SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
HI-LINE RETIREMENT CENTER INC
 
Employer identification number

20-2644464
Return Reference Explanation
FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS PRIOR TO FILING. AFTER FILING A COPY IS AVAILABLE TO BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS ARE REQUIRED TO FILL OUT CONFLICT OF INTEREST FORMS ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19 THE RETIREMENT CENTER'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C: NO CHANGE IN PROCESS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

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