efile Public Visual Render
ObjectId: 201941969349301259 - Submission: 2019-07-15
TIN: 94-6174066
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.
Go to
www.irs.gov/Form990
for the latest information.
OMB No. 1545-0047
20
17
Open to Public Inspection
Name of the organization
STANFORD HEALTH CARE
Employer identification number
94-6174066
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
(1)
CARE COUNSEL LLC
899 NORTHGATE DRIVE STE 530
SAN RAFAEL
,
CA
94903
68-0396696
HLTHCRE ADVOC
CA
2,086,135
556,204
SHC
(2)
STANFORD BLOOD CENTER LLC
3373 HILLVIEW AVENUE
PALO ALTO
,
CA
94304
81-0816100
BLOOD CENTER
CA
68,182,463
28,187,162
SHC
(3)
AUGMNTED INTELLIGENCE MED SYS PSYCHIATRY
PO BOX 60954
PALO ALTO
,
CA
94306
37-1865230
RESEARCH
DE
0
SHC
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)
THE BRD OF TRUST LELAND STANF JR UNIV
3145 PORTER DRIVE
PALO ALTO
,
CA
94304
94-1156365
EDUCATION
CA
501(C)(3)
2
NA
No
(2)
EAST PALO ALTO ACADEMY
475 POPE STREET
MENLO PARK
,
CA
94025
20-2699147
EDUCATIONAL
CA
501(C)(3)
2
STANFORD
Yes
(3)
HOSPITAL COMMITTEE FOR THE L-P AREAS
1111 E STANLEY BLVD
LIVERMORE
,
CA
94550
94-1429628
HOSPITAL
CA
501(C)(3)
3
SHC
Yes
(4)
LUCILE PACKARD FOUNDATION FOR CHILDREN'S
400 HAMILTON AVENUE SUITE 340
PALO ALTO
,
CA
94301
77-0440090
HEALTHCARE
CA
501(C)(3)
7
LPCH
Yes
(5)
LUCILE SALTER PACKARD CHILDRENS HOSPITAL
725 WELCH ROAD MC 5553
PALO ALTO
,
CA
94304
77-0003859
HEALTHCARE
CA
501(C)(3)
3
STANFORD
Yes
(6)
PACKARD CHILDREN'S HEALTH ALLIANCE
725 WELCH ROAD MC5551
PALO ALTO
,
CA
94304
32-0359189
HEALTHCARE
CA
501(C)(3)
3
LPCH
Yes
(7)
SHR HOLDINGS INC
485 BROADWAY MAIL CODE 8838
REDWOOD CITY
,
CA
94063
94-3187167
REAL ESTATE
CA
501(C)(25)
N/A
STANFORD
Yes
(8)
STANFORD FACULTY CLUB
PO BOX 7229
STANFORD
,
CA
94309
94-1187089
FAC INTERACT.
CA
501(C)(7)
N/A
STANFORD
Yes
(9)
STANFORD FEDERAL CREDIT UNION
1860 EMBARCADERO RD
PALO ALTO
,
CA
94303
94-1492212
CREDIT UNION
CA
501(C)(1)
N/A
STANFORD
Yes
(10)
STANFORD HABITAT CONSERVATION BOARD
485 BROADWAY MAIL CODE 8838
REDWOOD CITY
,
CA
94063
46-1882243
CONSERVATION
CA
501(C)(3)
7
STANFORD
Yes
(11)
STANFORD HEALTH CARE ADVANTAGE
1221 BROADWAY 3RD FLOOR
OAKLAND
,
CA
94612
46-4071746
HEALTHCARE
CA
501(c)(3)
12A, I
SHC
Yes
(12)
STANFORD PROGRAMME (CAPE TOWN) NPC
WAVERLY BUSINESS PARK BUILDING 11
CAPE TOWN
SF
EDUCATION
SF
501(C)(3)
N/A
STANFORD
Yes
(13)
STANFORD UNIVERSITY BOOKSTORE
BLDG 60 MAIN QUAD NO 105
STANFORD
,
CA
94305
94-0894150
SUPPORT
CA
501(C)(3)
12A, I
STANFORD
Yes
(14)
SU EMP BEN TRUST POST RETEMPYNT BEN
485 BROADWAY MAIL CODE 8838
REDWOOD CITY
,
CA
94063
94-3246199
BENEFITS
CA
