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ObjectId: 201731309349303858 - Submission: 2017-05-10
TIN: 86-0787634
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
15
Open to Public Inspection
Name of the organization
SPRING VALLEY MANOR INC
Employer identification number
86-0787634
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
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)
FSL PATHWAYS
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
86-0748876
GROUP HOUSING AND BEHAVORIAL HEALTH SERVICES TO MENTALLY IMPAIRED ADULTS
AZ
501(C)(3)
LINE 9
FOUNDATION FOR SENIOR LIVING
No
(2)
FOUNDATION FOR SENIOR ADULT LIVING INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
86-0462784
LOW-INCOME HOUSING AND RELATED SERVICES TO THE ELDERLY
AZ
501(C)(3)
LINE 9
FOUNDATION FOR SENIOR LIVING
No
(3)
FSL PROGRAMS
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
86-0411904
PROGRAMS FOR SENIOR ADULTS, PERSONS WITH DISABILITIES, AND THEIR FAMILIES
AZ
501(C)(3)
LINE 9
FOUNDATION FOR SENIOR LIVING
No
(4)
FSL HOME IMPROVEMENTS
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
38-3649930
REHABILITATION OF HOMES FOR THE BENEFIT OF FSL FACILITIES
AZ
501(C)(3)
LINE 9
FOUNDATION FOR SENIOR LIVING
No
(5)
FSL MANAGEMENT
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
86-0462786
MANAGEMENT SERVICES TO RELATED FOUNDATION FOR SENIOR LIVING ORGANIZATIONS
AZ
501(C)(3)
LINE 11A, I
FOUNDATION FOR SENIOR LIVING
No
(6)
FSL REAL ESTATE SERVICES
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
86-1006866
REAL ESTATE DEVELOPMENT SERVICES FOR FOUNDATION OF SENIOR LIVING ORGANIZATIO
AZ
501(C)(3)
LINE 11A, I
FOUNDATION FOR SENIOR LIVING
No
(7)
FSL RURAL DEVELOPMENT
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
86-0380470
LOW-INCOME HOUSING AND RELATED SERVICES TO THE ELDERLY
AZ
501(C)(3)
LINE 9
FOUNDATION FOR SENIOR LIVING
No
(8)
FOUNDATION FOR SENIOR LIVING
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
86-0298945
PROVIDE POLICY ADVICE AND GUIDANCE TO IT'S SUBSIDIARIES
AZ
501(C)(3)
LINE 7
N/A
No
(9)
FSL CHRISTOPHER PROPERTIES INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
30-0506152
LOW-INCOME HOUSING AND RELATED SERVICES TO THE ELDERLY
AZ
501(C)(3)
LINE 9
FOUNDATION FOR SENIOR LIVING
No
(10)
THE ROMAN CATHOLIC DIOCESE OF PHOENIX
400 E MONROE STREET
PHOENIX
,
AZ
85004
86-0223974
RELIGIOUS SERVICES
AZ
501(C)(3)
LINE 1
N/A
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Page 2
Schedule R (Form 990) 2015
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
(1)
FSL SOLAR ONE LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
80-0587023
REAL ESTATE RENTAL
AZ
N/A
(2)
FSL SOLAR TWO LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
80-0673259
REAL ESTATE RENTAL
AZ
N/A
(3)
FSL SOLAR THREE LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
80-0673255
REAL ESTATE RENTAL
AZ
N/A
(4)
FSL YUMA SENIOR TERRACES LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
20-0844505
REAL ESTATE RENTAL
AZ
N/A
(5)
FSL WHITE MOUNTAIN VILLAS LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
75-3233168
REAL ESTATE RENTAL
AZ
N/A
(6)
FSL ST PETER PLACE LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
80-0559418
REAL ESTATE RENTAL
AZ
N/A
(7)
FSL ST FRANCIS VILLAS LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
80-0439708
REAL ESTATE RENTAL
AZ
N/A
(8)
FSL BECKET HOUSE APARTMENTS LIMITED PARTNERSHIP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
20-5096899
REAL ESTATE RENTAL
AZ
N/A
(9)
HOLBROOK COURT APARTMENTS ASSOCIATES LIMITED PARTNERSHIP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
86-0993043
REAL ESTATE RENTAL
AZ
N/A
(10)
FSL COLLINS COURT LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
90-0646418
REAL ESTATE RENTAL
AZ
N/A
(11)
FSL SETON VILLAGE LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
80-0673263
REAL ESTATE RENTAL
AZ
N/A
(12)
FSL RUBY HEIGHTS VILLAGE LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
75-3233177
REAL ESTATE RENTAL
AZ
N/A
(13)
FSL ST MONICA VILLAS LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
38-3833524
REAL ESTATE RENTAL
AZ
N/A
(14)
FSL HERITAGE GLEN RETIREMENT APARTMENTS LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
