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SCH D, PART X, LINE 2 ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 AT DECEMBER 31, 2010 AND 2009, THE COMPANY EVALUATED WHETHER IT HAD UNCERTAIN TAX POSITIONS THAT SHOULD BE RECOGNIZED OR DERECOGNIZED BASED ON A 'MORE LIKELY THAN NOT' THRESHOLD FOR TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, INCLUDING THOSE TAX POSTIONS THAT WOULD NOT BE SUSTAINED UPON EXAMINATION IN ACCORDANCE WITH GUIDANCE RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE IMPLEMENTATION HAD NO IMPACT ON THE COMPANY'S FINANCIAL POSITION OR OPERATIONS FOR THE YEARS ENDED DECEMBER 31, 2010 AND DECEMBER 31, 2009. AS OF DECEMBER 31, 2010 AND 2009, THE COMPANY HAS NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS THAT WOULD BE EVALUATED UNDER THIS GUIDANCE. 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X X X X false true false false false false false true false J DANIEL CONNOR 487604 0 205040 0 42016 0 155657 0 4452 0 894769 0 0 0 SUSAN BARNES 246895 0 91590 0 48862 0 65557 0 938 0 453842 0 0 0 SALLY CAGLIOTI 261312 0 112610 0 18370 0 73879 0 938 0 467109 0 0 0 PATRICK MCEVOY 311666 0 129500 0 49200 0 60646 0 2135 0 553147 0 0 0 PETER TOMASULO MD 387146 0 130030 0 49200 0 15925 0 3027 0 585328 0 0 0 PATRICK HOLT 266504 0 104190 0 18050 0 21751 0 2849 0 413344 0 0 0 MICHAEL BUSCH MD 332381 0 125030 0 48100 0 51642 0 2849 0 560002 0 0 0 SCOTT NELSON 220296 0 80360 0 41802 0 38092 0 4452 0 385002 0 0 0 JONATHAN HARBER 197595 0 77100 0 21850 0 14700 0 3027 0 314272 0 0 0 DENNIS HARPOOL 182129 0 60060 0 24232 0 15891 0 3141 0 285453 0 0 0 MICHAEL HAYWARD 176597 0 64730 0 24300 0 15925 0 4250 0 285802 0 0 0 HANY KAMEL MD 250025 0 95740 0 31600 0 57779 0 3141 0 438285 0 0 0 LINDA MATTHEWS 187202 0 73680 0 45327 0 22811 0 501 0 329521 0 0 0 FRANK NIZZI 273234 0 77040 0 26100 0 24070 0 3141 0 403585 0 0 0 LARRY REESE 200974 0 72930 0 31600 0 39431 0 3141 0 348076 0 0 0 EUGENE ROBERTSON 191316 0 83970 0 40795 0 33090 0 4452 0 353623 0 0 0 DARYL STENSGAARD 152853 0 61430 0 39515 0 14533 0 501 0 268832 0 0 0 MARY BETH BASSETT 252165 0 80850 0 48100 0 47905 0 501 0 429521 0 0 0 PAULA VILLALOBOS 149166 0 60640 0 19310 0 11113 0 938 0 241167 0 0 0 VICKI FINSON 164923 0 56110 0 22000 0 12537 0 2135 0 257705 0 0 0 AUDREY JENNINGS 157137 0 66360 0 6510 0 11072 0 2135 0 243214 0 0 0 BEATA KWIATKOWSKA 232343 0 52540 0 32857 0 15925 0 2849 0 336514 0 0 0 PATRICK OOLEY 168125 0 38060 0 12366 0 13396 0 4452 0 236399 0 0 0 LEON SU MD 237834 0 