efile Public Visual Render
ObjectId: 201411969349301566 - Submission: 2014-07-15
TIN: 77-0003859
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
Attach to Form 990.
See separate instructions.
OMB No. 1545-0047
20
12
Open to Public Inspection
Name of the organization
Lucile Salter Packard Children's
Hospital at Stanford
Employer identification number
77-0003859
Part I
Identification of Disregarded Entities
(Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
Part II
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
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
STANFORD HOSPITAL AND CLINICS
300 PASTEUR DRIVE MC 5555
STANFORD
,
CA
94305
94-6174066
HEALTHCARE
CA
501(C)(3)
3
STANFORD
Yes
(2)
THE FREIDENRICH SUPPORT FOUNDATION
3145 PORTER DRIVE
PALO ALTO
,
CA
94304
30-0519583
SUPPORT
CA
501(C)(3)
11, TYPE I
STANFORD
Yes
(3)
SHR HOLDINGS INC
3145 PORTER DRIVE
PALO ALTO
,
CA
94304
94-3187167
REAL ESTATE
CA
501(C)(25)
N/A
STANFORD
Yes
(4)
SU EMP BEN TRUST POST RETEMPYNT BEN
3145 PORTER DRIVE
PALO ALTO
,
CA
94304
94-3246199
BENEFITS
CA
501(C)(9)
N/A
STANFORD
Yes
(5)
UNIVERSITY HEALTHCARE ALLIANCE
855 OAK GROVE AVE SUITE 100
MENLO PARK
,
CA
94205
94-3192446
HEALTHCARE
CA
501(C)(3)
3
SHC
Yes
(6)
THE DUDLEY E CHAMBERS FOUNDATION
JP MORGAN CHASE PO BOX 3038
MILWAUKEE
,
WI
53201
38-6841793
SUPPORT
NY
501(C)(3)
11,TYPE III
STANFORD
Yes
(7)
STANFORD UNIVERSITY BOOK STORE
BLDG 60 MAIN QUAD NO 105
STANFORD
,
CA
94305
94-0894150
SUPPORT
CA
501(C)(3)
11, TYPE I
STANFORD
Yes
(8)
STANFORD SCHOOLS CORPORATION
475 POPE STREET
MENLO PARK
,
CA
94025
20-2699147
EDUCATIONAL
CA
501(C)(3)
2
STANFORD
Yes
(9)
PACKARD CHILDREN'S HEALTH ALLIANCE
725 WELCH ROAD MC5551
PALO ALTO
,
CA
94304
32-0359189
HEALTHCARE
CA
501(C)(3)
3
LPCH
Yes
(10)
STANFORD HABITAT CONSERVATION BOARD
3160 PORTER DR STE 200
PALO ALTO
,
CA
94304
46-1882243
CONSERVATION
CA
501(C)(3)
7
STANFORD
Yes
(11)
STANFORD FACULTY CLUB
PO BOX 7229
STANFORD
,
CA
94309
94-1187089
FAC INTERACT.
CA
501(C)(7)
N/A
STANFORD
Yes
(12)
LELAND STANFORD JUNIOR UNIVERSITY
3145 PORTER DRIVE
PALO ALTO
,
CA
94304
94-1156365
ACADEMIA
CA
501(C)(3)
2
NA
Yes
(13)
STANFORD FEDERAL CREDIT UNION
1860 EMBARCADERO RD
PALO ALTO
,
CA
943033335
94-1492212
CREDIT UNION
CA
501(C)(1)
N/A
STANFORD
Yes
(14)
THE HONG KONGSU CHARITABLE TRUST
1401 CAROLINE CENTER
28 PING ROAD
,
CAUSEWAY
HK
SUPPORT
HK
501(C)(3)
STANFORD
Yes
(15)
THE STANFORD TRUST
65 HIGH STREET
OXFORD
,
OX1 46L
UK
SUPPORT
UK
501(C)(3)
STANFORD
Yes
(16)
STANFORD PROGRAMME (CAPE TOWN) NPC
WAVERLY BUSINESS PARK BUILDING 11
CAPE TOWN
SF
EDUCATION
SF
501(C)(3)
STANFORD
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Page 2
Schedule R (Form 990) 2012
Page
2
Part III
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
(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)
Disproprtionate allocations?
