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ObjectId: 201501909349300425 - Submission: 2015-07-09
TIN: 36-2193608
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Information about Schedule R (Form 990) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
14
Open to Public Inspection
Name of the organization
SHRINERS HOSPITALS FOR CHILDREN
Employer identification number
36-2193608
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on 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
(1)
PEDIATRIC ORTHOPEDIC & PROSTHETIC SERVICES - NORTH CALIFORNIA LLC
2425 STOCKTON BLVD
SACRAMENTO
,
CA
95817
27-2210763
ORTHOPEDICS & PROSTHETICS
DE
634,851
326,545
NO
(2)
PEDIATRIC ORTHOPEDIC & PROSTHETIC SERVICES - TAMPA LLC
12502 USF PINE DRIVE
TAMPA
,
FL
336129499
45-2723185
ORTHOPEDICS & PROSTHETICS
DE
812,977
170,971
NO
(3)
PEDIATRIC ORTHOPEDIC & PROSTHETIC SERVICES - GREENVILLE LLC
950 W FARIS RD
GREENVILLE
,
SC
29605
45-3940485
ORTHOPEDICS & PROSTHETICS
DE
287,801
156,716
NO
Part II
Identification of Related Tax-Exempt Organizations
Complete if the organization answered "Yes" on 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)
THE SHRINERS' HOSPITAL FOR CHILDREN
POST OFFICE BOX 31356
TAMPA
,
FL
336313356
04-2121377
HOSPITAL SYSTEM
MA
501(C)(3)
LINE 3
NO
No
(2)
SHRINERS INTERNATIONAL
POST OFFICE BOX 31356
TAMPA
,
FL
336313356
36-2158164
FOUNDED SHRINERS HOSPITALS FOR CHILDREN
IA
501(C)(10)
N/A
NO
No
(3)
SHRINERS HOSPITALS FOR CHILDREN EMPLOYEE DISASTER RELIEF FUND
2900 ROCKY POINT DRIVE
TAMPA
,
FL
33607
26-3733381
DISASTER RELIEF
DC
501(C)(3)
LINE 9
NO
No
(4)
SHRINERS HOSPITALS FOR CHILDREN (QUEBEC) INC
1529 CEDAR AVE
MONTREAL
H36 1A6
CA
HOSPITAL SYSTEM
CA
501(C)(3) EQUIVALENT
LINE 3
NO
No
(5)
SHRINERS HOSPITALS FOR CHILDREN A CANADIAN CORPORATION
1529 CEDAR AVE
MONTREAL
H36 1A6
CA
HOSPITAL SYSTEM
CA
501(C)(3) EQUIVALENT
LINE 3
NO
No
(6)
SHRINERS HOSPITALS FOR CHILDREN A MEXICAN ASSOCIATION
MX AV DEL IMAN NO 257
MEXICO CITY
04600
MX
HOSPITAL SYSTEM
MX
501(C)(3) EQUIVALENT
LINE 3
NO
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Page 2
Schedule R (Form 990) 2014
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on 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 V-UBI
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" on 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) 2014
Page 3
Schedule R (Form 990) 2014
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on 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
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
No
d
Loans or loan guarantees to or for related organization(s)
............................
1d
Yes
e
Loans or loan guarantees by related organization(s)
............................
1e
Yes
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
Yes
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
No
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
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
No
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 related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
THE SHRINERS' HOSPITAL FOR CHILDREN
E
51,846,504
CASH
(2)
THE SHRINERS' HOSPITAL FOR CHILDREN
B
25,592,194
CASH
(3)
SHRINERS INTERNATIONAL
D
106,670
CASH
(4)
THE SHRINERS' HOSPITAL FOR CHILDREN
O
0
AMOUNT UNDETERMINABLE
(5)
THE SHRINERS' HOSPITAL FOR CHILDREN
D
61,174,942
CASH
(6)
SHRINERS INTERNATIONAL
J
487,607
CASH
(7)
SHRINERS INTERNATIONAL
Q
232,720
CASH
(8)
SHRINERS INTERNATIONAL
P
5,605,163
CASH
(9)
SHRINERS HOSPITALS FOR CHILDREN CAN
B
13,220,664
CASH
(10)
SHRINERS HOSPITALS FOR CHILDREN MEX
B
14,337,787
CASH
Schedule R (Form 990) 2014
Page 4
Schedule R (Form 990) 2014
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on 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 sections 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 V-UBI
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) 2014
Page 5
Schedule R (Form 990) 2014
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2014
Additional Data
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