GREEN FOREST TRUST: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- GREEN FOREST TRUST (EIN 46-6536400)
- Tax period
- 2015-12-01 to 2016-11-30
- Filed
- 2017-08-16
- IRS object ID
- 201702289349300640
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-16T19:38:37-05:00 | ReturnTs |
| Tax Period End | 2016-11-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 430765316 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RubinBrown LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7881 W CHARLESTON BLVD STE 250 | AddressLine1Txt |
| City | LAS VEGAS | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89117 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-12-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 466536400 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREEN FOREST TRUST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GREE | BusinessNameControlTxt |
| Phone | 9492402423 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 MONARCH BAY PLAZA STE 203 | AddressLine1Txt |
| City | DANA POINT | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92629 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VICTOR LUNDQUIST | PersonNm |
| Person Title | TRUSTEE | PersonTitleTxt |
| Phone | 9492402423 | PhoneNum |
| Signature | 2017-08-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL B PATCHETT CPA | PreparerPersonNm |
| PTIN | P01369879 | PTIN |
| Phone | 7025797000 | PhoneNum |
| Preparation | 2017-08-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | VICTOR LUNDQUIST | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 MONARCH BAY PLAZA STE 203 | AddressLine1Txt |
| City | DANA POINT | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92629 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,647,833 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH, DENTAL AND VISION BENEFITS FOR PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 1 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,058,147 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,647,833 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $5,058,147 | PYTotalRevenueAmt |
| CY Total Revenue | $8,647,833 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $4,396,091 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $4,657,439 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,434,568 | PYOtherExpensesAmt |
| CY Other Expenses | $1,799,241 | CYOtherExpensesAmt |
| PY Total Expenses | $5,830,659 | PYTotalExpensesAmt |
| CY Total Expenses | $6,456,680 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$772,512 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,191,153 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $136,112 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,327,265 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $136,112 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,327,265 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE WELFARE BENEFITS FOR THOSE EMPLOYEES AND THEIR ELIGILBLE DEPENDENTS COVERED BY THE PLAN OF NORTH AMERICAN HEALTH CARE, INC AND RELATED ENTITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,456,680 | ExpenseAmt |
| Revenue | $8,647,833 | RevenueAmt |
| Desc | HEALTH, VISION, DENTAL INSURANCE COVERAGE PROVIDED TO PARTICIPANTS. | Desc |
| Total Program Service Expenses | $6,456,680 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 1 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPENCER OLSEN - NORTH AMERICAN HEALTH CARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9492402423 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 MONARCH BAY PLAZA STE 203 | AddressLine1Txt |
| City | DANA POINT | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92629 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VICTOR LUNDQUIST | PersonNm |
| Title | TRUSTEE | TitleTxt |
| Average Hours Per Week | 0.10 | AverageHoursPerWeekRt |
| Average Hours Per Week Rltd Org | 40.00 | AverageHoursPerWeekRltdOrgRt |
| Individual Trustee Or Director | Yes (X) | IndividualTrusteeOrDirectorInd |
| Reportable Comp From Org | $0 | ReportableCompFromOrgAmt |
| Reportable Comp From Rltd Org | $352,292 | ReportableCompFromRltdOrgAmt |
| Other Compensation | $0 | OtherCompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $352,292 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25500 N NORTERRA DRIVE BLDG B | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | THIRD PARTY ADMINISTRATOR | ServicesDesc |
| Compensation | $119,147 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EMPLOYER AND EMPLOYER | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $8,647,833 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,647,833 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,647,833 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,647,833 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,647,833 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,657,439 | TotalAmt |
| Program Services | $4,657,439 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,768,431 | TotalAmt |
| Program Services | $1,768,431 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| A&G BUSINESS TAXES | $29,473 | $29,473 |
| Accounting fees | $1,337 | $1,337 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,456,680 | TotalAmt |
| Program Services | $6,456,680 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,112 | BOYAmt |
| EOY | $2,327,265 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,112 | BOYAmt |
| EOY | $2,327,265 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,112 | BOYAmt |
| EOY | $2,327,265 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,112 | BOYAmt |
| EOY | $2,327,265 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,112 | BOYAmt |
| EOY | $2,327,265 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,191,153 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VICTOR LUNDQUIST | PersonNm |
| Title | TRUSTEE | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $352,292 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $352,292 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | CIGNA HANDLES ALL THE PROCESSING AND PAYMENT OF THE HEALTH AND WELFARE CLAIMS, ETC . |
| Form 990, Part VI, Section A, line 8b | THERE WAS NO COMMITTEE WITH AUTORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| Form 990, Part VI, Section B, line 11 | THE TRUSTEE IS GIVEN A COPY OF THE RETURN TO REVIEW BEFORE THE TAX RETURN IS EFILED. |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION MADE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC BY PROVIDING COPIES ON REQUEST DURING THE TAX YEAR. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (37 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|
| NORTH AMERICAN HEALTH CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880252963 | PLAN SPONSOR | CA | S | 0 |
| LOMITA VERDE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 330376540 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| RAMONA CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880253407 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| BP CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880253408 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| CHATSWORTH HOLDING LLC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 710916266 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| SCCH INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880302193 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| FCH INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880319648 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| VSNF INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880334959 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| AVCH INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880337360 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| WOODLAND SKILLED NURSING FACILITY INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880350425 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| CCHC INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880361567 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| PTCH INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 330725679 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| PACIFICA CARE CENTER | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 943255399 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| SUN HAVEN CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 330743732 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| DANVILLE LONG-TERM CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 943274729 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| VILLA CONVALESCENT HOSPITAL INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 952687468 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| ABRH INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880395825 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| HACIENDA CH INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880395836 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| PETALUMA CC INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880422961 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| PACIFICA LINDA MAR INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880426888 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| COTTONWOOD HC INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880430406 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| CARMICHAEL CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880484955 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| MONTEREY CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 880404123 | CONTRIBUTING EMPLOYER | AZ | S | 0 |
| LBHC HOLDING LLC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 753088252 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| COSTAL HEALTH CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 450509267 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| SEA BREEZE HEALTH CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 680547791 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| FAIRFIELD HELATH CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 510460208 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| GRAND TERRACE HEALTH CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 582673168 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| NORTHWEST CARE - WEST SEATTLE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 510475021 | CONTRIBUTING EMPLOYER | WA | S | 0 |
| NORTHWEST CARE - SHORELINE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 510475023 | CONTRIBUTING EMPLOYER | WA | S | 0 |
| EDGEWATER HEALTH CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 202742835 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| LODI SKILLED CURISNIG SERVICES | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 204524548 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| NORTHWEST CARE - ISSAQUAH INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 260895231 | CONTRIBUTING EMPLOYER | WA | S | 0 |
| BURIEN POST-ACUTE SERVICES INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 261809683 | CONTRIBUTING EMPLOYER | WA | S | 0 |
| STOCKTON HEALTHCARE SERVICES | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 264215679 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| NORTH COAST REHAB INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 462617469 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| RIVERSIDE CARE INC | ||||||||
| 3 MONARCH BAY PLAZA STE 203 | DANA POINT | CA | 92629 | 472196291 | CONTRIBUTING EMPLOYER | CA | S | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |