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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
HIRAM CERTIFIED HOME CARE COMPANY
D/B/A ACACIA CERTIFIED HOME CARE COMPANY
Employer identification number

54-2140847
Return Reference Explanation
FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO FILING WITH IRS
FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION FOLLOWS THE CONFLICT OF INTEREST POLICY OF ITS PARENT- THE TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND.
FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMPENSATION COMMITTEE THAT MEETS QUARTERLY AND REVIEWS EXECUTIVE STAFF.
FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE FOR INSPECTION UPON REQUEST
FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2017


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