501(C)(9)
N/A
STANFORD
Yes
(15)
THE DUDLEY E CHAMBERS FOUNDATION
JP MORGAN CHASE PO BOX 3038
MILWAUKEE
,
WI
53201
38-6841793
SUPPORT
NY
501(C)(3)
12D, III-O
STANFORD
Yes
(16)
THE FREIDENRICH SUPPORT FOUNDATION
485 BROADWAY MAIL CODE 8838
REDWOOD CITY
,
CA
94063
30-0519583
SUPPORT
CA
501(C)(3)
12A, I
STANFORD
Yes
(17)
THE HONG KONGSU CHARITABLE TRUST
1401 CAROLINE CENTER 28 PING ROAD
CAUSEWAY
HK
98-6078093
SUPPORT
HK
501(C)(3)
N/A
STANFORD
Yes
(18)
THE STANFORD TRUST
65 HIGH STREET
OXFORD
OX1 46L
UK
SUPPORT
UK
501(C)(3)
N/A
STANFORD
Yes
(19)
UNIVERSITY HEALTHCARE ALLIANCE
7999 GATEWAY BLVD STE 300
NEWARK
,
CA
94560
94-3192446
HEALTHCARE
CA
501(C)(3)
3
SHC
Yes
(20)
VALLEYCARE MEDICAL FOUNDATION INC
5655 W LAS POSITAS BLVD 220
PLEASANTON
,
CA
94588
26-2593526
SUPPRT SHC-VC
CA
501(C)(3)
10
HOSP CMTE LP
Yes
(21)
VALLEYCARE SENIOR HOUSING
1111 E STANLEY BLVD
LIVERMORE
,
CA
94550
94-3382224
SR. FACILITY
CA
501(C)(3)
12A, I
HOSP CMTE LP
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2017
Page 2
Schedule R (Form 990) 2017
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)
ADOM PARTNERS LP
590 MADISON AVENUE 27TH FLOOR
NEW YORK
,
NY
10022
81-3083288
INVESTMENTS
DE
NA
(2)
ALBUS SELECT FUND LP
750 MENLO AVENUE
MENLO PARK
,
CA
94025
81-2064357
INVESTMENTS
DE
NA
(3)
CANARY SC FUND LP
399 PARK AVENUE
NEW YORK
,
NY
10022
47-5662144
INVESTMENTS
DE
NA
(4)
CANARY SC MASTER FUND LP
89 NEXUS WAY CAMANA BAY
GRAND CAYMAN
KY1-9009
CA
98-1267847
INVESTMENTS
CJ
NA
(5)
CARLSBAD CO-INVEST LP
51 JOHN F KENNEDY PARKWAY SUITE 2
SHORT HILLS
,
NJ
07078
47-1702425
INVESTMENTS
DE
NA
(6)
CEE EQUITY HOLDINGS LP
JTC HOUSE 28 ESPLANADE
ST HELIER JERSEY
JE4 2QP
JE
INVESTMENTS
JE
NA
(7)
CLAIRVUE CAPITAL PARTNERS II-TE 1 LP
TWO EMBARCADERO CENTER SUITE 480
SAN FRANCISCO
,
CA
94111
80-0909516
INVESTMENTS
DE
NA
(8)
CLAIRVUE CAPITAL PARTNERS II-TE 2 LP
TWO EMBARCADERO CENTER SUITE 480
SAN FRANCISCO
,
CA
94111
80-0909556
INVESTMENTS
DE
NA
(9)
EZP OPPORTUNITY LP
635 KNIGHT WAY
STANFORD
,
CA
943057297
81-4562962
INVESTMENTS
DE
NA
(10)
FORTRESS IW COINVESTMENT (FUND B) LP
1345 AVE OF THE AMERICAS 45TH FL
NEW YORK
,
NY
10105
98-0509639
INVESTMENTS
CJ
NA
(11)
FOUR CROSSINGS INSTITUTIONAL PARTNERS V
ONE MARITIME PLAZA SUITE 200
SAN FRANCISCO
,
CA
94111
81-4323705
INVESTMENTS
DE
NA
(12)
FOXLANE LP
410 E WATER STREET SUITE 888
CHARLOTTESVILLE
,
VA
22902
81-3314647
INVESTMENTS
DE
NA
(13)
HHBG-II Investment LP
89 NEXUS WAY CAMANA BAY PO BOX 31
GRAND CAYMAN
KY1-9009
CA
INVESTMENTS
CJ
NA
(14)
KEB INVESTORS II LP
WASHINGTON MALL STE 304 7 REID ST
HAMILTON
HM 11
BD
INVESTMENTS
BD
NA
(15)
