2019-08-12T20:35:33-05:00 2018-09-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2017-10-01 342030255 MIRABELLA MIRA 8887246424 116 FAIRVIEW AVENUE NORTH SEATTLE WA 98109 STAN SCHILL BOARD CHAIR 8887246424 2019-07-23 1 KURT BENNION P01469618 4252506100 2019-07-23 67.137.57.251 2019-07-23 07:38:03 PD P 3605098DE1C5714001CCA2EBA3FCCF3F67934A02 C6A37568A41E0AB8BE07FF512B9036924B050377 2017 2019-02-21 02:37:17Z STAN SCHILL 1 WEST MAIN SUITE 303 MEDFORD OR 97501 35774540 0 X WWW.RETIREMENT.ORG X 2005 WA TO PROVIDE COMPREHENSIVE CARE AND HOUSING FOR THE ELDERLY. 9 9 436 180 0 0 329855 263152 27660066 29475888 707519 568405 72635 165064 28770075 30472509 0 0 0 0 13578209 13841861 0 0 0 21653521 21475396 35231730 35317257 -6461655 -4844748 217254190 213555138 326596527 327218413 -109342337 -113663275 NONE 0 0 30382546 0 29475888 MIRABELLA IS A CONTINUING CARE RETIREMENT COMMUNITY, DEDICATED TO ENHANCING OUR RESIDENTS' QUALITY OF LIFE IN A STIMULATING, SECURE ENVIRONMENT. WE PROVIDE HIGH-QUALITY SERVICES INCLUDING HOUSING, NUTRITIOUS MEALS, NURSING, HOUSEKEEPING, MAINTENANCE, AND OTHER SUPPORT TO THOSE WE SERVE. OUR LEVELS OF SERVICE INCLUDE INDEPENDENT LIVING, ASSISTED LIVING, AND SKILLED NURSING. 30382546 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 76 0 1 436 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X JOSH BLACKSON 5418577205 1 WEST MAIN SUITE 303 MEDFORD OR 97501 X X TODD MARTIN CHAIR (THROUGH JANUARY 2018) 1.00 4.00 X X 0 0 0 STAN SCHILL VICE CHAIR & CHAIR 1.00 0.00 X X 0 0 0 WILLIAM POOLE DIRECTOR & VICE CHAIR 1.00 0.00 X X 0 0 0 ANTHONY P WARTNIK SECRETARY / TREASURER 1.00 0.00 X X 0 0 0 RUTH BENFIELD RESIDENT DIRECTOR 1.00 0.00 X 0 0 0 LEE BURNSIDE DIRECTOR 1.00 0.00 X 0 0 0 MARITE BUTNERS DIRECTOR 1.00 0.00 X 0 0 0 GREGG HATCH DIRECTOR 1.00 0.00 X 0 0 0 TIFF WOOD DIRECTOR 1.00 2.00 X 0 0 0 OLEG ZASLAVSKY DIRECTOR 1.00 0.00 X 0 0 0 STEVE BRUDNICK EXEC. DIRECTOR (THROUGH NOV 2017) 40.00 1.00 X 368088 0 31040 TRAVIS DUNCAN EXECUTIVE DIRECTOR 40.00 1.00 X 135666 0 16530 GAIL CARTER-LINDBERG HUMAN RESOURCES DIRECTOR 40.00 0.00 X 107000 0 14923 SUSAN WHITE SALES COUNSELOR 40.00 0.00 X 101507 0 14598 TEMA BUKOWITZ DIRECTOR OF DINING SERVICES 40.00 0.00 X 102885 0 11643 DELPHINE TAFEN-NYA HC CHARGE NURSE 40.00 0.00 X 106123 0 1812 921269 0 90546 6 0 1 0 PACIFIC RETIREMENT SERVICES INC 1 WEST MAIN SUITE 303 MEDFORD OR 97501 MANAGEMENT SERVICES 1744604 CONSONUS REHAB PO BOX 4800 UNIT 12 PORTLAND OR 97208 THERAPY SERVICES 708077 CONSONUS PHARMACY SERVICES WA LLC PO BOX 84157 SEATTLE WA 98124 PHARMACY SERVICES 208486 PETERSON COMPANY PO BOX 3513 SEATTLE WA 981243513 REAL ESTATE DEVELOPEMENT 117816 STANDARD PARKING 8037 COLLECTION CENTER DRIVE CHICAGO IL 60693 PARKING SERVICES 114155 5 263152 263152 SERVICE FEES 623000 20379411 20379411 HEALTH CENTER 623000 5277001 5277001 ENTRANCE FEES 623000 1838203 1838203 HOME CARE/PRIVATE DUTY 623000 843001 843001 DIETARY 623000 485728 485728 652544 652544 29475888 111165 111165 307540 307540 165064 0 165064 165064 165064 5451731 5302031 149700 149700 149700 30472509 29475888 0 733469 325700 325700 10427443 9480175 947268 334548 300161 34387 1951036 1575022 376014 803134 738493 64641 1857741 1857741 79317 79317 24500 24500 36902 36902 818646 636179 182467 208177 80 208097 659914 571039 88875 171903 171903 1902252 1902252 93561 32295 61266 38760 31348 7412 6067016 6067016 5864791 5864791 297305 297305 OTHER DIETARY EXPENSE 1660071 1660071 