)? f. g. h. i. j. k. l. Have you filed an amended federal tax return for any of the last five taxale periods? If "," for whih years have you filed amended Montana returns? Did an individual at the end of the taxale year own, diretly or indiretly, 50% or more of the voting stok ~~~~~~~~~~~~~~~~ of this orporation? If "," enter name and % of ownership Did a partnership, orporation, estate or trust at the end of the taxale year own, diretly or indiretly, 50% or more of the voting stok of this orporation? If "," enter name and % of ownership If the answer to question (g) or (h) is "," did the same individual, partnership, orporation, estate or trust at the end of the taxale year also own, diretly or indiretly, 50% or more of the voting stok of another (rother-sister) orporation? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did this orporation or any memer of the onsolidated group own, diretly or indiretly, 50% or more of the outstanding voting stok of a domesti orporation that is not inluded in the onsolidated group? ~~~~~~~~~ Did this orporation or any memer of the onsolidated group own, diretly or indiretly, 50% or more of the outstanding voting stok of a foreign orporation? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Was your orporation owned 50% or more, diretly or indiretly, y a orporation or entity that was organized or inorporated outside the U.S.? If "," enter foreign entity's name and % of ownership If you answered "" to any of the aove questions (h) through (l), you need to omplete and inlude Shedule M. Part IV - Reporting of Speial Transations. Mark "" if you filed any of the following forms with the Internal Revenue Servie. You will need to inlude with a. your Montana tax return a omplete opy of any of these appliale forms. I filed federal Form 818- Material Advisor Dislosure Statement with the Internal Revenue Servie. Form 818 is required to e filed y material advisors to any reportale transations.. I filed federal Form 88 - Like-Kind Exhanges with the Internal Revenue Servie. Mark "" if your like-kind exhange inludes Montana property. Form 88 is used to report eah exhange of usiness or investment property for property of a like-kind.. I filed federal Form Return of U.S. Persons With Respet to Certain Foreign Partnerships with the Internal Revenue Servie. Form 8865 is used to report the information required under 6 USC 608 (reporting with respet to ontrolled foreign partnerships), Setion 608B (reporting of transfers to foreign partnerships), or Setion 606A (reporting of aquisitions, dispositions, and hanges in foreign partnership interest). d. I filed federal Form Reportale Transation Dislosure Statement with the Internal Revenue Servie. e. Form 8886 is used to dislose information for eah reportale transation in whih you partiipated. I filed federal Shedule UTP - Unertain Tax Position Statement with the Internal Revenue Servie. Shedule UTP is used to dislose unertain tax positions CCH A1

38 HOME HEALTH SECTION OF THE AMERICAN PHYS Form CIT, Page Period End Date FEIN Computation of Montana Taxale Inome and Net Amount Due 1. Taxale inome reported on your federal tax return (line 8) (inlude a opy of signed federal Form 110) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1.. Additions a... d. e. f. g. h. i. State, loal, foreign and franhise taxes ased on inome (inlude reakdown of your Form 110, line 17) ~~~~~~~~~~~~~~~ a. Federal tax exempt interest ~~~~~~~~~~~~~~~~~~~~ Contriutions used to ompute qualified endowment redit ~~~~~ Inome/loss of foreign parent and foreign susidiaries for worldwide omined filers ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Inome/loss of unitary orporations not inluded in federal onsolidated return ~~~~~~~~~~~~~~~~~~~~~~~~ Deemed dividends - Water's Edge filers only (inlude Shedule WE) Inome/loss of orporations inorporated in tax havens - Water's Edge filers only ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Federal apital loss arry-over utilized on federal return (inlude Shedule D) All of your other additions (inlude a detailed reakdown) Add lines a through i and enter the result. This is the total of your additions. ~~~~~~~~~~~~.. Redutions a... d. e. f. g.. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines a through g and enter the result. This is the total of your redutions. ~~~~~~~~~~~. Add lines 1 and, then sutrat line and enter the result. This is your adjusted taxale inome. ~~~ ~ ~~~~~~ IRC Setion dividend reeived dedution ~~~~~~~~~~~ a. nusiness inome (inlude a detailed reakdown) Montana reyling dedution (inlude Form RCYL) Inome/loss of nonunitary orporations inluded in federal ~~~~~~~~ ~~~~~~~~~ onsolidated return ~~~~~~~~~~~~~~~~~~~~~~~~ Inome/loss of 80/0 ompanies - Water's Edge filers only ~~~~~ Capital loss inurred in urrent year (inlude federal Shedule D) ~~ All of your other redutions (inlude a detailed reakdown) ~~~~~.. d. e. f. g. h. i... d. e. f. g Inome apportioned to Montana (multiply line % from Shedule K, line 5) ~~~ Comined filers must use the Shedule K inluded on page 5 of Form CIT. Enter the inome that you alloated diretly to Montana (inlude a detailed reakdown) ~~~~~~~~~ Montana taxale inome efore net operating loss (add lines 5 and 6 or enter amount reported on line ) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If line 7 is a loss, do you wish to forego the net operating loss arry-ak provision? te: If you have reported a loss on line 7 and have not marked either ox, the loss has to e arried ak first. STMT 1 Enter your Montana net operating loss arried over to this period (inlude a detailed shedule) ~~~~~ Sutrat line 8 from line 7 and enter the result here. This is your Montana taxale inome. ~~~~~~~. Multiply line y 6.75% (or line y 7% if you have a valid Water's Edge eletion). This is your Montana tax liaility. (This amount annot e less than the minimum tax liaility of $50.) ~~~~~~~~ Mark this ox if you are alulating your tax liaility using the Alternative Tax method (please see the Form CIT instrutions efore heking this ox). Questions? Call us at (06) -6, or TDD (06) -80 for hearing impaired CCH A1

39 HOME HEALTH SECTION OF THE AMERICAN PHYS Form CIT, Page Period End Date FEIN Computation of Montana Taxale Inome and Net Amount Due (ontinued) Payments 1a d. 1e. 1f. 1g Your Montana tax liaility from line 10 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ overpayment Tentative payment Add lines 1a through 1f and sutrat line 1g; enter the result. This is the total of your payments. ~~~ 1. Add lines 1 and 1, then sutrat from line 11 and enter result. This is your tax due or overpayment. ~~ 1. Add lines 1 and 15; enter the result. This is your net tax due or overpayment. ~~~~~~~~~~~~~~ Penalty 1a a. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1a. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Quarterly estimated tax payments ~~~~~~~~~~~~~~~~~~~~~~ 1. Montana mineral royalty tax withheld (inlude Form(s) 10) ~~~~~~~~~ 1d. Montana tax withheld from pass-through entities (inlude MT Shedule(s) K-1) ~ 1e. All other payments. Desrie. ~ 1f. Previously issued refunds. (Do not inlude any overpayments to 018.) ~~~~ 1g. Enter total redits (from Shedule C) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Enter the amount of overpayment that you want to e applied to your 018 estimated tax ~~~~~~~~~ 15. Enter interest on all the tax paid after the due date, alulated at 1% per year, on a daily asis ~~~~~~ 17. Enter estimated tax underpayment interest (inlude Form CIT-UT) ~~~~~~~~~~~~~~~~~~~~~ 18. Mark this ox if you are using the annualized inome or adjusted seasonal inome method. Enter your late filing penalty (see instrutions) ~~~~~~~~~~~~~~~~ 1a. Enter your late payment penalty (see instrutions) ~~~~~~~~~~~~~~~ 1. Add lines 1a and 1; enter the result. This is your total penalty. ~~~~~~~~~~~~~~~~~~~~ 1. Add lines 16 through 1; enter the result on line 0a or 0 elow. If the result is positive, enter the amount due here. This is your total amount due. ~~~~~~~~~~~ 0a. Visit our wesite at revenue.mt.gov for eletroni payment options or inlude your remittane payale to Montana Department of Revenue. 0. If the result is negative, enter the refund due here. This is your total refund. ~~~~~~~~~~~~~~ For Diret Deposit of your refund, omplete 1,, and. 1. RTN#. ACCT#. If using diret deposit, you are required to mark one ox. Cheking Savings. Is this refund going to an aount that is loated outside of the United States or its territories? Paid preparer information. Please print. Name Address City, State and ZIP Contat's Name JUNKERMIER,CLARK,CAMPANELLA,STEVENS PC P.O. BO 167 MISSOULA MT 5808 PTIN, SSN or FEIN Date Telephone Numer May the DOR disuss this return with your tax preparer?* * If you would like to authorize a representative to disuss tax matters with the department, you must omplete a Power of Attorney form. This form is availale on our wesite at revenue.mt.gov Delaration - Under penalties of false swearing, I delare that I have examined this return, inluding aompanying shedules and statements, and to the est of my knowledge and elief, it is true, orret, and omplete. Signature of Offier Date Telephone Numer Printed Name of Offier Title TREASURER Please mail your ompleted Form CIT to: Montana Department of Revenue, PO Box 801, Helena, MT CCH A1