MIRA BELLA: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MIRA BELLA (EIN 34-2030255)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-11
IRS object ID
201102239349302705
Schema version
2009v1.7
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

FieldValueIRS element (for citing)
Timestamp2011-08-11T15:54:35-07:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHAEL L PIELS CPAs LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1940 TOWN CENTRE DRAddressLine1
CityMEDFORDCity
StateORState
ZIP Code975046100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN342030255EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MIRABELLABusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMIRANameControl
Phone5418577854Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 MIRA MAR AVEAddressLine1
CityMEDFORDCity
StateORState
ZIP Code97504ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRIAN MCLEMOREName
TitlePresident-PRSTitle
Date Signed2011-08-11DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameSTEWART C PARMELE CPAName
Phone5417798261Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRIAN MCLEMORENameOfPrincipalOfficerPerson
Gross Receipts16126808GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501cXOrganization501c
Web SiteRETIREMENT.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2008YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE CARE AND HOUSING FOR THE ELDERLY.ActivityOrMissionDescription
Nbr Voting Members Governing Body2NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees279TotalNbrEmployees
Total Nbr Volunteers187TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year5418410ProgramServiceRevenuePriorYear
Program Service Revenue CY16053247ProgramServiceRevenueCY
Investment Income Prior Year494727InvestmentIncomePriorYear
Investment Income Current Year52044InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year5913137TotalRevenuePriorYear
Total Revenue Current Year16105291TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4375434SalariesEtcPriorYear
Salaries Etc Current Year7906374SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year19098681OtherExpensePriorYear
Other Expenses Current Year20484222OtherExpensesCurrentYear
Total Expenses Prior Year23474115TotalExpensesPriorYear
Total Expenses Current Year28390596TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-17560978RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-12285305RevenuesLessExpensesCY
Total Assets BOY275396254TotalAssetsBOY
Total Assets EOY246241704TotalAssetsEOY
Total Liabilities BOY310106979TotalLiabilitiesBOY
Total Liabilities EOY293237734TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-34710725NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-46996030NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE CARE AND HOUSING FOR THE ELDERLY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense4208757Expense
DescriptionHEALTH CARE CENTER TO CARE FOR THE NEEDS OF RESIDENTS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense3528343Expense
DescriptionRESIDENTIAL COMMUNAL CARE FOR RESIDENTS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense3152673Expense
DescriptionFOOD SERVICE PROGRAM TO PROVIDE QUALITY AND NUTRITIONAL MEALS TO RESIDENTS.Description
FieldValueIRS element (for citing)
Total Program Service Expense10889773TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109615NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees279NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Nbr Voting Governing Body Members2NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledWAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonPACIFIC RETIREMENT SERVICESNamePerson
Telephone Number5418577854TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11200 MIR MAR AVEAddressLine1
CityMEDFORDCity
StateORState
ZIP Code97504ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (4 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
LEN MERRYMAN
VICE CHAIRMAN1.00X000
LARRY BOECK
SECRETARY/TREAS1.00X000
KAREN E HERNDON
FACILITY DIREC40.00X105394016118
JAMES MUNN
Executive Direc40.00X153429040125
FieldValueIRS element (for citing)
Total Reportable Comp From Org258823TotalReportableCompFromOrg
Total Other Compensation56243TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
EBMS INC
PO BOX 1400PORTLANDOR97207MEDICAL BENEFITS125923
CONSONUS REHAB SERVICES
PO BOX 4800PORTLANDOR97208MEDICAL SERVICES186900
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
SERVICE FEES92076869207686
OTHER REVENUE762035762035
HEALTH CENTER REVENUE27159172715917
ENTRANCE FEES33676093367609
FieldValueIRS element (for citing)
Total Program Service Revenue16053247TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column73561TotalRevenueColumn
Exclusion$73,561ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other21517Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-21517Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-21517TotalRevenueColumn
Related Or Exempt Function Income-21517RelatedOrExemptFunctionIncome

