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ObjectId: 201441189349300719 - Submission: 2014-04-24
TIN: 04-3567502
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
PARTNERS IN HEALTH A NONPROFIT CORPORATION
Employer identification number
04-3567502
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)
Inshuti Mu Buzima - Rwanda
Rwinkwavu
Rwinkwavu
RW
Healthcare
RW
N/A
Yes
(2)
Partners In Health - Lesotho
New Europa 438 Pope John Paul
Maseru
LT
Healthcare
LT
N/A
Yes
(3)
Socios En Salud - Sucursal Peru
Av Merino Reyna 575 06 Porras B
Carabayllo
PE
Healthcare
PE
N/A
Yes
(4)
Partners In Health - Malawi
PO Box 56 Neno Boma 624200
Neno
,
Neno District
MI
Healthcare
MI
N/A
Yes
(5)
Partners In Health - Russia
11 13 Trekprudniy Pereulok 10
Moscow
RS
Healthcare
RS
N/A
Yes
(6)
Companeros En Salud - Mexico
5a Avenida Norte Poniente No 42
frente al hospital
Angel Albino Corzo
,
Chiapas CP
30370
MX
Healthcare
MX
N/A
Yes
(7)
Partners In Health - Kazahkstan
99 Gogol Street 19
Almaty
KZ
Healthcare
KZ
N/A
Yes
(8)
PIH - Canada
c/o St Paul University
223 Main Street
Ottawa
,
Ontario
CA
International Development
CA
N/A
Yes
(9)
The River Street Development Foundation
888 Commonwealth Avenue 3rd Floor
Boston
,
MA
02215
52-2117495
Support PIH
MA
501(c)(3)
11 Type II
N/A
No
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
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
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
.
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1a
No
b
Gift, grant, or capital contribution to related organization(s)
.
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1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
.
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1c
No
d
Loans or loan guarantees to or for related organization(s)
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1d
No
e
Loans or loan guarantees by related organization(s)
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1e
No
f
Dividends from related organization(s)
.
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1f
No
g
Sale of assets to related organization(s)
.
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1g
No
h
Purchase of assets from related organization(s)
.
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1h
No
i
Exchange of assets with related organization(s)
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1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
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1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
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1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
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1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
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1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
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1n
No
o
Sharing of paid employees with related organization(s)
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1o
Yes
p
Reimbursement paid to related organization(s) for expenses
.
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1p
No
q
Reimbursement paid by related organization(s) for expenses
.
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1q
No
r
Other transfer of cash or property to related organization(s)
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1r
No
s
Other transfer of cash or property from related organization(s)
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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)
Inshuti Mu Buzima - Rwanda
b
10,974,044
Amount is determined based on fiscal year budget proposal from site, budget review, revision, and PIH Board approval
(2)
Inshuti Mu Buzima - Rwanda
l
618,962
PIH in Boston raises funds for all country sites. These expenses are allocated based on the proportion that the site expenses bear to the total program expenses across all sites.
(3)
Inshuti Mu Buzima - Rwanda
l
724,934
This amount represents payments processed by PIH in Boston to contractors performing their jobs at the country sites.
(4)
Inshuti Mu Buzima - Rwanda
o
415,018
This amount represents HR costs (excluding consultant costs) paid by PIH in Boston to employees performing their jobs for the sites
(5)
Partners In Health - Lesotho
b
4,689,117
Amount is determined based on fiscal year budget proposal from site, budget review, revision, and PIH Board approval
(6)
Partners In Health - Lesotho
l
225,122
PIH in Boston raises funds for all country sites. These expenses are allocated based on the proportion that the site expenses bear to the total program expenses across all sites.
(7)
Partners In Health - Lesotho
l
151,710
This amount represents payments processed by PIH in Boston to contractors performing their jobs at the country sites.
(8)
Partners In Health - Lesotho
o
92,079
This amount represents HR costs (excluding consultant costs) paid by PIH in Boston to employees performing their jobs for the sites
(9)
Socios En Salud - Sucursal Peru
b
762,247
Amount is determined based on fiscal year budget proposal from site, budget review, revision, and PIH Board approval
(10)
Socios En Salud - Sucursal Peru
l
223,377
PIH in Boston raises funds for all country sites. These expenses are allocated based on the proportion that the site expenses bear to the total program expenses across all sites.
(11)
Socios En Salud - Sucursal Peru
l
161,557
This amount represents payments processed by PIH in Boston to contractors performing their jobs at the country sites.
(12)
Socios En Salud - Sucursal Peru
o
117,780
This amount represents HR costs (excluding consultant costs) paid by PIH in Boston to employees performing their jobs for the sites
(13)
Partners In Health - Malawi
b
1,604,743
Amount is determined based on fiscal year budget proposal from site, budget review, revision, and PIH Board approval
(14)
Partners In Health - Malawi
l
142,135
PIH in Boston raises funds for all country sites. These expenses are allocated based on the proportion that the site expenses bear to the total program expenses across all sites.
(15)
Partners In Health - Malawi
l
201,461
This amount represents payments processed by PIH in Boston to contractors performing their jobs at the country sites.
(16)
Partners In Health - Malawi
o
159,122
This amount represents HR costs (excluding consultant costs) paid by PIH in Boston to employees performing their jobs for the sites
(17)
Partners In Health - Russia
b
2,469,575
Amount is determined based on fiscal year budget proposal from site, budget review, revision, and PIH Board approval
(18)
Partners In Health - Russia
l
146,179
PIH in Boston raises funds for all country sites. These expenses are allocated based on the proportion that the site expenses bear to the total program expenses across all sites.
(19)
Partners In Health - Russia
o
197,880
This amount represents HR costs (excluding consultant costs) paid by PIH in Boston to employees performing their jobs for the sites
(20)
Companeros En Salud - Mexico
b
298,860
Amount is determined based on fiscal year budget proposal from site, budget review, revision, and PIH Board approval
(21)
Companeros En Salud - Mexico
o
55,090
This amount represents HR costs (excluding consultant costs) paid by PIH in Boston to employees performing their jobs for the sites
(22)
Partners In Health - Kazahkstan
b
256,020
Amount is determined based on fiscal year budget proposal from site, budget review, revision, and PIH Board approval
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
SchR_P05_S00_L01l
Schedule R, Part V, Line 1l
Development staff at Partners In Health in Boston raise funds for all country sites. For purposes of Schedule R, these expenses have been allocated based on the proportion that the site expenses bear to the total program expenses across all sites.
Additional Data
Software ID:
12000197
Software Version:
v1.00