efile Public Visual Render
ObjectId: 202341639349300929 - Submission: 2023-06-12
TIN: 43-1170012
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 instructions and the latest information.
OMB No. 1545-0047
20
21
Open to Public Inspection
Name of the organization
BOOTH MANOR INC
Employer identification number
43-1170012
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)
THE SALVATION ARMY
5550 PRAIRIE STONE PKWY
HOFFMAN ESTATES
,
IL
60192
36-2167910
CHURCH
IL
501 ( C) 3
1
No
(2)
THE SALVATION ARMY SERVICES INC
5550 PRAIRIE STONE PKWY
HOFFMAN ESTATES
,
IL
60192
36-3805307
LOW-INCOME HOUSING
IL
501 ( C) 3
9
SALVATION ARMY
No
(3)
BOOTH MANOR INC
5040 N PULASKI RD
CHICAGO
,
IL
60630
36-3712591
LOW-INCOME HOUSING
IL
501 ( C) 3
9
SALVATION ARMY
No
(4)
BOOTH MANOR-COLUMBUS INC
3100 N MERIDIAN ST
INDIANAPOLIS
,
IN
46208
38-3651271
LOW-INCOME HOUSING
IN
501 ( C) 3
9
SALVATION ARMY
No
(5)
BOOTH MANOR INC
1331 N 75TH PLACE
KANSAS CITY
,
KS
66112
43-1477670
LOW-INCOME HOUSING
KS
501 ( C) 3
9
SALVATION ARMY
No
(6)
BOOTH MANOR INC
3100 N MERIDIAN ST
INDIANAPOLIS
,
IN
46208
35-1894464
LOW-INCOME HOUSING
IN
501 ( C) 3
9
SALVATION ARMY
No
(7)
BOOTH MANOR OF ST LOUIS INC
3133 IOWA STREET
ST LOUIS
,
MO
63118
31-1569553
LOW-INCOME HOUSING
MO
501 ( C) 3
9
SALVATION ARMY
No
(8)
BOOTH MANOR INC
923 N 38TH ST
OMAHA
,
NE
68131
47-0775707
LOW-INCOME HOUSING
NE
501 ( C) 3
7
SALVATION ARMY
No
(9)
BOOTH MANOR INC
11315 W WATERTOWN PLANK RD
WAUWATOSA
,
WI
53226
39-1591829
LOW-INCOME HOUSING
WI
501 ( C) 3
9
SALVATION ARMY
No
(10)
BOOTH MANOR TWO INC
11315 W WATERTOWN PLANK RD
WAUWATOSA
,
WI
53226
39-1802991
LOW-INCOME HOUSING
WI
501 ( C) 3
9
SALVATION ARMY
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Page 2
Schedule R (Form 990) 2021
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) 2021
Page 3
Schedule R (Form 990) 2021
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
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
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
Yes
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
No
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
(1)
THE SALVATION ARMY
M
37,020
FMV
(2)
THE SALVATION ARMY
P
30,418
FMV
(3)
THE SALVATION ARMY
E
6,794
FMV
Schedule R (Form 990) 2021
Page 4
Schedule R (Form 990) 2021
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) 2021
Page 5
Schedule R (Form 990) 2021
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) 2021
Additional Data
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