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column16105291TotalRevenueColumn
Related Or Exempt Function Income16031730RelatedOrExemptFunctionIncome
Exclusion$73,561ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total315066Total
Management And General315066ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6384924Total
Program Services5614757ProgramServices
Management And General770167ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total53894Total
Program Services37920ProgramServices
Management And General15974ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total557644Total
Program Services463812ProgramServices
Management And General93832ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total594846Total
Program Services516548ProgramServices
Management And General78298ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total632475Total
Management And General632475ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total462387Total
Management And General462387ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total225382Total
Management And General225382ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total334812Total
Management And General334812ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total107052Total
Management And General107052ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total24430Total
Program Services12156ProgramServices
Management And General12274ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total7129460Total
Management And General7129460ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6320322Total
Management And General6320322ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total279575Total
Management And General279575ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
UTILITIES94853794849245
SUPPLIES48420045096233238
HEALTHCARE SERVICES901685901685
FOOD & BEVERAGE694410694410
CONTRACT SERVICES45018236053189651

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1489313Total
Program Services888500ProgramServices
Management And General600813ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total28390596Total
Program Services10889773ProgramServices
Management And General17500823ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3720283BOY
EOY2258366EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2419199BOY
EOY612562EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY78093BOY
EOY57805EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1032971BOY
EOY150469EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis235024689LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec11608286LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY229374940BOY
EOY223416403EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY38770768BOY
EOY19746099EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY275396254BOY
EOY246241704EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1285424BOY
EOY954653EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY94326521BOY
EOY130034262EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY187450000BOY
EOY134950000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY652164BOY
EOY650728EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY26392870BOY
EOY26648091EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY310106979BOY
EOY293237734EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-34710725BOY
EOY-46996030EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-34710725BOY
EOY-46996030EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY275396254BOY
EOY246241704EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Total0Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year5418410CurrentTaxYearMinus1Year
Current Tax Year16053247CurrentTaxYear
Total21471657Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year5418410CurrentTaxYearMinus1Year
Current Tax Year16053247CurrentTaxYear
Total21471657Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50921471657PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year580091CurrentTaxYearMinus1Year
Current Tax Year73561CurrentTaxYear
Total653652Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year580091CurrentTaxYearMinus1Year
Current Tax Year73561CurrentTaxYear
Total653652Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Total22125309Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis21194646OtherCostOrOtherBasis
Book Value21194646BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis208120490OtherCostOrOtherBasis
Depreciation10467367Depreciation
Book Value197653123BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis5133595OtherCostOrOtherBasis
Depreciation964030Depreciation
Book Value4169565BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis575958OtherCostOrOtherBasis
Depreciation176889Depreciation
Book Value399069BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings223416403TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
RESTRICTED DEPOSITS AND FUNDED RESERVES1741610
BOND ISSUE COSTS (NET)2607823
ASSETS RESTRICTED UNDER BOND INDENTURE15396666
FieldValueIRS element (for citing)
Total Book Value Other Assets19746099TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
REFUNDABLE DEPOSITS$2,139,610
ENTRANCE FEES REFUNDABLE-REOCCUPANCY$3,489,900
DUE TO AFFILIATES$13,235,960
CONTINGENT LIABILITY$7,782,621
FieldValueIRS element (for citing)
Total Of Amounts26648091TotalOfAmounts
Total Revenue16105291TotalRevenue
Total Expenses28390596TotalExpenses
Excess Or Deficit For Year-12285305ExcessOrDeficitForYear
Excess Or Deficit Per FS-12285305ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt16126808TotRevenueEtcAuditedFinclStmt
Other Revenues21517OtherRevenues
Revenue Not Rptd F99021517RevenueNotRptdF990
Revenue Subtotal16105291RevenueSubtotal
Total Revenue Per Form99016105291TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt28412113TotExpensesEtcAuditedFinclStmt
Other Expenses Included21517OtherExpensesIncluded
Expenses Not Rptd F99021517ExpensesNotRptdF990
Expenses Subtotal28390596ExpensesSubtotal
Total Expenses Per Form99028390596TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XIII, Line 2dPart XIII, Line 2d: Other expenses and losses per audited F/SLOSS ON DISPOSAL OF ASSETS $21517
Part XII, Line 2dPart XII, Line 2d: Other revenue amounts included in F/S but not included on form 990LOSS ON DISPOSAL OF ASSETS $21517

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredtrueSubstantiationRequired
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonJAMES MUNNNamePerson
Base Compensation Filing Org153429BaseCompensationFilingOrg
Deferred Comp Filing Org20236DeferredCompFilingOrg
Nontaxable Benefits Filing Org19889NontaxableBenefitsFilingOrg
Total Compensation Filing Org193554TotalCompensationFilingOrg

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
WASHINGTON STATE HOUSING COMMISSION SERIES 2006B
911874730939783PW02006-10-256000000CONSTRUCTION OF NEW BUILDINGfalsefalse
WASHINGTON STATE HOUSING COMMISSION SERIES 2006A
911874730939783PV22006-10-25250745000CONSTRUCTION OF NEW BUILDINGfalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceeds
600000060000002008falsefalsetruetrue
250745002363352382008falsefalsetruetrue80000006409762

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableALL REQUESTS GO THROUGH CORPORATE COUNSEL.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesORGANIZATION'S BOARD REVIEWS AND APPROVES THE ANNUAL BUDGET.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsCORPORATE COUNSEL ISSUES POLICY ANNUALLY TO KEY EMPLOYEES AND BOARD MEMBERS.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessTHE FORM 990 IS REVIEWED BY THE CONTROLLER AND THE BOARD.
Form 990, Part VI, Line 7aForm 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyPACIFIC RETIREMENT SERVICES CAN APPOINT BOARD MEMBERS TO THE MIRABELLA BOARD.
Form 990, Part VI, Line 6Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderPACIFIC RETIREMENT SERVICES IS THE SOLE MEMBER OF MIRABELLA.
Form 990, Part VI, Line 3Form 990, Part VI, Line 3: Description of Delegated Duties to Management CompanyMIRABELLA BOARD DELEGATES MANAGEMENT TO PACIFIC RETIREMENT SERVICES.
Form 990, Part VI, Line 2Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtONE OR MORE BOARD MEMBERS SERVE ON BOTH THE MIRABELLA BOARD AND SEVERAL AFFILIATED BOARDS, INCLUDING THE PACIFIC RETIREMENT SERVICES BOARD. PACIFIC RETIREMENT SERVICES HAS A MANAGEMENT AGREEMENT WITH MIRABELLA. NO INDIVIDUAL BOARD MEMBER HAVE ANY BUSINESS TRANSACTIONS WITH MIRABELLA, SO NO SCHEDULE L IS REQUIRED.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (45 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
MIRABELLA MARIN
1200 MIRA MAR AVEMEDFORDOR97504263800433SENIOR HOUSINGCA501(C)(3)9PACIFIC RETIREMENT SERVICES
CORBINTON RETIREMENT
1200 MIRA MAR AVEMEDFORDOR97504262987036SENIOR HOUSINGNC501(C)(3)9PACIFIC RETIREMENT SERVICES
PRS SCHOOL OF AGING SERVICES INC
1200 MIRA MAR AVEMEDFORDOR97504262477424SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM MANSFIELD HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504900292647SENIOR HOUSINGTX501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM CENTRAL POINT HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504300315618SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM PORTLAND II HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504300037898SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM PORTLAND HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504311780332SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM MYRTLE CREEK II HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504311715321SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM DAVIS HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504311662208SENIOR HOUSINGCA501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM GRANTS PASS II HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504311662259SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM ROSEBURG II HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504311587420SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM MEDFORD III HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504311587418SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM FORT WORTH II HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504311587415SENIOR HOUSINGTX501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM BEND II HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943260016SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM FT WORTH HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504311520436SENIOR HOUSINGTX501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM EUGENE HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943247154SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM YREKA HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943212540SENIOR