Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 08-01-2010 and ending 07-31-2011
BCheck if applicable:
CName of organization
NCR OF CHILLICOTHE II OHIO
 
Doing Business As
HOPETON TERRACE
 
Number and street (or P.O. box if mail is not delivered to street address)
2335 NORTH BANK DRIVE
 
Room/suite
City or town, state or country, and ZIP + 4
COLUMBUS, OH43220
D Employer identification number

31-1361782
E Telephone number

G Gross receipts $ 247,885
F Name and address of principal officer:
MARK R RICKETTS
2335 NORTH BANK DRIVE
COLUMBUS,OH43220
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.NCR.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet5048
K Form of organization:
 
L Year of formation: 1992
M State of legal domicile: OH
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: PROVIDE HOUSING FOR LOW AND MODERATE INCOME PERSONS.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 7
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 7
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 0
6 Total number of volunteers (estimate if necessary) .... 6 11
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 67,933 99,291
9 Program service revenue (Part VIII, line 2g) ......... 148,556 146,658
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 217 724
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 277 990
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 216,983 247,663
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 0 0
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 245,557 281,684
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 245,557 281,684
19 Revenue less expenses. Subtract line 18 from line 12...... -28,574 -34,021
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 1,557,103 1,520,017
21 Total liabilities (Part X, line 26)............ 2,389,797 2,386,732
22 Net assets or fund balances. Subtract line 21 from line 20 ..... -832,694 -866,715
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: THE MISSION OF NATIONAL CHURCH RESIDENCES IS TO PROVIDE QUALITY HOUSING AND CARE AT AFFORDABLE PRICES IN COMMUNITIES OF CARING PERSONS. OUR MINISTRY IS NATIONAL IN SCOPE AND ORIGINATES FROM A CHRISTIAN COMMITMENT OF SERVICE TO OLDER ADULTS, WHICH BEGAN IN 1961. WHILE OUR MINISTRY HAS BEEN TARGETED PRIMARILY TOWARD OLDER ADULTS, WE HAVE SPECIAL CONCERN FOR LOW- AND MODERATE-INCOME SENIORS, PERSONS WITH DISABILITIES, AND LOW- AND MODERATE-INCOME FAMILIES. WE ARE COMMITTED TO EXPANDING AND FUNDING SERVICES IN ASSISTED LIVING, NURSING HOMES, AND FULL-SERVICE RETIREMENT COMMUNITIES. WE ALSO PLAN FOR THOUGHTFUL GROWTH IN AFFORDABLE FAMILY HOUSING. WE ARE COMMITTED TO PROFESSIONALISM IN THE MANAGEMENT OF PROPERTY, PROGRAMS, AND HUMAN RESOURCES AND EQUALLY COMMITTED TO COMPASSION FOR THE PEOPLE WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 230,914 including grants of $ 0 ) (Revenue $ 147,648 )
THE SOLE PURPOSE IS TO PROVIDE SUBSIDIZED LOW AND MODERATE-INCOME APARTMENT RENTAL HOUSING FOR PRIMARILY ELDERLY PERSONS THROUGH THE U.S. DEPARTMENT OF HUD SECTIONS 202 AND 8 PROGRAMS.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 230,914
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
7
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
7
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
OH
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
MARK R RICKETTS
2335 NORTH BANK DRIVE
COLUMBUS,OH43220
(614) 451-2151
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) ALLEN RUPIPER
DIRECTOR
 .10 X           0 0 0
(2) ANNE CARTER
DIRECTOR
 .10 X           0 0 0
(3) DONALD RUSSELL
DIRECTOR
 .10 X           0 0 0
(4) ELEANOR ALVAREZ
DIRECTOR
 .10 X           0 0 0
(5) KATHLEEN HUPPER
DIRECTOR
 .10 X           0 0 0
(6) LEA BLACKBURN
DIRECTOR
 .10 X           0 0 0
(7) PAUL BLOOMFIELD
DIRECTOR
 .10 X           0 0 0
(8) KENNETH PIERCE
DIRECTOR
 .10 X           0 0 0
(9) FLOYD JONES
DIRECTOR
 .10 X           0 0 0
(10) RONALD ADAMS
DIRECTOR
 .10 X           0 0 0
(11) STEPHEN RISH
DIRECTOR
 .10 X           0 0 0
(12) MARK R RICKETTS
PRESIDENT
 .10     X       0 323,122 53,105
(13) JOSEPH R KASBERG
VP/SEC/TREASURER
 .10     X       0 279,646 43,699








Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 0 602,768 96,804
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet0
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 99,291
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 99,291
Program Service Revenue Business Code
2a RENTS - NET 531,110 146,658 146,658    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 146,658
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 946     946
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses   222
c Gain or (loss)   -222
d Net gain or (loss)..........MediumBullet -222     -222
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a MISCELLANEOUS 531,110 990 990    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 990
12 Total revenue. See Instructions....MediumBullet 247,663 147,648 0 724
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees ....        
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages        
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....        
9 Other employee benefits .......        
10 Payroll taxes ...........        
11 Fees for services (non-employees):        
a Management ...... 40,695   40,695  
b Legal .........        
c Accounting ........... 10,075   10,075  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 33,112 33,112    
12 Advertising and promotion .... 403 403    
13 Office expenses ....... 15,949 15,949    
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 86,841 86,841    
17 Travel ............        
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 1,055 1,055    
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 60,930 60,930    
23 Insurance .............. 79 79    
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a CONTRACT SERVICES 32,202 32,202    
b
c
d
e
f All other expenses 343 343    
25 Total functional expenses. Add lines 1 through 24f 281,684 230,914 50,770 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 910 1 20,394
2 Savings and temporary cash investments ....... 215,426 2 236,790
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 20,669 4  
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............   9  
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 2,309,422
b Less: accumulated depreciation. ..... 10b 1,060,772 1,305,933 10c 1,248,650
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 14,165 15 14,183
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,557,103 16 1,520,017
Liabilities 17 Accounts payable and accrued expenses . 26,137 17 23,754
18 Grants payable ..........   18  
19 Deferred revenue .......... 173 19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 2,350,600 23 2,350,600
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 12,887 25 12,378
26 Total liabilities. Add lines 17 through 25..... 2,389,797 26 2,386,732
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... -832,694 27 -866,715
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... -832,694 33 -866,715
34 Total liabilities and net assets/fund balances ..... 1,557,103 34 1,520,017
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
247,663
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
281,684
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
-34,021
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
-832,694
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
0
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
-866,715
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
NCR OF CHILLICOTHE II OHIO
 
Employer identification number

31-1361782
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .     55,686 67,933 99,291 222,910
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... 176,698 191,278 131,087 148,556 146,658 794,277
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5. 176,698 191,278 186,773 216,489 245,949 1,017,187
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...           0
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.           0
c Add lines 7a and 7b..           0
8 Public Support (Subtract line 7c from line 6.)           1,017,187
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6... 176,698 191,278 186,773 216,489 245,949 1,017,187
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 7,086 5,973 3,811 2,047 946 19,863
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b. 7,086 5,973 3,811 2,047 946 19,863
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) 15,362 18,747 7,118 277 990 42,494
13 Total support (Add lines 9, 10c, 11 and 12.). 199,146 215,998 197,702 218,813 247,885 1,079,544
14
Section C. Computation of Public Support Percentage
15
15
94.220 %
16
16
92.150 %
Section D. Computation of Investment Income Percentage
17
17
1.840 %
18
18
2.110 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE SERVICE COORDINATOR REVENUE
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
NCR OF CHILLICOTHE II OHIO
 
Employer identification number

31-1361782
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
NCR OF CHILLICOTHE II OHIO
  		Employer identification number

31-1361782
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
NCR OF CHILLICOTHE II OHIO
  		Employer identification number

31-1361782
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
NCR OF CHILLICOTHE II OHIO
  		Employer identification number