59940 0 14700 0 15925 0 4452 0 332851 0 0 0 SCHEDULE J SUPPLEMENTAL COMPENSATION INFORMATION PART I, LINE 4B - BLOOD SYSTEMS, INC. SPONSORS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), COVERING SELECTED EXECUTIVES, AS APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD. THE SERP PROVIDES FOR A LUMP SUM PAYMENT TO EACH EXECUTIVE AT VESTING DATE, AS DEFINED IN THE SERP AGREEMENT. THE FOLLOWING INDIVIDUALS, REPORTED IN 990, PART VII, PARTICIPATED IN THE PLAN AND HAD THE FOLLOWING AMOUNTS DEFERRED DURING THE CURRENT YEAR: J. DANIEL CONNOR - $8,575 PATRICK MCEVOY - $8,575 SALLY CAGLIOTI - $8,575 SUSAN BARNES - $8,575 PAT HOLT - $8,575 SCOTT NELSON - $8,575 MICHAEL BUSCH - $8,575 LINDA MATTHEWS - $8,575 HANY KAML - $8,575 MARY BETH BASSETT - $ 8,575 LARRY REESE - $ 8,575 JONATHAN HARBER - $ 8,575 DENNIS HARPOOL - $ 8,575 EUGENE ROBERTSON - $ 8,575 DARYL STENSGAARD - $ 7,825 MICHAEL HAYWARD - $ 8,575 FRANK NIZZI - $ 8,575 PAULA VILLALOBOS - $ 7,718 VICKI FINSON - $ 7,657 AUDREY JENNINGS - $ 7,816 BEATA KWIATKOWSKI - $ 8,575 PAT OOLEY - $ 7,213 LEON SU - $ 8,575 PETER TOMASULO - $ 8,575 PART I, LINE 7 BLOOD SYSTEMS HAS AN INCENTIVE BONUS PLAN FOR MANAGEMENT AND EXECUTIVES. AWARDS UNDER THE PROGRAM ARE AT THE DISCRETION OF THE BOARD OF TRUSTEES. THE PLAN MEASURES PERFORMANCE AGAINST MULTIPLE METRICS WHICH CARRY VARIOUS WEIGHTINGS, THE MOST HEAVILY WEIGHTED BEING QUALITY, SAFETY AND CUSTOMER SERVICE. TO ASSURE FINANCIAL STABILITY OF THE COMPANY, ONE OF THE METRICS IS ALSO A MEASUREMENT OF NET MARGIN FINANCIAL PERFORMANCE AS A PERCENT OF REVENUES. ARIZONA HEALTH FACILITIES AUTHORITY 860453292 040507FG5 2004-12-23 54833136 SERIES 2004A REV BONDS-SEE PART V false false false 54883136 4615187 1100963 33634272 2005 true false true true false false false true false 0.00000 0.01200 0.01200 true false false false false false false SCHEDULE K, PART I, COLUMN (F) DESCRIPTION OF BOND PURPOSE PURCHASE LAND, CONSTRUCT AND EQUIP 11 BLOOD CENTERS IN VARIOUS STATES FOR THE PURPOSE OF RECRUITING, COLLECTING, PROCESSING AND DISTRIBUTING BLOOD PRODUCTS. REFUNDING OF ABAG 2002 BOND ISSUE USED TO CONSTRUCT A BLOOD CENTER IN SAN FRANCISCO, CA, REFUNDING OF AHFA 1995 VARIABLE RATE BOND ISSUE USED TO CONSTRUCT AND EQUIP A NATIONAL BLOOD TESTING LABORATORY IN TEMPE, ARIZONA. ORRIN H CAMP SPOUSE OF OFFICER 178213 COMPENSATION - BSI EMPLOYEE false X 3 49363 COST/SELLING PRICE X VOUCHERS 45 5750645 COST/SELLING PRICE X JEWELRY 2 25625 COST/SELLING PRICE 0 false true false FORM 990, PART I, LINE 1 