Schedule R-1 (F 99 Continuation Sheet for Schedule R

OMB No. 1545-0047

SCHEDULE R-1
(Form 990)

Continuation Sheet for Schedule R (Form 990)

2009

©

Attach to Form 990 to list additional information for Schedule R
(Form 990), Part I; Part II; Part III; Part IV; Part V, line 2; or Part VI.

Department of the Treasury
Internal Revenue Service

©

Open to Public
Inspection

See instructions for Schedule R (Form 990).

Employer identification number

Name of filing organization

Part I

Continuation of Identification of Disregarded Entities
(a)
Name, address, and EIN of disregarded entity

(b)
Primary activity

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

(c)
Legal domicile (state
or foreign country)

Cat. No. 51055Z

(d)
Total income

(e)
End-of-year assets

(f)
Direct controlling
entity

Schedule R-1 (Form 990) 2009

Schedule R-1 (Form 990) 2009

Part II

Page

2

Continuation of Identification of Related Tax–Exempt Organizations
(a)
Name, address, and EIN of related organization

(b)
Primary activity

(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section

(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

Schedule R-1 (Form 990) 2009

Schedule R-1 (Form 990) 2009

Part III

Page

3

Continuation of Identification of Related Organizations Taxable as a Partnership

(a)
Name, address, and EIN of
related organization

(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)
(i)
(j)
Disproportionate Code V—UBI amount on General or
allocations?
box 20 of K-1
managing
partner?

Yes No

Yes No

Schedule R-1 (Form 990) 2009

Schedule R-1 (Form 990) 2009

Part IV

Page

4

Continuation of Identification of Related Organizations Taxable as a Corporation or Trust
(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)

(h)

Share of
end-of-year
assets

Percentage
ownership

Schedule R-1 (Form 990) 2009

Schedule R-1 (Form 990) 2009

Part V

Page

5

Continuation of Transactions With Related Organizations (Schedule R (Form 990), Part V, line 2)
(a)
Name of other organization

(b)
Transaction
type (a–r)

(c)
Amount involved

(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
Schedule R-1 (Form 990) 2009

Schedule R-1 (Form 990) 2009

Part VI

Page

6

Continuation of Unrelated Organizations Taxable as a Partnership
(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 on box
20 of K-1

(h)
General or
managing
partner?

Yes

No

Schedule R-1 (Form 990) 2009