HEALTH CENTER EXPENSE 1027197 1027197 OTHER FACILITY SERVICE 415653 199122 216531 PROGRAM FUND EXPENSES 251690 251690 35317257 30382546 4934711 0 4913663 4172427 17511493 17651081 1507358 2136804 82673 125940 378803 491242 241554313 58384412 187518311 183169901 4373207 5433804 968682 373939 217254190 213555138 5737525 6707956 13215076 13375703 107613981 106956260 404529 589044 1400000 400000 198225416 199189450 326596527 327218413 X -109678771 -114066338 336434 403063 -109342337 -113663275 217254190 213555138 X -4844748 -207154 730965 X 0 1 X 1 0 X 4354 2636 262758 329855 263152 862755 22582253 28315105 38518851 27660066 29475888 146552163 22586607 28317741 38781609 27989921 29739040 147414918 109196 123648 232844 0 109196 123648 232844 147182074 580542 490656 1039573 419167 583769 3113707 580542 490656 1039573 419167 583769 3113707 23167149 28808397 39821182 28409088 30322809 150528625 0.97780 0.97940 0.02070 0.01860 X 0 0 0 35317257 35317257 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 250000 250000 250000 250000 1000000 1500000 0 1 X 21194646 21194646 210111773 52066500 158045273 10000659 6317912 3682747 247235 247235 183169901 REFUNDABLE ENTRANCE FEES 180522174 DUE TO AFFILIATES 17667276 OTHER CURRENT LIABILITIES 1000000 199189450 X PART IV, LINE 2B: RESIDENT SECURITY DEPOSITS ARE HELD IN A SEPARATE BANK ACCOUNT. WHEN THE RESIDENT LEAVES THE FACILITY THE SECURITY DEPOSIT, MINUS ANY AMOUNTS RETAINED FOR REPAIRS, IS REFUNDED. PART X, LINE 2: THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2018 AND 2017, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. 1 0 0 0 0 0 0 0 1 0 STEVE BRUDNICK EXEC. DIRECTOR (THROUGH NOV 2017) 251788 0 6900 0 109400 0 10348 0 20692 0 399128 0 0 0 TRAVIS DUNCAN EXECUTIVE DIRECTOR 135666 0 0 0 0 0 9002 0 7528 0 152196 0 0 0 PART I, LINE 3 COMPENSATION WAS RECOMMENDED BY PACIFIC RETIREMENT SERVICES, INC. AND APPROVED BY THE MIRABELLA BOARD AS PART OF THE ANNUAL BUDGET PROCESS. PART I, LINE 4A STEVE BREDNICK RECEIVED $109,400 IN CALENDAR YEAR 2017. PART I, LINE 8 THE ORGANIZATION PAID BONUSES THIS YEAR. THE PROCESS FOR DETERMINING EXECUTIVE BONUSES IS DISCRETIONARY. IT IS DETERMINED BY THE VP OF OPERATIONS FOR PRS AND IT IS BASED ON THE PERFORMANCE OF THE COMMUNITY FOR THE YEAR. A WASHINGTON STATE HOUSING FINANCE COMMISSION 911874730 939783RB4 2012-12-27 119990000 CURRENT REFUNDING AND TO FINANCE CERTAIN CAPITAL IMPROVEMENTS 0 0 0 A 10715000 120002706 6118299 26119 1784800 2320240 115871547 1 0 1 1 A 0 1 1 1 0 0.00800 0.00100 0.00900 0 0 1 A 0 0 1 1 1 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WASHINGTON STATE HOUSING FINANCE COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 01/22/2018 PART I, COLUMN F: THE SERIES 2006A BONDS WERE ISSUED ON NOVEMBER 3, 2006. PART II, LINE 3: THE DIFFERENCE BETWEEN PART PART I, COLUMN E AND PART II, LINE 3 IS DUE TO INTEREST EARNINGS ON INVESTED BOND PROCEEDS. PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. FORM 990, PART VI, SECTION A, LINE 3 MIRABELLA'S BOARD DELEGATES MANAGEMENT DUTIES TO PACIFIC RETIREMENT SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE MEMBER, PACIFIC RETIREMENT SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A PACIFIC RETIREMENT SERVICES, INC. HAS THE RIGHT TO VOTE ON THE ELECTION OF DIRECTORS FOR THE BOARD OF MIRABELLA. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS THE EXCLUSIVE POWER TO TAKE THE FOLLOWING ACTIONS: (A) ADOPT, AMEND OR RESTATE THE ARTICLES OF INCORPORATION OR BYLAWS OF THE ORGANIZATION; (B) ADOPT, AMEND OR RESTATE THE ORGANIZATION'S ANNUAL BUDGET, LONG-RANGE PLAN, STRATEGIC PLAN, OR MISSION STATEMENT; (C) APPROVE ANY MERGER OR CONSOLIDATION OF THE ORGANIZATION WITH ANOTHER ENTITY, OR ANY PARTIAL OR TOTAL LIQUIDATION OF THE ORGANIZATION'S ASSETS; (D) APPROVE THE ORGANIZATION'S INCURRING ANY DEBT, MAKING ANY EXPENDITURE, OR ENTER INTO ANY CONTRACT NOT CONTEMPLATED BY THE ANNUAL BUDGET, IF THE DOLLAR AMOUNT OF SUCH DEBT, EXPENDITURE OR CONTRACT EXCEEDS THE SUM OF $100,000; (E) MAKE ANY GIFTS OR GRATUITOUS TRANSFERS IN EXCESS OF $5,000 IN ANY CALENDAR YEAR; (F) CREATE A TAXABLE OR TAX-EXEMPT SUBSIDIARY OR AFFILIATED ORGANIZATION; (G) ACQUIRE A CONTROLLING INTEREST IN ANOTHER ENTITY; (H) APPOINT OUTSIDE AUDITORS; (I) APPOINT A MANAGER TO MANAGE THE OPERATIONS OF THE ORGANIZATION'S CONTINUING CARE RETIREMENT COMMUNITY; (J) ELECT OR APPOINT THE ORGANIZATION'S DIRECTORS (INCLUDING A RESIDENT DIRECTOR NOMINATED BY THE RESIDENT COUNCIL), INCLUDING THE FILLING OF VACANCIES CAUSED BY THE DEATH, REMOVAL OR RESIGNATION OF A DIRECTOR; (K) ELECT OR APPOINT A DIRECTOR TO BE THE PRS REPRESENTATIVE DIRECTOR; AND (L) REMOVE ANY OF THE ORGANIZATION'S DIRECTORS OR OFFICERS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CFO, ASSISTANT CONTROLLER, VP OF ACCOUNTING, AND THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE ARE SENT TO ALL BOARD MEMBERS AND KEY EMPLOYEES ANNUALLY. THERE ARE TWO POLICIES RELATED TO CONFLICTS OF INTEREST: 1) BOARD OF DIRECTORS; 2)KEY EMPLOYEES, WHICH IDENTIFY THE PURPOSE, DEFINITIONS, AND PROCEDURES. IF A CONFLICT IS SELF-IDENTIFIED BY A BOARD MEMBER OR KEY EMPLOYEE IN THE QUESTIONNAIRE AND/OR MEETING, PROCEDURES ARE FOLLOWED AND DOCUMENTED ACCORDING TO THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A A COMPENSATION COMMITTEE OF THE PRS BOARD EXISTS TO DETERMINE COMPENSATION FOR THE EXECUTIVE DIRECTOR OF EACH COMMUNITY. THIS COMMITTEE IS COMPRISED OF THE OFFICERS OF THE PRS BOARD OF DIRECTORS. THE COMMITTEE HAS A CHARTER THAT OUTLINES ITS DUTIES AND RESPONSIBILITIES. IT ALSO HAS AGENDA ELEMENTS THAT DESCRIBE THE ACTIVITIES THAT THE COMMITTEE UNDERTAKES DURING THE YEAR. THE VP OF HUMAN RESOURCES PROVIDED SALARY STUDIES FROM THE FOLLOWING RESOURCES TO THE COMMITTEE RELATIVE TO EXECUTIVE DIRECTOR COMPENSATION: SALARY.COM, PAYSCALE.COM, 990 REVIEW (LIKE SIZE ORGANIZATIONS), CEMO (CHIEF EXECUTIVE OFFICERS OF MULTI-FACILITY ORGANIZATIONS) SALARY STUDY RESULTS, AND INDUSTRY STATE ASSOCIATION SALARY STUDY RESULTS BASED ON GEOGRAPHICAL LOCATION. THE RECOMMENDATION FOR BASE COMPENSATION AND BONUS ARE PROVIDED BY THE EXECUTIVE DIRECTOR'S DIRECT SUPERVISOR (COO OR VP OF OPERATIONS). FORM 990, PART VI, SECTION C, LINE 19 ALL REQUESTS GO THROUGH CORPORATE COUNSEL. FORM 990, PART VII, SECTION A: NOTE THAT STEVE BRUDNICK AND TRAVIS DUNCAN ARE LEASED EMPLOYEES OF PACIFIC RETIREMENT SERVICES, INC. AND PERFORM SERVICES ON BEHALF OF MIRABELLA PURSUANT TO A MANAGEMENT SERVICES AGREEMENT BETWEEN MIRABELLA AND PACIFIC RETIREMENT SERVICES, INC. UNDER THE MANAGEMENT SERVICES AGREEMENT, THEIR COMPENSATION IS REIMBURSED BY MIRABELLA. COMPENSATION HAS BEEN REPORTED IN FORM 990, PART VII, SECTION A IN ORDER TO HIGHLIGHT AMOUNTS PAID BY MIRABELLA, NOTWITHSTANDING THAT THEY ARE LEASED EMPLOYEES OF PACIFIC RETIREMENT SERVICES, INC. FORM 990, PART XI, LINE 9: CHANGES IN INTEREST IN NET ASSETS OF FOUNDATION 51,227. CHANGE IN FUTURE