AND PART III, LINE 1 ORGANIZATION'S MISSION THE MISSION OF BLOOD SYSTEMS, INC. ("BSI") IS TO MAKE A DIFFERENCE IN PEOPLE'S LIVES BY BRINGING TOGETHER THE BEST PEOPLE, INSPIRING INDIVIDUALS TO DONATE BLOOD, PRODUCING A SAFE AND AMPLE BLOOD SUPPLY, ADVANCING CUTTING-EDGE RESEARCH AND EMBRACING CONTINUOUS QUALITY IMPROVEMENT. TO FURTHER ITS MISSION, BSI OPERATES 18 COMMUNITY BLOOD CENTERS. THESE CENTERS RECRUIT BLOOD DONORS AND COLLECT, PROCESS AND DISTRIBUTE APPROXIMATELY 1,300,000 BLOOD DONATIONS TO MEET THE BLOOD NEEDS OF PATIENTS IN MORE THAN 500 HOSPITALS THROUGHOUT THE COUNTRY. THE STAFF OF NEARLY 3,400 SERVES A GEOGRAPHIC AREA COVERING ONE-THIRD OF THE UNITED STATES, FROM THE GULF COAST TO CALIFORNIA AND FROM THE CANADIAN BORDER TO MEXICO. BSI IS KNOWN MORE COMMONLY THROUGHOUT THE UNITED STATES BY THE NAME OF ITS BLOOD BANKING DIVISION, UNITED BLOOD SERVICES. BSI IS LICENSED BY THE U.S. FOOD AND DRUG ADMINISTRATION ( "FDA" ) AS A PROVIDER OF BLOOD AND BLOOD SERVICES. THE COMPANY'S THREE OPERATING DIVISIONS ARE: (1) THE BLOOD BANKING DIVISION, WHICH INCLUDES UNITED BLOOD SERVICES; (2) THE BIOCARE DIVISION; AND (3) THE BLOOD SYSTEMS RESEARCH INSTITUTE. THESE OPERATING DIVISIONS ARE UNINCORPORATED DIVISIONS DOING BUSINESS UNDER REGISTERED TRADENAMES AND SERVICE MARKS. BSI CONDUCTS ITS BLOOD BANKING ACTIVITIES THROUGH ITS REGIONAL BLOOD CENTERS LOCATED IN THE FOLLOWING STATES: ALABAMA, ARIZONA, ARKANSAS, CALIFORNIA, COLORADO, LOUISIANA, MISSISSIPPI, MONTANA, NEVADA, NEW MEXICO, NORTH DAKOTA, SOUTH DAKOTA, TEXAS AND WYOMING. BSI HAS TWO CENTRALIZED TESTING FACILITIES AT LABORATORIES LOCATED IN BEDFORD, TEXAS AND TEMPE, ARIZONA. THE BIOCARE DIVISION DISTRIBUTES PLASMA-DERIVED PRODUCTS THROUGH HOSPITALS, COMMUNITY BLOOD CENTER LOCATIONS AND ALSO DIRECTLY FROM ITS HEADQUARTERS IN TEMPE, ARIZONA. BLOOD-RELATED RESEARCH IS CONDUCTED AT THE BLOOD SYSTEMS RESEARCH INSTITUTE LOCATED IN SAN FRANCISCO, CALIFORNIA. FORM 990, PART III, LINE 3 CHANGES IN PROGRAM SERVICES PRIOR TO 2010, BLOOD TESTING SERVICES WERE PERFORMED UNDER THE BLOOD SYSTEMS LABORATORIES DIVISION OF BSI. AS OF JANUARY 1, 2010, THE BSI CREATED A JOINT VENTURE WITH FLORIDA BLOOD SERVICES ("FBS") IN ST PETERSBURG, FLORIDA. THE JOINT VENTURE, CREATIVE TESTING SOLUTIONS ("CTS") COMBINED THE BSI'S TWO DONOR TESTING LABORATORIES IN TEMPE, ARIZONA AND BEDFORD, TEXAS WITH FBS' DONOR TESTING LABORATORY IN ST PETERSBURG, FLORIDA. BLOOD TESTING SERVICES PREVIOUSLY PERFORMED BY BSI ARE NOW PERFORMED BY CTS. CTS HAS BEEN GRANTED TAX-EXEMPT STATUS BY THE IRS AS AN ORGANIZATION THAT IS ORGANIZED AND OPERATED EXCLUSIVELY TO TEST FOR PUBLIC SAFETY UNDER 509(A)(4). FORM 990, PART III, LINES 4A-C PROGRAM SERVICE ACCOMPLISHMENTS 4A) UNITED BLOOD SERVICES THE BLOOD BANKING DIVISION OPERATES UNDER THE NAME UNITED BLOOD SERVICES (UBS). THE PRIMARY PURPOSE OF UBS IS TO PROVIDE A SAFE AND STABLE SUPPLY OF BLOOD AND BLOOD COMPONENTS TO HOSPITALS AND MEDICAL FACILITIES. THE STRENGTH OF UBS IS THAT IT OPERATES AS LOCAL BLOOD CENTERS THAT ARE PART OF THE COMMUNITY AND YET HAS ACCESS TO A LARGE NETWORKED ORGANIZATION WITH ALL THE ADVANTAGES AND EFFICIENCIES THAT ARE REALIZED THROUGH STANDARDIZATION AND ECONOMIES OF SCALE. UBS COLLECTS BLOOD FROM VOLUNTEER DONORS, PERFORMS SCREENING AND TESTING ON THE DONATED BLOOD, AND PROCESSES THE WHOLE BLOOD INTO BLOOD COMPONENTS SUCH AS RED CELLS, PLATELETS AND PLASMA. BLOOD AND BLOOD COMPONENTS ARE THEN STORED AND DISTRIBUTED TO HOSPITALS AND OTHER HEALTH CARE PROVIDERS. 4B) BIOCARE THE BIOCARE DIVISION PROVIDES PHARMACEUTICAL PRODUCTS, PRIMARILY HUMAN-PLASMA DERIVED PRODUCTS, THAT SERVE AS ADJUNCT THERAPIES IN TRANSFUSION MEDICINE AND HEALTHCARE. PLASMA DERIVATIVES ARE BASICALLY PROTEIN THERAPIES PROVIDED FROM PLASMA LEFT OVER FROM WHOLE BLOOD DONATIONS. EXAMPLES OF SUCH PLASMA DERIVATIVES INCLUDE: INTRAVENOUS IMMUNE GLOBULINS, COAGULATION FACTORS, ALBUMIN AND FIBRIN SEALANTS. THESE PRODUCTS ARE USED AS THERAPIES FOR IMMUNE SYSTEM DISORDERS, BLEEDING DISORDERS AND WOUND MANAGEMENT. 4C) BLOOD SYSTEMS RESEARCH INSTITUTE BLOOD SYSTEMS RESEARCH INSTITUTE ("BSRI") FACILITATES RESEARCH PRIMARILY FUNDED BY EXTRAMURAL GRANTS (NIH AND OTHERS). THE RESEARCH IS IN TRANSFUSION MEDICINE EPIDEMIOLOGY, HEALTH POLICY, VIROLOGY, VIRAL DISCOVERY, THE IMMUNE REACTION TO TRANSFUSION AND TO TRANSFUSION-TRANSMITTED INFECTIOUS AGENTS, CELL THERAPY AND GENETIC EPIDEMIOLOGY. AREAS STUDIED INCLUDE IMPLICATIONS OF RECEIVING COMPONENTS AT DIFFERENT STORAGE AGES; MECHANISM OF VIRUS ENTRY INTO CELLS; HOW TRANSFUSION TRANSMITTED VIRUSES CAUSE SYMPTOMS; THE USE OF COMMERCIALLY AVAILABLE OR LOCALLY-DEVELOPED DONOR TESTS; THE FACTORS LEADING TO CHIMERISM, ETC. BSRI SUPPORTS TRAINING PROGRAMS FOR SPECIALISTS IN TRANSFUSION MEDICINE AND THE DEVELOPMENT OF EPIDEMIOLOGY RESEARCH SCIENTISTS. BSRI INVESTIGATORS PUBLISH MORE THAN 45 PAPERS EACH YEAR IN THE PEER-REVIEWED SCIENTIFIC LITERATURE. THERE ARE 7 PRINCIPAL INVESTIGATORS AND 2 CLINICAL INVESTIGATORS ALONG WITH A NUMBER OF RESEARCH ASSOCIATES AND OTHER SUPPORT