45-4609705
REAL ESTATE RENTAL
AZ
N/A
(15)
FSL YUMA SENIOR TERRACES II LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
45-4609379
REAL ESTATE RENTAL
AZ
N/A
(16)
FSL ESPERANZA VILLAGE LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
20-0844462
REAL ESTATE RENTAL
AZ
N/A
(17)
FSL ST ANNE VILLAGE LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
32-0333661
REAL ESTATE RENTAL
AZ
N/A
(18)
MOUNTAIN VILLAGE SENIORS LLC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
83-0403683
REAL ESTATE RENTAL
AZ
FSL MOUNTAIN VILLAGE INC
RELATED
No
No
(19)
FSL PADUA HILLS LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
46-4913798
REAL ESTATE RENTAL
AZ
N/A
(20)
FSL ST ISADORE VILLAS LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
47-3123489
REAL ESTATE RENTAL
AZ
N/A
(21)
FSL ST RAMONA VILLAS LP
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
47-3142125
REAL ESTATE RENTAL
AZ
N/A
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
(1)
FSL HOLDING PROPERTIES LLC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
02-0605634
REAL ESTATE RENTAL
AZ
N/A
C
No
(2)
ROESER SENIOR RESIDENCES LLC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
86-1005141
REAL ESTATE RENTAL
AZ
N/A
C
No
(3)
FSL MOUNTAIN VILLAGE INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
20-1094637
REAL ESTATE RENTAL
AZ
N/A
C
No
(4)
FSL SOLAR 1 INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
80-0587030
RENTAL REAL ESTATE
AZ
N/A
C
No
(5)
FSL SOLAR 2 INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
90-0646941
RENTAL REAL ESTATE
AZ
N/A
C
No
(6)
FSL SOLAR 3 INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
90-0646403
RENTAL REAL ESTATE
AZ
N/A
C
No
(7)
FSL ROESER VILLAGE INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
86-0462785
MANAGEMENT RESIDENTIAL RENTAL
AZ
N/A
C
No
(8)
FSL YUMA SENIOR TERRACES I INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
87-0796479
MANAGEMENT RESIDENTIAL RENTAL
AZ
N/A
C
No
(9)
FSL WHITE MOUNTAIN INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
87-0796482
RENTAL REAL ESTATE
AZ
N/A
C
No
(10)
FSL ST PETER INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
90-0559415
RENTAL REAL ESTATE
AZ
N/A
C
No
(11)
FSL ST FRANCIS INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
80-0439674
RENTAL REAL ESTATE
AZ
N/A
C
No
(12)
FSL ST MONICA INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
37-1623334
MANAGEMENT RESIDENTIAL RENTAL
AZ
N/A
C
No
(13)
FSL GIBSON GARDEN INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
80-0439678
RENTAL REAL ESTATE
AZ
N/A
C
No
(14)
FSL RUBY HEIGHTS INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
87-0796484
RENTAL REAL ESTATE
AZ
N/A
C
No
(15)
FSL SETON INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
90-0646416
RENTAL REAL ESTATE
AZ
N/A
C
No
(16)
FSL ST ANNE INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
30-0665774
MANAGEMENT RESIDENTIAL RENTAL
AZ
N/A
C
No
(17)
AFFORDABLE SERVICES FOR SENIORS INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
71-0869419
RENTAL REAL ESTATE
AZ
N/A
C
No
(18)
FSL SOUTH MOUNTAIN VISTA LLC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
REAL ESTATE RENTAL
AZ
N/A
C
No
(19)
FSL YUMA SENIOR TERRACES II LLC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
REAL ESTATE RENTAL
AZ
N/A
C
No
(20)
FSL COLLINS INC
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
30-0506152
REAL ESTATE RENTAL
AZ
N/A
C
No
(21)
ST CLAIRE SENIOR LIVING
1201 E THOMAS ROAD
PHOENIX
,
AZ
85014
75-3021717
REAL ESTATE RENTAL
AZ
N/A
C
No
Schedule R (Form 990) 2015
Page 3
Schedule R (Form 990) 2015
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
No
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
No
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
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
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
No
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
Schedule R (Form 990) 2015
Page 4
Schedule R (Form 990) 2015
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) 2015
Page 5
Schedule R (Form 990) 2015
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) 2015
Additional Data
Software ID:
Software Version: