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
2016
Open to Public
Inspection
Name of the organization
Rest Haven Inc
 
Employer identification number

35-2145265
Return Reference Explanation
Form 990, Part VI, Section A. Governing Body and Management, Line 6 The organization is organized under Indiana state law as a non-stock, not-for-profit corporation with members. The persons on the governing body are the organizations only members.
Form 990, Part VI, Section A. Governing Body and Management, Line 7b On occasion the organization allowed Oaklawn Psychiatric Center Inc. the right to approve or ratify certain decisions of the organizations governing body. Oaklawn Psychiatric Center Inc. provides professional psychiatric care to patients and Rest Haven Inc. provides a residency of Anabaptis lifestyle for patients with reiligious beliefs of the Old Order Amish or similar faiths that are also patients of Oaklawn Psychiatric Center Inc. As a result, Rest Haven Inc. will consult with Oaklawn Psychiatric Inc. for the approval or ratification of certain decisions specifically involving the mental and medical care of residents.
Form 990, Part VI, Section A. Governing Body and Management, Line 8b The organization had no committees.
Form 990, Part VI, Section B. Policies, Line 11b The organization has no specific policy in place to govern the review of completed Form 990. Form 990 is basically reviewed by the officer signing the completed form.
Form 990, Part VI, Section C. Disclosure, Line 19 Copies of the governing documents and financial statements of the organization are made available to the public upon request.
Form 990, Part IX, Line 11g, Other Fees for Services non-employees Fees paid to independent contractors for their services of providing commuting transportation for officer, employees, and residents of the organization, amount 134,464.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2016


Additional Data


Software ID: 16000333
Software Version: 17.2.1.0