STAFF. FORM 990, PART VI, LINE 2 BUSINESS AND FAMILY RELATIONSHIPS JOHN LEWIS, HEATHER ALLEN AND ARMANDO FLORES HAVE A BUSINESS RELATIONSHIP UNRELATED TO BLOOD SYSTEMS. FORM 990, PART VI, LINE 11 FORM 990 REVIEW PROCESS A COPY OF THE DRAFT FORM 990 AND SCHEDULES IS SUPPLIED TO ALL BOARD MEMBERS PRIOR TO THE MEETING HELD TO ACCEPT THE RETURNS. THE AUDIT AND GOVERNANCE COMMITTEE OF THE BOARD ALSO RECEIVES A COPY OF ALL SUPPORTING DOCUMENTATION SUCH AS W-2S AND 1099S FOR REVIEW. THE PAID PREPARER, ERNST & YOUNG, AND MEMBERS OF MANAGEMENT REVIEW THE FORM 990 WITH THE COMMITTEES AND ARE AVAILABLE FOR ANSWERING QUESTIONS. ANY COMMENTS FROM THE BOARD ARE CONSIDERED PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, LINE 12C ENFORCEMENT OF CONFLICT OF INTEREST POLICY EACH YEAR, THE BOARD OF TRUSTEES AND SENIOR MANAGEMENT ARE REQUIRED TO SIGN AND RETURN A CONFLICT OF INTEREST FORM TO COMPANY COUNSEL. ANY CONFLICTS DISCLOSED ARE DISCUSSED IN EXECUTIVE SESSION WITH THE BOARD AND RESOLVED. IN ADDITION, IN PREPARATION FOR THE FORM 990 FILING, THE TRUSTEES, OFFICERS AND KEY EMPLOYEES IDENTIFIED ARE REQUIRED TO RESPOND TO A COMPREHENSIVE CONFLICT OF INTEREST AND FAMILY RELATIONSHIP QUESTIONNAIRE. ANY CONFLICTS DISCLOSED ARE DISCUSSED WITH THE BOARD AND DISCLOSED APPROPRIATELY ON THE FORM 990. FORM 990, PART VI, LINES 15A AND 15B PROCESS USED TO DETERMINE COMPENSATION THE BOARD OF TRUSTEES HAS A COMPENSATION AND HUMAN RESOURCE COMMITTEE WHOSE PURPOSE, AMONG OTHER THINGS, IS TO HIRE AN INDEPENDENT CONSULTING FIRM ONCE EVERY 2-3 YEARS TO PROVIDE DATA ON COMPETITIVENESS OF SALARIES AND BENEFITS FOR THE CEO AND OTHER OFFICERS OF THE CORPORATION. THE HUMAN RESOURCE DEPARTMENT COLLECTS INFORMATION THROUGH SURVEYS AND OTHER SOURCES IN ADDITION TO THE INDEPENDENT CONSULTING FIRM. THE MEMBERS OF THE HUMAN RESOURCE AND COMPENSATION COMMITTEE OF THE BOARD ARE ALL INDEPENDENT TRUSTEES AND INCLUDE NO MEMBERS OF MANAGEMENT. THE RECOMMENDATIONS OF THE COMMITTEE ARE REVIEWED BY THE ENTIRE BOARD PRIOR TO APPROVAL. COMPENSATION FOR THESE INDIVIDUALS IS SET AND APPROVED BY THE BOARD EACH YEAR. THE RESULTS OF THESE DISCUSSIONS, REVIEWS AND APPROVALS ARE DOCUMENTED IN THE EXECUTIVE MINUTES OF THE BOARD MEETINGS. THIS PROCESS WAS LAST COMPLETED IN 2010. FORM 990, PART VI, LINE 19 PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC THE FORM 990 IS MADE AVAILABLE ON THE COMPANY'S INTRA-NET FOR ALL OPERATING LOCATIONS TO ACCESS. UPON REQUEST, THE FORM CAN BE PRINTED OR VIEWED ON-LINE. UPON WRITTEN REQUEST TO THE CHIEF FINANCIAL OFFICER, A COPY OF THE FORM 990 WILL BE MAILED TO THE REQUESTOR. THE FORM 990 FOR CURRENT AND PAST YEARS IS ALSO POSTED ON GUIDESTAR FOR ORGANIZATIONS TO ACCESS. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE ORGANIZATION'S COMBINED FINANCIAL STATEMENTS ARE MADE PUBLIC VIA THE ANNUAL REPORT POSTED ON THE ORGANIZATION'S WEBSITE. FORM 990, PART XI, LINE 5 OTHER CHANGES IN NET ASSETS UNREALIZED GAINS ON INVESTMENTS $8,280,486 PENSION EXPENSES OTHER THAN PERIODIC COST (3,227,136) ACTUARIAL LOSS IN BENEFIT PLAN ASSETS (1,891,038) --------- TOTAL $3,162,312 ========== ATTACHMENT TO 12/31/2010 FORM 926 AND FORM 5471 FORM 926, PART III - INFORMATION REGARDING TRANSFERS OF PROPERTY INFORMATION REQUIRED PURSUANT TO REGULATION SECTION 1.6038B-1(C) (1) TRANSFEROR NAME: BLOOD SYSTEMS, INC. FEIN: 86-0098929 ADDRESS: P.O. BOX 1867 SCOTTSDALE, AZ 85252 (2) TRANSFEREE (I) NAME: CANYON STATE INSURANCE COMPANY FEIN: N/A ADDRESS: GRAND PAVILION COMMERCIAL CENTRE, WEST BAY ROAD, P.O. BOX 10073 APO, GRAND CAYMAN, CAYMAN ISLANDS COUNTRY OF INCORPORATION OF TRANSFEREE FOREIGN CORPORATION: CAYMAN ISLANDS (II) A GENERAL DESCRIPTION OF THE TRANSFER: CASH AND DEEMED CASH CONTRIBUTIONS OF $4,094,734 ADDITIONAL PAID IN CAPITAL (3) CONSIDERATION RECEIVED: BEFORE AND AFTER THE EXCHANGE, BLOOD SYSTEMS, INC. OWNED 100% OF CANYON STATE INSURANCE COMPANY. (4) PROPERTY TRANSFERRED, INCLUDING THE ESTIMATED FAIR MARKET VALUE ("FMV") AND ADJUSTED BASIS ("AB") OF THE PROPERTY: (I) ACTIVE BUSINESS PROPERTY: CASH; FMV AND AB OF $4,094,734 (II) STOCK OR SECURITIES: N/A (III) DEPRECIATED PROPERTY: N/A (IV) PROPERTY TO BE LEASED: N/A (V) PROPERTY TO BE SOLD: N/A (VI) TRANSFERS TO FSCS: N/A (VII) TAINTED PROPERTY: N/A (VIII) FOREIGN LOSS BRANCH: N/A (IX) OTHER INTANGIBLES: N/A (5) TRANSFER OF FOREIGN BRANCH WITH PREVIOUSLY DEDUCTED LOSSES: (I) BRANCH OPERATION: N/A (II) BRANCH PROPERTY: N/A (III) PREVIOUSLY DEDUCTED LOSSES: N/A (IV) CHARACTER OF GAIN: N/A (6) APPLICATION OF SECTION 367(A)(5): N/A ATTACHMENT TO 12/31/2010 FORM 5471 FORM 926, PART III - INFORMATION REGARDING TRANSFERS OF PROPERTY TRANSFEREE CORPORATION'S INFORMATION STATEMENT FILED IN ACCORDANCE WITH REG. 1.351-3(B) TRANSFEROR NAME: BLOOD SYSTEMS, INC. TAXABLE YEAR ENDED: 12/31/2010 FEIN: 86-0098929 TRANSFEREE NAME: CANYON STATE INSURANCE COMPANY EIN: N/A TRANSFEREE ADDRESS: GRAND PAVILION COMMERCIAL CENTRE, WEST BAY ROAD P.O. BOX 10073 APO GRAND CAYMAN, CAYMAN ISLANDS THIS STATEMENT IS BEING FILED WITH CANYON STATE INSURANCE COMPANY, THE TRANSFEREE, FORM 5471, INFORMATION RETURN OF U.S. PERSONS, WITH RESPECT TO THE TRANSFEREE, FOR THE TAXABLE YEAR ENDED 12/31/2010. THIS STATEMENT IS FILED IN ACCORDANCE WITH REG. 1.351-3(B) TO DISCLOSE THE DETAILS OF PROPERTY TRANSFERRED TO THE ABOVE CONTROLLED CORPORATION. 