LSF V DHB HOLDINGS LP
2711 N HASKELL AVE STE 1700
DALLAS
,
TX
75204
27-2858604
INVESTMENTS
DE
NA
(16)
OLIFANT FUND LTD
635 KNIGHT WAY
STANFORD
,
CA
94305
INVESTMENTS
CJ
NA
(17)
OUTLAWS CASINO LTD
485 BROADWAY MAIL CODE 8838
REDWOOD CITY
,
CA
94063
84-1457498
HOLDING COMPANY
CO
NA
(18)
PALO ALTO LP
13 CASTLE STREET
ST HELIER JERSEY
JE
98-1126622
INVESTMENTS
JE
NA
(19)
RMS FOREST GROWTH II LP
31 INVERNESS CENTER PARKWAY STE 36
BIRMINGHAM
,
AL
35242
20-0841908
INVESTMENTS
CA
NA
(20)
SANDOVAL LP
635 KNIGHT WAY
STANFORD
,
CA
943057297
37-1873346
INVESTMENTS
DE
NA
(21)
SANDPIPER FUND LP
2000 MCKINNEY AVE STE 2125
DALLAS
,
TX
75201
26-0341626
INVESTMENT
TX
NA
(22)
SAROFIM MULTIFAMILY PARTNERS LP
8115 PRESTON RD ST400
DALLAS
,
TX
75225
20-1929002
RE DEVELOPMENT
TX
NA
(23)
SCP REAL ASSETS FUND (A) LP
2498 SAND HILL RD
MENLO PARK
,
CA
94025
20-3949682
INVESTMENTS
DE
NA
(24)
SEQUOIA MFM OPERATING COMPANY LLC
770 WELCH ROAD LPCH- ADMIN MC5551
PALO ALTO
,
CA
94304
47-5060529
MFM PROGRAM
CA
NA
(25)
SIC SNOWCREEK VIII LLC
635 KNIGHT WAY
STANFORD
,
CA
94305
27-5431605
RE DEVELOPMENT
CA
NA
(26)
SP SMC PARTNERS LLC
PO BOX 5377
NEW YORK
,
NY
10185
47-3103791
INVESTMENTS
DE
NA
(27)
STANFORD EMANUEL RADIATION ONCOLOGY CENT
825 DELBON AV
TURLOCK
,
CA
95382
20-8885091
RADIOLOGY
CA
SHC
RELATED
3,131,180
9,501,782
No
0
No
60.000 %
(28)
STANFORD PET-CT LLC
300 PASTEUR DR MC 5555
STANFORD
,
CA
94305
61-1423414
MED. DIAGNOST
CA
SHC
RELATED
8,583,783
10,604,260
No
0
Yes
50.000 %
(29)
STANFORD-STARTX FUND LLC
485 BROADWAY MAIL CODE 8838
REDWOOD CITY
,
CA
94063
46-4297719
INVESTMENTS
DE
NA
EXCLUDED
307,726
63,804,982
No
0
No
33.333 %
(30)
SUMIT HOLDING INTERNATIONAL LLC
1400 PAGE MILL ROAD MC5713
PALO ALTO
,
CA
94304
26-3934706
HOLDING COMPANY
DE
SHC
RELATED
-1,885,785
41,729,132
No
0
No
82.000 %
(31)
TESSERA IONIC LP
635 KNIGHT WAY
STANFORD
,
CA
943057297
INVESTMENTS
DE
NA
(32)
VEDA INVESTORS FUND LP
ONE FAWCETT PL
GREENWICH
,
CT
06830
81-1810345
INVESTMETNS
DE
NA
(33)
VERMILION PEAK MASTER FUND
635 KNIGHT WAY
STANFORD
,
CA
943057297
INVESTMENTS
DE
NA
(34)
WINTER ROCK ALTERNATIVE CREDIT MASTER L
PO BOX 10008 WILLOW HOUSE CRICKET
GRAND CAYMAN
KY1-1001
CJ
94-1141686
INVESTMENTS
CJ
NA
(35)
WOLFF REAL ESTATE PARTNERS III A LP
6710 E CAMELBACK ROAD SUITE 100
SCOTTSDALE
,
AZ
85251
47-4780701
INVESTMENTS
DE
NA
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)
ALPINE CHALET INC
PO BOX 9988
SOUTH LAKE TAHOE
,
CA
96158
94-1556099
SKI LODGE
CA
NA
C CORP
(2)
BIENVILLE ARGENTINA OPPS OFFSHORE FUND
405 LEXINGTON AVE 34TH FLOOR
NEW YORK
,
NY
10174
INVESTMENTS
CJ
NA
C CORP
(3)
BISHOP ROCK OPPORTUNITY OFFSHORE FUND LT
635 KNIGHT WAY
STANFORD
,
CA
94305
INVESTMENTS
CJ
NA
C CORP
(4)
BREP VII Alberta Feeder (Offshore) TE7
635 KNIGHT WAY
STANFORD
,
CA
94305
98-1066351
INVESTMENTS
CA
NA
C CORP
(5)
BREP VII Alberta Feeder (Offshore) TE7-
635 KNIGHT WAY
STANFORD
,
CA
94305
98-1066355
INVESTMENTS
CA
NA
C CORP
(6)
CANARY SC FUND LTD
89 NEXUS WAY CAYMANA BAY
GRAND CAYMAN
KY1-9009
CJ
98-1268195
INVESTMENTS
CJ
NA
C CORP
(7)
CLAT (16)
CHARITABLE TR
CA
NA
TRUST
(8)
CRT (552)
CHARITABLE TR
CA
NA
TRUST
(9)
EAST SAIL
C/O INTL FS INC IFS COURT
TWENTYEIGHT CYBERCITY EBENE
MP
INVESTMENTS
MP
NA
C CORP
(10)
GAVEA INVESTMENT FUND II-C LP
PO BOX 896GT HARBOUR CENTRE
GEORGE TOWN
CJ
98-0537952
INVESTMENTS
CJ
NA
C CORP
(11)
HHBG SF Limited
635 KNIGHT WAY
STANFORD
,
CA
94305
REAL ESTATE
CA
NA
C CORP
(12)
KAIZEN FUND
2ND FL MIDTOWN PLAZA PO BOX 448
GRAND CAYMAN
KY1-1106
CJ
INVESTMENTS
CJ
NA
C CORP
(13)
LS ALBERTA III LP
C/O JE ROBERT COS 1650 TYSON BLVD
MCLEAN
,
VA
22102
98-0493425
INVESTMENTS
CA
NA
C CORP
(14)
OTHER (5)
CHARITABLE TR
CA
NA
TRUST
(15)
PIF (2)
CHARITABLE TR
CA
NA
TRUST
(16)
PROFESSIONAL EXCHANGE ASSURANCE COMPANY
201 MERCHANT STREET SUITE 2400
HONOLULU
,
HI
96813
90-0897686
INSURANCE
HI
NA
C CORP
(17)
SBFF LTD
PO BOX 1344
GEORGE TOWN
KY1-1108
CJ
INVESTMENTS
CJ
NA
C CORP
(18)
SEA SMOKE FUND LLC
190 ELGIN AVENUE
GEORGE TOWN
KY 9005
CJ
INVESTMENTS
DE
NA
C CORP
(19)
SEA SMOKE FUND LTD
635 KNIGHT WAY
STANFORD
,
CA
943057297
INVESTMENTS
CJ
NA
C CORP
(20)
STANFORD (BEIJING) CNSLTNG CO LTD (WFOE)
5275TH FLBLDG CACADEMY SOUTH RD
BEIJING
CH
EDUCATION
CH
NA
C CORP
(21)
STANFORD IN JAPAN GODO KAISHA
DOSHISHA UNIVERSITY MEITOKUKAN-NAI
KYOTOSHI
JA
EDUCATION
JA
NA
C CORP
(22)
STANFORD INDIA PVT LTD
333 3RD FLOOR DEVIKA TOWER 6 NEH
DELHI
IN
EDUCATION
IN
NA
C CORP
(23)
STANFORD INTL MEDICAL SERVICES RAK FZE
PO BOX 56500
AE
PATIENT SRVC
AE
NA
C CORP
0
0
100.000 %
Yes
(24)
STANFORD MEDICINE INTL (HONG KONG) CO LT
833 CHEUNG SHA WAN ROAD
KOWLOON
HK
PATIENT SRVC
HK
NA
C CORP
0
0
100.000 %
Yes
(25)
STANFORD SGGS EUROPE INC
UGLAND HOUSE S CHURCH ST PO BOX 3
GEORGE TOWN
CJ
13-1684331
INVESTMENTS
CJ
NA
C CORP
(26)
STANFORD UNIV MED NETWORK RISK AUTHORITY
1400 PAGE MILL RD MSC 5713
PALO ALTO
,
CA
94304
46-1132002
RISK MGMT CON
CA
NA
C CORP
(27)
STRUCTURED SERVICING HOLDINGS (OFFSHORE)
87 MARY STREET
GEORGE TOWN
KY1-9002
CJ
INVESTMENTS
CJ
NA
C CORP
(28)
THE RUBRUM FUND
PO BOX 309 UGLAND HOUSE
GRAND CAYMAN
CJ
INVESTMENTS
CJ
NA
C CORP
(29)
VERMILION PEAK FUND
635 KNIGHT WAY
STANFORD
,
CA
943057297
INVESTMENTS
CJ
NA
C CORP
(30)
WINTER ROCK ALTERNATIVE CREDIT I LP
PO BOX 10008 WILLOW HOUSE CRICKET
