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SCHEDULE R
(Form 990)
Related Organizations and Unrelated Partnerships
©
2009
Complete if the organization answered “Yes” to Form 990, Part IV, line 33, 34, 35, 36, or 37.
©
Department of the Treasury
Internal Revenue Service
Attach to Form 990.
©
Open to Public
Inspection
See separate instructions.
Employer identification number
Name of the organization
Part I
Identification of Disregarded Entities (Complete if the organization answered “Yes” to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity
Part II
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
Identification of Related Tax–Exempt Organizations (Complete if the organization answered “Yes” to Form 990, Part IV, line 34 because it
had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization
(b)
Primary activity
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
Cat. No. 50135Y
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
Schedule R (Form 990) 2009
Schedule R (Form 990) 2009
Part III
2
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered “Yes” to Form 990, Part IV, line 34
because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization
Part IV
Page
(b)
Primary activity
(c)
Legal
domicile
(state or
foreign
country)
(d)
Direct controlling
entity
(e)
Predominant
income (related,
unrelated,
excluded from
tax under
sections
512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproportionate
allocations?
(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
Yes No
(j)
General or
managing
partner?
Yes No
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered “Yes” to Form 990, Part IV,
line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile
(state or
foreign country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of
end-of-year assets
(h)
Percentage
ownership
Schedule R (Form 990) 2009
Schedule R (Form 990) 2009
Part V
Page
3
Transactions With Related Organizations (Complete if the organization answered “Yes” to Form 990, Part IV, line 34, 35, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
1 During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II–IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity
b Gift, grant, or capital contribution to other organization(s)
c Gift, grant, or capital contribution from other organization(s)
d Loans or loan guarantees to or for other organization(s)
e Loans or loan guarantees by other organization(s)
Yes
No
1a
1b
1c
1d
1e
f
g
h
i
Sale of assets to other organization(s)
Purchase of assets from other organization(s)
Exchange of assets
Lease of facilities, equipment, or other assets to other organization(s)
1f
1g
1h
1i
j
k
l
m
n
Lease of facilities, equipment, or other assets from other organization(s)
Performance of services or membership or fundraising solicitations for other organization(s)
Performance of services or membership or fundraising solicitations by other organization(s)
Sharing of facilities, equipment, mailing lists, or other assets
Sharing of paid employees
1j
1k
1l
1m
1n
1o
1p
o Reimbursement paid to other organization for expenses
p Reimbursement paid by other organization for expenses
1q
q Other transfer of cash or property to other organization(s)
r Other transfer of cash or property from other organization(s)
1r
2 If the answer to any of the above is “Yes,” see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type (a–r)
(c)
Amount involved
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2009
Schedule R (Form 990) 2009
Part VI
Page
4
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered “Yes” to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets
or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Are all partners
section
501(c)(3)
organizations?
Yes
No
(e)
Share of
end-of-year
assets
(f)
Disproportionate
allocations?
Yes No
(g)
Code V—UBI
amount in box 20
of Schedule K-1
(Form 1065)
(h)
General or
managing
partner?
Yes
No
Schedule R (Form 990) 2009
File Type | application/pdf |
File Title | 2009 Form 990 (Schedule R) |
Subject | Fillable |
Author | SE:W:CAR:MP |
File Modified | 2010-02-03 |
File Created | 2010-02-03 |