(i)
Code VUBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
ARCOLA LP
C/O ARCOLOA GP LLC 1 EMBARCADERO C
SAN FRANCISCO
,
CA
94111
20-4222260
RE DEVELOPMENT
DE
NA
(2)
ATWATER 12 LP
2001 ROSS AVE STE 1600
DALLAS
,
TX
75201
75-2944481
INVESTMENTS
DE
NA
(3)
AVENUE ASIA CAPITAL PARTNERS LP
399 Park Ave 6th Fl
NEW YORK
,
NY
10022
01-0553224
FOREIGN INV.
DE
NA
(4)
JER R E QUALIFIED PARTNERS EUROPE LP
C/O JE ROBERT COS 1650 TYSON BL
STE MCLEAN
,
VA
22102
54-2029560
INVESTMENTS
DE
NA
(5)
LINCOLN COMMERCE PARK II LTD
PO BOX 1920
DALLAS
,
TX
75221
20-4681486
RE DEVELOPMENT
DE
NA
(6)
PARMENTER REALTY FUND II LP
1111 BRICKELL AVE STE 2910
MIAMI
,
FL
33131
20-0973616
INVESTMENTS
DE
NA
(7)
REGENT OFFICE CENTER LP
c/o Bentall Kennedy US LP 1215 4
SEATTLE
,
WA
33131
91-2116424
INVESTMENTS
TX
NA
(8)
SANDPIPER FUND LP
2100 MCKINNEY AVE STE 1770
DALLAS
,
TX
98161
26-0341626
INVESTMENTS
TX
NA
(9)
SAROFIM MULTIFAMILY PARTNERS LP
8115 PRESTON RD STE 400
DALLAS
,
TX
75201
20-1929002
RE DEVELOPMENT
DE
NA
(10)
SKY HARBOR ASSOCIATES LP
PO BOX 1920
DALLAS
,
TX
75225
20-5803431
INVESTMENTS
DE
NA
(11)
SNOWCREEK VI PARTNERS LLC
C/O SMC 2770 SAND HILL RD
MENLO PARK
,
CA
75221
86-1089966
RE DEVELOPMENT
CA
NA
(12)
STERLING STAMOS REAL ASSETS FUND (A) LP
250 PARK AVE 29TH FL
NEW YORK
,
NY
94025
20-3949682
INVESTMENTS
DE
NA
(13)
DEK PORTFOLIO LLC
C/O SPAULDING SLYE INV 1 PO S
BOSTON
,
MA
10022
04-3446765
INVESTMENTS
DE
NA
(14)
BROWN BARK I LP
PO BOX 1068
STAFFORD
,
TX
77497
72-1604614
INVESTMENTS
DE
NA
(15)
BROWN BARK II LP
PO BOX 1068
STAFFORD
,
TX
77497
20-8727391
INVESTMENTS
DE
NA
(16)
BROWN BARK III LP
PO BOX 1068
STAFFORD
,
TX
77497
26-1780743
INVESTMENTS
DE
NA
(17)
STANFORD PET-CT LLC
300 PASTEUR DRIVE M/C 5555
STANFORD
,
CA
94305
61-1423414
MED. DIAGNOSICS
CA
NA
(18)
LSF V DHB HOLDINGS LP
2711 N Haskell Ave Ste 1700
DALLAS
,
TX
75204
27-2858604
INVESTMENTS
DE
NA
(19)
SIC SNOWCREEK VIII LLC
635 KNIGHT WAY
STANFORD
,
CA
94305
27-5431605
RE DEVELOPMENT
CA
NA
(20)
SUMIT HOLDING INTERNATIONAL LLC
1400 PAGE MILL ROAD MC5713
PALO ALTO
,
CA
94305
26-3934706
HOLDING COMPANY
DE
NA
(21)
ARCOLA VENTURE LLC
C/O STANFORD MGMT CO 635 KNIGHT W
STANFORD
,
CA
94304
37-1689632
RE DEVELOPMENT
DE
NA
(22)
BLACKSTONE REP VII TE 7-NQ LP
C/O THE BLACKSTONE GROUP 345 PARK
NEW YORK
,
NY
943057297
90-0878802
INVESTMENTS
DE
NA
(23)
OUTLAWS CASINO LTD
3160 PORTER DR
PALO ALTO
,
CA
94304
84-1457498
HOLDING COMPANY
CO
NA
(24)
STANFORD EMANUEL RAD ONCOLOGY
RADIOLOGY
CA
NA
(25)
SAND HILL INVESTMENTS LP
C/O SMC 635 KNIGHT WAY
STANFORD
,
CA
943057297
37-1557441
INVESTMENT
DE
NA
(26)
KEB INVESTORS II LP
WASHINGTON MALL STE 304 7 REID ST
HAMILTON
BD
FOREIGN INV.
BD
NA
(27)
PALO ALTO LP
OGIER HOUSE THE ESPLANADE
ST. HELIER
XC JE4 9WG
JE
FOREIGN INV.
JE
NA
(28)
FORTRESS IW COINVESTMENT (FUND B) LP
1345 AVE OF THE AMERICAS 23RD FL
NEW YORK
,
NY
10105
98-0509639
INVESTMENTS
CJ
NA
(29)
JER REAL ESTATE PARTNERS EUROPE II LP
CLARGES HOUSE 6-12 CLARGES ST
LONDON
,
EN
W1J 8AD
UK
INVESTMENTS
UK
NA
(30)
CEE EQUITY HOLDINGS LP
Elizabeth House 9 Castle St
St. Helier,
,
Je
JE4 2QP
JE
INVESTMENTS
JE
NA
Part IV
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
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
MARINER VOYAGER INTERNATIONAL LTD
C/O STUARTS CORP SVCS PO BOX 2510
GEORGE TOWN
CJ
INVESTMENTS
CJ
NA
C CORP
(2)
STANFORD SGGS EUROPE INC
UGLAND HOUSE S CHURCH ST
PO BOX 309GT, GEORGE TOWN
CJ
13-1684331
INVESTMENTS
CJ
NA
C CORP
(3)
BLACK RIVER EMEA INVESTORS FUND LTD
UGLAND HOUSE S CHURCH ST
GEORGE TOWN
CJ
98-0428006
INVESTMENTS
CJ
NA
C CORP
(4)
EAST SAIL
C/O INTL FS INC IFS COURT
TWENTYEIGHT, CYBERCITY, EBENE
MP
INVESTMENTS
MP
NA
C CORP
(5)
GAVEA INVESTMENT FUND II-C LP
PO BOX 896GT HARBOUR CENTRE
GEORGE TOWN
CJ
98-0537952
INVESTMENTS
CJ
NA
C CORP
(6)
JER ALBERTA LP
C/O JE ROBERT COS 1650 TYSON BLVD
MCLEAN
,
VA
22102
98-0537952
INVESTMENTS
CA
NA
C CORP
(7)
JER ALBERTA III LP
C/O JE ROBERT COS 1650 TYSON BLVD
MCLEAN
,
VA
22102
98-0423557
INVESTMENTS
CA
NA
C CORP
(8)
MARBLETON PROPERTY FUND (ALBERTA) LP
C/O JE ROBERT COMPANIES 1650 TYSON
MCLEAN
,
VA
22102
98-0493425
INVESTMENTS
CA
NA
C CORP
(9)
CLAT (16)
CHARITABLE TR
CA
NA
TRUST
(10)
CRT (513)
CHARITABLE TR
CA
NA
TRUST
(11)
OTHER (10)
CHARITABLE TR
CA
NA
TRUST
(12)
PIF (82)
CHARITABLE TR
CA
NA
TRUST
(13)
MIDPOINT TECHNOLOGY PARK OWNERS ASSOC
3145 PORTER DR
PALO ALTO
,
CA
94304
94-3287254
REAL ESTATE
CA
NA
C CORP
(14)
ALPINE CHALET INC
PO BOX 9988
SOUTH LAKE TAHOE
,
CA
96158
SKI LODGE
CA
NA
C CORP
(15)
NW CAMPUS MIDPOINT TECH PARK OWNRS ASSOC
3145 PORTER DR
PALO ALTO
,
CA
94304
94-3287254
REAL ESTATE
CA
NA
C CORP
(16)
STANFORD CAMPUS RECREATION ASSOCIATION
3145 PORTER DR
PALO ALTO
,
CA
94304
94-1539127
SOCIAL CLUB
CA
NA
C CORP
(17)
STANFORD (BEIJING) CNSLTNG CO LTD (WFOE)
5275TH FLBLDG CACADEMY SOUTH RD
HAIDAN DISTRICT
,
BEIJING
CH
EDUCATION
CH
NA
C CORP
(18)
STANFORD UNIV MED NETWORK RISK AUTHORITY
1400 PAGE MILL RD MSC 5713
PALO ALTO
,
CA
94304
46-1132002
RISK MGMT CONSULT
CA
NA
C CORP
(19)
PROFESSIONAL EXCHANGE ASSURANCE COMPANY
201 MERCHANT STREET SUITE 2400
HONOLULU
,
HI
96813
90-0897686
INSURANCE
HI
NA
C CORP
(20)
ARCOLA RES DEVELOPMENT CORP
C/O SMC 635 KNIGHT WAY
STANFORD
,
CA
943057297
80-0804754
INVESTMENT
CA
NA
C CORP
(21)
BREP VII ALBERTA FEEDER (OFFSHORE) TE7LP
C/O THE BLACKSTONE GROUP 345 PARK
NEW YORK
,
NY
10154
98-1066351
INVESTMENTS
CA
NA
C CORP
(22)
BREP VII ALBERTA FEEDER(OFFSHORE)TE7NQLP
C/O THE BLACKSTONE GROUP 345 PARK
NEW YORK
,
NY
10154
98-1066355
INVESTMENTS
CA
NA
C CORP
(23)
SPM DIRECT MORTGAGE PREPAY OFFSHORE FUND
INVESTMENTS
CJ
NA
C CORP
(24)
WOODBOURNE CANADA PARTNERS II -CAYMAN LP
98-0705321
INVESTMENTS
CJ
NA
C CORP
Schedule R (Form 990) 2012
Page 3
Schedule R (Form 990) 2012
Page
3
Part V
Transactions With Related Organizations
(Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization 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
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1a
No
b
Gift, grant, or capital contribution to related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1b
No
c
Gift, grant, or capital contribution from related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1d
No
e
Loans or loan guarantees by related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1e
No
f
Dividends from related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1f
No
g
Sale of assets to related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1g
No
h
Purchase of assets from related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1h
No
i
Exchange of assets with related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1k
Yes
l
Performance of services or membership or fundraising solicitations for related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1n
Yes
o
Sharing of paid employees with related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1q
Yes
r
Other transfer of cash or property to related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1r
Yes
s
Other transfer of cash or property from related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1s
No
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-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
STANFORD HOSPITAL AND CLINICS (SHC)
K,L
67,488,379
FMV
(2)
STANFORD HOSPITAL AND CLINICS (SHC)
N
21,157,980
FMV
(3)
STANFORD HOSPITAL AND CLINICS (SHC)
O,P
135,801,519
FMV
(4)
OTHER TRUST
C
596,980
FMV
Schedule R (Form 990) 2012
Page 4
Schedule R (Form 990) 2012
Page
4
Part VI
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)
Predominant income (related, unrelated, excluded from tax under section 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code VUBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2012
Page 5
Schedule R (Form 990) 2012
Page
5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier
Return Reference
Explanation
SCHEDULE R, PART IV, LINE 2
CHARITABLE LEAD ANNUITY TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART IV, LINE 3 CHARITABLE REMAINDER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. LPCH IS THE DIRECT CONTROLLING ENTITY OF 6 OF THESE TRUSTS WHICH ARE SECTION 512(b)(13) CONTROLLED ENTITIES. SCHEDULE R, PART IV, LINE 4 OTHER TRUSTS ARE PRINCIPALLY DOMICILIED IN CALIFORNIA. LPCH IS THE DIRECT CONTROLLING ENTITY OF 1 OF THESE TRUSTS WHICH IS A SECTION 512(b)(13) CONTROLLED ENTITY. SCHEDULE R, PART IV, LINE 5 POOLED INVESTMENT FUNDS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART V THE PURCHASED SERVICES PAYMENT WITH STANFORD HOSPITAL AND CLINICS IS CALCULATED BASED ON THE RATIO OF DIRECT COST TO CHARGES PLUS NEGOTIATED OVERHEAD. THE SHARED SERVICES WITH STANFORD HOSPITAL AND CLINICS IS A NEGOTIATED FIXED DOLLAR ANNUAL RATE. FOR OTHER SERVICES, PAYMENT IS BASED ON EITHER NEGOTIATED RATE OR CONTRACT AGREEMENT.
Additional Data
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