SERVICES OBLIGATION 679,738. PACIFIC RETIREMENT SERVICES INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931067253 SUPPORTING ORGANIZATION OR 501(C)(3) LINE 12C, III-FI N/A 0 PACIFIC RETIREMENT SERVICES FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 472352652 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 PACIFIC RETIREMENT SERVICES INC 0 ROGUE VALLEY MANOR 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930453216 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 THE CUMBERLAND REST INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 750891470 SENIOR HOUSING TX 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 CASCADE MANOR INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930557803 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 UNIVERSITY RETIREMENT COMMUNITY AT DAVIS 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931179254 SENIOR HOUSING CA 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 HOLLADAY PARK PLAZA 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930513697 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 CAPITOL LAKES INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 391412320 SENIOR HOUSING WI 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 ROGUE VALLEY MANOR FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930712867 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 ROGUE VALLEY MANOR 0 UNIVERSITY RETIREMENT COMMUNITY FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931301816 PUBLIC FOUNDATION CA 501(C)(3) LINE 7 UNIVERSITY RETIREMENT COMMUNITY AT DAVIS 0 TRINITY TERRACE FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 912162130 PUBLIC FOUNDATION TX 501(C)(3) LINE 7 THE CUMBERLAND REST INC 0 HOLLADAY PARK PLAZA FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 264529118 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 HOLLADAY PARK PLAZA 0 MIRABELLA WASHINGTON FOUNDATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 450574348 PUBLIC FOUNDATION WA 501(C)(3) LINE 7 MIRABELLA 1 CASCADE MANOR FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931330100 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 CASCADE MANOR INC 0 CAPITOL LAKES FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 383781089 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 CAPITOL LAKES INC 0 MIRABELLA PORTLAND FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 452508860 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 MIRABELLA AT SOUTH WATERFRONT 0 MIRABELLA AT SOUTH WATERFRONT 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 711016384 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 COMMUNITY VOLUNTEER NETWORK 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930892261 COMMUNITY SERVICES OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930864466 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM ASHLAND HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930942933 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM GRANTS PASS HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943136037 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM ROSEBURG HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943179782 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM MYRTLE CREEK HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943162074 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM BEND HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943163349 