HOUSINGCA501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM REEDSPORT HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943212538SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM LIVELY OAKS HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943194409SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM MEDFORD II HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943212537SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM KLAMATH FALLS HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943196455SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM EAGLE POINT HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943191447SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM BEND HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943163349SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM MYRTLE CREEK HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943162074SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM ROSEBURG HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943179782SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM GRANTS PASS HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504943136037SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM ASHLAND HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504930942933SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM HOUSING CORPORATION
1200 MIRA MAR AVEMEDFORDOR97504930864466SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
RVM COMMUNITY SERVICES
1200 MIRA MAR AVEMEDFORDOR97504930892261COMMUNITY SERVICESOR501(C)(3)9PACIFIC RETIREMENT SERVICES
MIRABELLA SAN FRANCISCO BAY
1200 MIRA MAR AVEMEDFORDOR97504200428927SENIOR HOUSINGCA501(C)(3)9PACIFIC RETIREMENT SERVICES
MIRABELLA SOUTH WATERFRONT
1200 MIRA MAR AVEMEDFORDOR97504711016384SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
CAPITOL LAKES FOUNDATION
1200 MIRA MAR AVEMEDFORDOR97504383781089PUBLIC FOUNDATIONOR501(C)(3)9PACIFIC RETIREMENT SERVICES
CASCADE MANOR FOUNDATION INC
1200 MIRA MAR AVEMEDFORDOR97504931330100PUBLIC FOUNDATIONOR501(C)(3)9PACIFIC RETIREMENT SERVICES
MIRABELLA WASHINGTON FOUNDATION
1200 MIRA MAR AVEMEDFORDOR97504450574348PUBLIC FOUNDATIONWA501(C)(3)9PACIFIC RETIREMENT SERVICES
HPP FOUNDATION
1200 MIRA MAR AVEMEDFORDOR97504264529118PUBLIC FOUNDATIONOR501(C)(3)9PACIFIC RETIREMENT SERVICES
TRINITY TERRACE FOUNDATION
1200 MIRA MAR AVEMEDFORDOR97504912162130PUBLIC FOUNDATIONTX501(C)(3)9PACIFIC RETIREMENT SERVICES
URCAD FOUNDATION
1200 MIRA MAR AVEMEDFORDOR97504931301816PUBLIC FOUNDATIONCA501(C)(3)9PACIFIC RETIREMENT SERVICES
ROGUE VALLEY MANOR FOUNDATION
1200 MIRA MAR AVEMEDFORDOR97504930712867PUBLIC FOUNDATIONOR501(C)(3)9PACIFIC RETIREMENT SERVICES
CAPITOL LAKES
1200 MIRA MAR AVEMEDFORDOR97504391412320SENIOR HOUSINGWI501(C)(3)9PACIFIC RETIREMENT SERVICES
HOLLADAY PARK PLAZA
1200 MIRA MAR AVEMEDFORDOR97504930513697SENIOUR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
URCAD
1200 MIRA MAR AVEMEDFORDOR97504931179254SENIOR HOUSINGCA501(C)(3)9PACIFIC RETIREMENT SERVICES
CASCADE MANOR
1200 MIRA MAR AVEMEDFORDOR97504930557803SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
THE CUMBERLAND REST INC
1200 MIRA MAR AVEMEDFORDOR97504750891470SENIOR HOUSINGTX501(C)(3)9PACIFIC RETIREMENT SERVICIES
ROGUE VALLEY MANOR
1200 MIRA MAR AVEMEDFORDOR97504930453216SENIOR HOUSINGOR501(C)(3)9PACIFIC RETIREMENT SERVICES
PACIFIC RETIREMENT SERVICES
1200 MIRA MAR AVEMEDFORDOR97504931067253SUPPORTING ORGANIZATIONOR501(C)(3)9PACIFIC RETIREMENT SERVICES

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1965 ELLENDALE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11200 MIRA MAR AVEAddressLine1
CityMEDFORDCity
StateORState
ZIP Code97504ZIPCode
FieldValueIRS element (for citing)
EIN931067253EIN
Primary ActivityREALESTATEPrimaryActivity
Legal Domicile StateORLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PRSBusinessNameLine1
FieldValueIRS element (for citing)
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnerfalseGeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
CENTENNIAL INC
1200 MIRA MAR AVEMEDFORDOR97504510554651GOLF COURSEORPACIFIC RETIREMENT SERVICESC CORP
RS INC
1200 MIRA MAR AVEMEDFORDOR97504931328250MANAGEMENT CO.ORPACIFIC RETIREMENT SERVICESC CORP
CREST PARK
1200 MIRA MAR AVEMEDFORDOR97504931169683HOTELORPACIFIC RETIREMENT SERVICESC CORP
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
PACIFIC RETIREMENT SERVICES
n116940
PACIFIC RETIREMENT SERVICES
l879723
PACIFIC RETIREMENT SERVICES
e800000

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