31-1361782
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NCR OF CHILLICOTHE II OHIO
 
Employer identification number

31-1361782
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   80,000 80,000
b Buildings ................   1,931,949 835,578 1,096,371
c Leasehold improvements ............        
d Equipment ................   63,683 59,700 3,983
e Other .................   233,790 165,494 68,296
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 1,248,650
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
DEPOSITS 12,378








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 12,378
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 247,663
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 281,684
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 -34,021
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 0
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -34,021
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 247,885
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e 0
3 Subtract line 2e from line 1..................... 3 247,885
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b -222
c Add lines 4a and 4b....................... 4c -222
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 247,663
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 281,906
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d 222
e Add lines 2a through 2d...................... 2e 222
3 Subtract line 2e from line 1..................... 3 281,684
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 281,684
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION, AND HAS CONCLUDED THAT AS OF JULY 31, 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2007.
PART XII, LINE 4B - OTHER ADJUSTMENTS:   LOSS ON DISPOSAL OF FIXED ASSETS -222.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:   LOSS ON DISPOSAL OF FIXED ASSETS 222.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NCR OF CHILLICOTHE II OHIO
 
Employer identification number

31-1361782
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) MARK R RICKETTS (i)
(ii)		 0
227,505 		0
92,000 		0
3,617 		0
38,377 		0
14,728 		0
376,227 		0
0
(2) JOSEPH R KASBERG (i)
(ii)		 0
199,061 		0
61,000 		0
19,585 		0
29,647 		0
14,052 		0
323,345 		0
0














Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
NCR OF CHILLICOTHE II OHIO
 
Employer identification number

31-1361782
Identifier Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6   THE SOLE MEMBER OF THE CORPORATION SHALL, AT ALL TIMES, BE NCR.
FORM 990, PART VI, SECTION A, LINE 7A   MEMBERS OR TRUSTEES SHALL HAVE THE APPROVAL OF THE BOARD OF TRUSTEES OF NCR.
FORM 990, PART VI, SECTION A, LINE 7B   NCR IS REQUIRED TO APPROVE THE SELECTION OF THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 11   THE 990 RETURN IS MADE AVAILABLE TO THE BOARD PRIOR TO FILING. AN OFFICER REVIEWS THE 990 RETURN PRIOR TO SIGNATURE.
  FORM 990, PART VI, SECTION B, LINE 12C ANY DIRECTOR, EXECUTIVE OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS IS COVERED UNDER THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ANY PERSON COVERED UNDER THIS POLICY MUST DISCLOSE THE EXISTENCE OF A CONFLICT AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF BOARD COMMITTEES. ALL DIRECTORS AND OFFICERS SHALL ALSO REVIEW AND SIGN THE CONFLICT OF INTEREST DISCLOSURE STATEMENT ON AN ANNUAL BASIS, IDENTIFYING FAMILY MEMBERS, POSSIBLE RELATED BUSINESSES, AND INVESTMENTS AND PROMPTLY REPORT ANY CHANGES TO THE CHAIRPERSON THAT OCCUR THROUGHOUT THE YEAR. IF A CONFLICT EXISTS, PARTICIPATION AND VOTING RIGHT RESTRICTIONS ARE IMPOSED.
  FORM 990, PART VI, SECTION B, LINE 15 FOLLOWING AN ESTABLISHED EXECUTIVE COMPENSATION POLICY, THE HUMAN RESOURCE COMMITTEE REVIEWS AND APPROVES SALARIES OF ALL OFFICERS AND REPORTS TO THE EXECUTIVE COMMITTEE ON THEIR ACTION. THE COMMITTEES BASE THE SALARY DECISIONS ON SURVEY DATA FROM COMPARABLE ORGANIZATIONS, USE OF AN INDEPENDENT COMPENSATION CONSULTANT AND ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE. THE COMPENSATION POLICY REVIEW WAS LAST PERFORMED IN 2010.
  FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST AND THROUGH A SECURED WEBSITE.
  FORM 990, PART VII MARK R. RICKETTS AND JOSEPH R. KASBERG WORK AN ESTIMATED 40-50 TOTAL HOURS A WEEK ON THE SOLE MEMBER, NCR, AND ITS AFFILIATES.
  FORM 990, PART XI, LINE 2C: THE ORGANIZATION HAS AN AUDIT COMMITTEE WHICH OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
  FORM 990, SCHEDULE R, PART II: THE RELATED TAX EXEMPT ORGANIZATIONS ARE ALL MEMBERS OF GROUP EXEMPTION # 5048.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NCR OF CHILLICOTHE II OHIO
 