GRAND CAYMAN
KY1-1001
CJ
98-1140761
INVESTMENTS
CJ
NA
C CORP
Schedule R (Form 990) 2017
Page 3
Schedule R (Form 990) 2017
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
Yes
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
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
Yes
g
Sale of assets to related organization(s)
............................
1g
Yes
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
Yes
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
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
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
Yes
s
Other transfer of cash or property from related organization(s)
............................
1s
Yes
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
(1)
SUMIT HOLDING INTERNATIONAL LLC
F
4,182,000
BOOK
(2)
SUMIT HOLDING INTERNATIONAL LLC
R
10,711,983
BOOK
(3)
LPCH
L
84,279,710
FMV
(4)
LPCH
M
607,965
FMV
(5)
LPCH
N
3,437,550
FMV
(6)
LPCH
O
33,724,945
FMV
(7)
LPCH
Q
12,604,963
COST
(8)
LPCH
S
2,068,019
COST
(9)
UNIVERSITY HEALTHCARE ALLIANCE
B
45,069,622
BOOK
(10)
UNIVERSITY HEALTHCARE ALLIANCE
L
9,152,158
COST
(11)
UNIVERSITY HEALTHCARE ALLIANCE
P
47,939,388
COST
(12)
UNIVERSITY HEALTHCARE ALLIANCE
Q
18,479,526
COST
(13)
UNIVERSITY HEALTHCARE ALLIANCE
S
22,340,747
COST
(14)
HOSPITAL COMMITTEE FOR THE L-P AREAS
A
2,123,325
COST
(15)
HOSPITAL COMMITTEE FOR THE L-P AREAS
P
15,597,393
COST
(16)
HOSPITAL COMMITTEE FOR THE L-P AREAS
Q
29,886,740
COST
(17)
HOSPITAL COMMITTEE FOR THE L-P AREAS
R
54,527,634
COST
(18)
HOSPITAL COMMITTEE FOR THE L-P AREAS
S
2,070,000
COST
(19)
STANFORD HEALTH CARE ADVANTAGE
B
14,800,000
BOOK
(20)
STANFORD HEALTH CARE ADVANTAGE
L
8,887,463
COST
(21)
STANFORD HEALTH CARE ADVANTAGE
O
349,394
COST
(22)
STANFORD HEALTH CARE ADVANTAGE
Q
522,661
COST
(23)
STANFORD HEALTH CARE ADVANTAGE
S
5,224,962
COST
(24)
SEROC
C
1,800,000
COST
(25)
SEROC
Q
1,030,131
COST
Schedule R (Form 990) 2017
Page 4
Schedule R (Form 990) 2017
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) 2017
Page 5
Schedule R (Form 990) 2017
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
SCHEDULE R, PART IV, LINE 5
CHARITABLE LEAD ANNUITY TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.
SCHEDULE R, PART IV, LINE 6
CHARITABLE REMAINDER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.
SCHEDULE R, PART IV, LINE 5
OTHER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.
SCHEDULE R, PART IV, LINE 6
POOLED INCOME FUNDS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.
Schedule R (Form 990) 2017
Additional Data
Software ID:
Software Version: