Instrumentl eFile Render
Object ID: 202122289349303482 - Rendered 2024-05-04
TIN: 46-3368230
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
19
Open to Public Inspection
Name of the organization
VASHON COMMUNITY CARE FOUNDATION
Employer identification number
46-3368230
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)
PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST
1980 112TH AVENUE SUITE 210
BELLEVUE
,
WA
98004
91-0666887
PROVIDE CARE FOR SENIORS
WA
501(C)(3)
LINE 10
N/A
No
(2)
PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST FOUNDATION
1980 112TH AVENUE SUITE 210
BELLEVUE
,
WA
98004
91-1586491
BENEFIT RESIDENTS AND EMPLOYEES OF PRESBYTERIAN RETIREMENT COMMUNITIES NW
WA
501(C)(3)
LINE 12A, I
PRESBYTERIAN RETIREMENT COMMUNITIES NW
No
(3)
FRED LIND MANOR
1980 112TH AVENUE SUITE 210
BELLEVUE
,
WA
98004
91-0579225
PROVIDE SENIOR SERVICES
WA
501(C)(3)
LINE 10
PRESBYTERIAN RETIREMENT COMMUNITIES NW
No
(4)
VASHON ISLAND COMMUNITY CARE
1980 112TH AVENUE SUITE 210
BELLEVUE
,
WA
98004
91-1703092
PROVIDE CARE FOR SENIORS
WA
501(C)(3)
LINE 10
PRESBYTERIAN RETIREMENT COMMUNITIES NW
No
(5)
FULL LIFE CARE
1980 112TH AVENUE SUITE 210
BELLEVUE
,
WA
98004
91-1095588
SERVICES FOR THE ELDERLY
WA
501(C)(3)
LINE 7
PRESBYTERIAN RETIREMENT COMMUNITIES NW
No
(6)
CHRISTIAN RETIREMENT HOMES
6315 O STREET
LINCOLN
,
NE
68510
47-6041813
SENIOR LIVING
NE
501(C)(3)
LINE 10
PRESBYTERIAN RETIREMENT COMMUNITIES NW
No
(7)
EASTMONT TOWERS FOUNDATION
6315 O STREET
LINCOLN
,
NE
68510
91-1767080
BENEFIT RESIDENTS AND EMPLOYEES OF CHRISTIAN RETIREMENT HOMES
NE
501(C)(3)
LINE 10
PRESBYTERIAN RETIREMENT COMMUNITIES NW
No
(8)
GERMAN RETIREMENT HOME OF THE STATE OF WASHINGTON
11853 97TH AVENUE NE
KIRKLAND
,
WA
98034
91-0630507
SENIOR LIVING
WA
501(C)(3)
LINE 7
PRESBYTERIAN RETIREMENT COMMUNITIES NW
No
(9)
DOWNTOWN ACTION TO SAVE HOUSING
11018 NE 11TH STREET
BELLEVUE
,
WA
98004
94-3155152
HOUSING
WA
501(C)(3)
LINE 7
PRESBYTERIAN RETIREMENT COMMUNITIES NW
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
(1)
TRANSFORMING AGE INC
715 NINTH AVENUE SUITE 400
SEATTLE
,
WA
98104
47-1755666
FOR-PROFIT VENTURES AND ACTIVITIES
WA
N/A
C
No
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
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
Yes
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
No
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) 2019
Schedule R (Form 990) 2019
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) 2019
Schedule R (Form 990) 2019
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) 2019
Additional Data
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