Employer identification number

31-1361782
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No












For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) ABBEY CHURCH VILLAGE LIMITED PARTNERSHIP

6003 ABBEY CHAPEL DR
DUBLIN,OH430171529
31-1416957 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(2) AUSTIN MANOR LIMITED PARTNERSHIP

95 ELIZABETH ST
DELAWARE,OH430152358
31-1183157 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(3) BATTERY PARK SENIOR HOUSING LIMITED PARTNERSHIP

1 BATTLE SQUARE
ASHEVILLE,NC288012712
26-0069390 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS NC  
        No     No  
(4) BRISTOL COURT APARTMENTS LIMITED PARTNERSHIP

600 E FIFTH ST
WAVERLY,OH456901566
20-2470977 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(5) CHAMBERS BRIDGE URBAN RENEWAL HOUSING LP

175 CHAMBERSBRIDGE RD
BRICK,NJ087233400
22-3479382 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS NJ  
        No     No  
(6) CHANTRY PLACE HOUSING LIMITED PARTNERSHIP

5500 MILLERSFIELD DRIVE
COLUMBUS,OH432327764
20-1872900 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(7) CHATEAU GARDENS HOUSING LLC

912 MARTIN AVE
FOND DU LAC,WI549356336
71-0955814 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS WI  
        No     No  
(8) CLARA PARK VILLAGE APARTMENTS LIMITED PARTNERSHIP

4805 CLARA ST
CUDAHY,CA902015200
20-2869540 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(9) CLINTON PLACE LIMITED DIVIDEND HOUSING ASSOCIATION

147 N RIVER CT
MOUNT CLEMENS,MI48043
38-2318315 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MI  
        No     No  
(10) COEUR D'ALENE SENIOR HOUSING LIMITED PARTNERSHIP

7712 N HEARTLAND DR
COEUR DALENE,ID838158906
31-1639271 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS ID  
        No     No  
(11) COLORADO PLAZA SENIOR HOUSING LIMITED PARTNERSHIP

420 COLORADO ST
MANHATTAN,KS665020659
31-1714217 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS KS  
        No     No  
(12) COMBINED LOCKS SENIOR HOUSING LIMITED PARTNERSHIP

334 WALLACE STREET
COMBINED LOCKS,WI54113
20-5556388 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS WI  
        No     No  
(13) COSMAS AND DAMIAN LIMITED DIVIDEND HOUSING ASSOCIATION LP

16400 DIX-TOLEDO HWY
SOUTHGATE,MI48195
20-0509679 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MI  
        No     No  
(14) COUNTRY RIDGE APARTMENTS LIMITED PARTNERSHIP

5656 FARMHOUSE LANE
HILLIARD,OH430267846
31-1504074 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(15) COURTYARD AT WILLOW WOODS LIMITED PARTNERSHIP

1500 LINCOLN AVENUE
TOMAH,WI546602463
20-3678605 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS WI  
        No     No  
(16) CYPRESS SUNRISE VILLAGE APARTMENTS LIMITED PARTNERSHIP

9151 GRINDLAY ST
CYPRESS,CA906303088
20-2869574 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(17) DELOWE & MYRTLE SENIOR HOUSING LIMITED PARTNERSHIP

1881 MYRTLE DRIVE SW
ATLANTA,GA30311
26-2082332 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS GA  
        No     No  
(18) DUBLIN HOUSE SENIOR HOUSING LIMITED PARTNERSHIP