1. PROPERTY RECEIVED AT VARIOUS TIMES THROUGHOUT THE YEAR, THE TAXPAYER RECEIVED CASH AND DEEMED CASH CONTRIBUTIONS IN THE AMOUNT OF USD $4,094,734 FROM BLOOD SYSTEMS, INC. 2. ADJUSTED BASIS OF PROPERTY BLOOD SYSTEMS, INC.'S BASIS IN THE PROPERTY TRANSFERRED ON THE DATE OF THE EXCHANGE WAS USD $4,094,734. 3. CAPITAL STOCK OF CONTROLLED CORPORATION CLASS IMMEDIATELY PRIOR ISSUED IN IMMEDIATELY OF STOCK TO THE EXCHANGE EXCHANGE AFTER THE EXCHANGE (I) TOTAL SHARES ISSUED AND OUTSTANDING: CLASS A COMMON 500,000 NONE 500,000 (II) TOTAL SHARES ISSUED AND OUTSTANDING FOR CANYON STATE INSURANCE COMPANY: CLASS A COMMON 500,000 NONE 500,000 (III) THE FAIR MARKET VALUE OF THE CAPITAL ISSUED TO BLOOD SYSTEMS, INC. ON THE DATE OF EXCHANGE: $4,094,734 4. SECURITIES OF THE TRANSFEREE CORPORATION: N/A 5. AMOUNT OF MONEY PAID IN THE EXCHANGE TO THE TRANSFEROR(S): N/A 6. OTHER PROPERTY PASSING TO THE TRANSFEROR(S) IN THE EXCHANGE: N/A 7. EACH OF THE TRANSFEROR'S LIABILITIES ASSUMED BY THE TRANSFEREE CORPORATION: N/A ACTIVITIES PREVIOUSLY NOT REPORTED TO IRS FORM 990EZ PART V LINE 33 1) BLOOD SYSTEMS FOUNDATION, AN AFFILIATE OF BLOOD SYSTEMS, INC. WAS DISSOLVED DURING THE YEAR. THE NET ASSETS OF BLOOD SYSTEMS FOUNDATION WERE MERGED INTO BLOOD SYSTEMS, INC. DURING THE YEAR. SEE LINE 20. 2) BLOOD SYSTEMS, INC. WAS THE PARENT ORGANIZATION OF GROUP RULING UNDER EXEMPTION NUMBER 2635. UPON DISSOLUTION OF BLOOD SYSTEMS FOUNDATION, THE GROUP CEASED TO EXIST. BLOOD CENTERS OF THE PACIFIC 270 MASONIC AVENUE SAN FRANCISCO CA 94118 941156555 BLOOD BANKING CA 501(C)3 9 NA INLAND NORTHWEST BLOOD CENTER 210 W CATALDO AVENUE SPOKANE WA 99201 910499130 BLOOD BANKING WA 501(C)3 9 NA CREATIVE TESTING SOLUTIONS 6210 EAST OAK STREET SCOTTSDALE AZ 85257 271120123 SAFETY TEST. AZ 501(C)(3) 10 NA true true false false false false false false false true true true false false false false true true BLOOD CENTERS OF THE PACIFIC J 1107515 CANYON STATE INSURANCE COMPANY Q 4094734 CREATIVE TESTING SOLUTIONS A 3456883 CREATIVE TESTING SOLUTIONS B 11250000 BLOOD CENTERS OF THE PACIFIC K 9047705 BLOOD CENTERS OF THE PACIFIC l 65447 INLAND NORTHWEST BLOOD CENTER L 857359 CREATIVE TESTING SOLUTIONS L 36478309 CREATIVE TESTING SOLUTIONS K 261167