efile Public Visual Render
ObjectId: 201801169349301100 - Submission: 2018-04-26
TIN: 23-2862231
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
16
Open to Public Inspection
Name of the organization
Allied Services Personal Care Inc
Employer identification number
23-2862231
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)
ALLIED HEALTH CARE SERVICES
100 ABINGTON EXECUTIVE PARK
CLARKS SUMMIT
,
PA
18411
24-0860110
HOME HEALTH SERVICES
PA
501(c)(3)
Line 3
allied services foundation
No
(2)
ALLIED NORTHEAST APARTMENTS
100 ABINGTON EXECUTIVE PARK
CLARKS SUMMIT
,
PA
18411
23-2523679
inactive
PA
501(c)(3)
Line 10
allied health care services
No
(3)
ALLIED PROJECT OPPORTUNITY
100 ABINGTON EXECUTIVE PARK
CLARKS SUMMIT
,
PA
18411
23-2523680
LOW INCOME HOUSING
PA
501(c)(3)
Line 10
allied health care services
No
(4)
ALLIED SERVICES CONTINUING CARE RETIREMENT COMMUNITY
100 TERRACE LANE
SCRANTON
,
PA
18508
20-4472148
ASSISTED LIVING FACILITY
PA
501(c)(3)
Line 12a, I
allied services foundation
No
(5)
ALLIED SERVICES FOUNDATION
100 ABINGTON EXECUTIVE PARK
cLARKS SUMMIT
,
PA
18411
23-2523682
HELD AND INVESTED FUNDS IN SUPPORT OF ALLIED HEALTH CARE SERVICES
PA
501(c)(3)
Line 7
N/A
No
(6)
ALLIED SERVICES INSTITUTE OF REHAB MEDICINE
100 ABINGTON EXECUTIVE PARK
CLARKS SUMMIT
,
PA
18411
23-2523395
REHABILITATION HOSPITAL
PA
501(c)(3)
Line 3
allied services foundation
No
(7)
ALLIED SERVICES SKILLED NURSING CENTER
100 ABINGTON EXECUTIVE PARK
CLARKS SUMMIT
,
PA
18411
23-2523688
SKILLED AND INTERMEDIATE NURSING FACILITY
PA
501(c)(3)
Line 3
allied services foundation
No
(8)
JOHN HEINZ INSTITUTE OF REHAB MEDICINE
100 ABINGTON EXECUTIVE PARK
CLARKS SUMMIT
,
PA
18411
23-2262852
REHABILITATION HOSPITAL
PA
501(c)(3)
Line 3
allied services foundation
No
(9)
ALLIED SERVICES RISK RETENTION GROUP
1327 ASHLEY RIVER ROAD BLDG C SUITE
charleston
,
SC
29407
20-1177431
PROVIDE INSURANCE, CLAIMS DEFENSE, ADMINISTRATION & INDEMNITY TO AFFILIATES
SC
501(c)(3)
Line 12a, I
allied services foundation
No
(10)
The Burnley Workshop of the Poconos Inc
4219 manor drive
stroudsburg
,
PA
18360
23-1642528
Operate a Vocational REhabilitation Facility
PA
501(c)(3)
Line 7
allied health care services
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2016
Page 2
Schedule R (Form 990) 2016
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) 2016
Page 3
Schedule R (Form 990) 2016
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
Yes
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
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) 2016
Page 4
Schedule R (Form 990) 2016
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) 2016
Page 5
Schedule R (Form 990) 2016
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) 2016
Additional Data
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