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM EAGLE POINT HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943191447 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM KLAMATH FALLS HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943196455 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM MEDFORD II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943212537 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM LIVELY OAKS HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943194409 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM REEDSPORT HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943212538 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM YREKA HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943212540 SENIOR HOUSING CA 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM EUGENE HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943247154 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM FORT WORTH I HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311520436 SENIOR HOUSING TX 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM BEND II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943260016 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM FORT WORTH II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311587415 SENIOR HOUSING TX 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM MEDFORD III HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311587418 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM ROSEBURG II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311587420 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM GRANTS PASS II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311662259 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM DAVIS HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311662208 SENIOR HOUSING CA 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM MYRTLE CREEK II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311715321 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM PORTLAND HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311780332 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM PORTLAND II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 300037898 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM CENTRAL POINT HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 300315618 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM MANSFIELD HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 900292647 SENIOR HOUSING TX 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 MIDDLETON GLEN INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 911859494 SENIOR HOUSING WI 501(C)(3) LINE 10 CAPITOL LAKES INC 0 SENIOR HOUSING OF MIDDLETON INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 470825736 SENIOR HOUSING WI 501(C)(3) LINE 10 CAPITOL LAKES INC 0 MIRABELLA AT ASU INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 813784956 SENIOR HOUSING AZ 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 BAY AREA SENIOR SERVICES INC 1 BALDWIN AVENUE SAN MATEO CA 94401 943008774 SENIOR HOUSING CA 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 CREST PARK INC 1 WEST MAIN SUITE 303 MEDFORD OR 97501 931169683 REAL ESTATE OR N/A C 0 PRS MANAGEMENT INC 1 WEST MAIN SUITE 303 MEDFORD OR 97501 931328250 MANAGEMENT COMPANY OR N/A C 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0