1425 CENTRAL AVE
MIDDLETOWN,OH450444180
20-4064054 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(19) EAST VALLEY SENIOR HOUSING LIMITED PARTNERSHIP

16010 EAST VALLEYWAY AVE
VERADALE,WA990378937
91-2033951 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS WA  
        No     No  
(20) EDEN PLACE SENIOR HOUSING LP

1220 JEFFERSON AVE
SEGUIN,TX781555934
74-3017793 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS TX  
        No     No  
(21) ELIZABETH SENIOR HOUSING LIMITED PARTNERSHIP

122 SEVENTH STREET
ELIZABETH,NJ072012822
20-2862379 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS NJ  
        No     No  
(22) HARBOURVIEW SENIOR HOUSING LIMITED PARTNERSHIP

115 FRANKLIN STREET
SANDUSKY,OH448702806
20-2471589 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(23) HARVARD ELDERLY LIMITED PARTNERSHIP

6900 HARVARD AVE
CLEVELAND,OH441055016
34-1863728 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(24) HAYDEN SENIOR HOUSING LP

88 W SARGENT DR
HAYDEN,ID838358882
46-0493154 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS ID  
        No     No  
(25) HEARTLAND SENIOR HOUSING LP

7745 N HEARTLAND DR
COEUR DALENE,ID838158904
54-2064319 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS ID  
        No     No  
(26) HERITAGE PLACE AT TRAILS EDGE LIMITED PARTNERSHIP

2620 EAST STATE BLVD
FORT WAYNE,IN468054730
20-1469685 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS IN  
        No     No  
(27) HILLTOP II SENIOR HOUSING LIMITED PARTNERSHIP

3630 MOORES TRAIL RD
COLUMBUS,OH432284345
52-2367292 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(28) HILLTOP SENIOR HOUSING LIMITED PARTNERSHIP

300 OVERSTREET WAY
COLUMBUS,OH432284335
31-1592983 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(29) HURON-CLARK ASSOCIATES LDHA LP

1450 CHESTNUT DR
YPSILANTI,MI48197
38-2569196 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MI  
        No     No  
(30) KIRBY MANOR SENIOR LIMITED PARTNERSHIP

11500 DETROIT AVENUE
CLEVELAND,OH441020000
87-0704525 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(31) KIWANIS VILLAGE SENIOR HOUSING LIMITED PARTNERSHIP

1200 CROY DR
FINDLAY,OH458406707
20-4063620 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(32) LA VISTA FOUNDATION I LIMITED PARTNERSHIP

1615 REDWOOD RD
SAN MARCOS,TX786661410
74-2794169 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS TX  
        No     No  
(33) LAKESIDE APARTMENT HOUSING LP

2590 FRANCISCO BLVD
PACIFICA,CA940442732
02-0668710 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS CA  
        No     No  
(34) LAKEWOOD CHRISTIAN MANOR LIMITED PARTNERSHIP

2141 SPRINGDALE RD SW
ATLANTA,GA303156100
31-1647433 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(35) LEONARDTOWN SENIOR HOUSING LIMITED PARTNERSHIP

22810 DORSEY ST
LEONARDTOWN,MD206503831
20-8599565 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MD  
        No     No  
(36) LINCOLN GARDENS II SENIOR HOUSING LIMITED PARTNERSHIP

110 STURBRIDGE RD
COLUMBUS,OH432284424
26-4310827 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(37) MADISON HEIGHTS WIN LIMITED DIVIDEND HOUSING ASSOCIATION LIMITED PARTNERSHI

27777 DEQUINDRE RD
MADISON HEIGHTS,MI48071
20-3638189 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MI  
        No     No  
(38) MADISON THREE LIMITED DIVIDEND HOUSING ASSOCIATION LIMITED PARTNERSHIP

27795 DEQUINDRE
MADISON HEIGHTS,MI480715708
38-3004835 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MI  
        No     No  
(39) MANSFIELD WOODS LIMITED PARTNERSHIP

382 WOODRIDGE DR
MANSFIELD,OH449062103
31-1592987 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(40) MAPLEWOOD ASSOCIATES LDHA LP

1450 CHESTNUT DR
YPSILANTI,MI48197
38-2569044 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MI  
        No     No  
(41) MEADOWVIEW SENIOR HOUSING LIMITED PARTNERSHIP

338 W MAIN ST
MT STERLING,OH431431291
20-2471060 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(42) MEMORIAL TOWERS LIMITED PARTNERSHIP

1405 SOUTH 7TH AVE
PHOENIX,AZ850070000
30-0230394 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(43) MT BALDY SENIOR HOUSING LP

839 KOOTENAI CUT OFF RD
PONDERAY,ID838529804
74-3085816 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS ID  
        No     No  
(44) PRESBYTERIAN HOMES OF PASCO NPR LIMITED PARTNERSHIP

5852 SEA FOREST DR
NEW PORT RICHEY,FL346522049
59-3283881 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS FL  
        No     No  
(45) RENAISSANCE II SENIOR HOUSING LIMITED PARTNERSHIP

419 N ST CLAIR ST
TOLEDO,OH436041562
26-2062189 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(46) RIVERCREST SENIOR HOUSING ASSOCIATES LIMITED PARTNERSHIP

7210 WILLIAMS RD
NIAGARA FALLS,NY143043735
20-2518262 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS NY  
        No     No  
(47) RIVERSIDE DEVELOPMENT LDHALP

159 S GROVE RD
YPSILANTI,MI48198
38-2723325 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MI  
        No     No  
(48) ROMULUS WIN LIMITED DIVIDEND HOUSING ASSOCIATION LIMITED PARTNERSHIP

36500 BIBBINS STREET
ROMULUS,MI48174
42-1674512 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MI  
        No     No  
(49) ROOSEVELT TOWNE APARTMENTS LLC

711 N EUCLID AVE
ST LOUIS,MO631081632
13-4242467 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(50) SAN ANTONIO SENIOR HOUSING LIMITED PARTNERSHIP

3503 CAMINO REAL
SAN ANTONIO,TX782383401
31-1592980 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(51) SANTIAGO FAJARDO VILLAGE LIMITED PARTNERSHIP SE

1 CALLE 5-1 ADM OFFICE
FAJARDO,PR007384849
20-2907605 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(52) SOLBERG WIN LIMITED DIVIDEND HOUSING ASSOCIATION LIMITED PARTNERSHIP

27787 DEQUINDRE RD
MADISON HEIGHTS,MI48071
42-1674495 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MI  
        No     No  
(53) SOUTHWOOD GARDENS ADULT COMMUNITY LIMITED PARTNERSHIP

3550 CEDAR CREEK RD
SHREVEPORT,LA711182326
31-1484717 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(54) SPRAGUE SENIOR HOUSING LIMITED PARTNERSHIP

14303 E SPRAGUE AVE
SPOKANE,WA992163121
91-2123013 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS WA  
        No     No  
(55) SUMMERFIELD VILLAGE APARTMENTS LIMITED PARTNERSHIP

2624 TRACTION AVE
SACRAMENTO,CA958152485
20-2869621 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(56) SUPERIOR ARBORETUM SENIOR HOUSING LIMITED PARTNERSHIP

199 GRAY DR
SUPERIOR,AZ852734633
26-2084830 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS AZ  
        No     No  
(57) THE COMMONS AT BUCKINGHAM HOUSING LIMITED PARTNERSHIP

328 BUCKINGHAM STREET
COLUMBUS,OH43215
26-0223422 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(58) THE COMMONS AT GRANT LIMITED PARTNERSHIP

398 S GRANT AVE
COLUMBUS,OH432155549
31-1797406 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(59) THE COMMONS AT LIVINGSTON HOUSING LIMITED PARTNERSHIP

3349 EAST LIVINGSTON AVE
COLUMBUS,OH43227
26-4416286 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(60) TOWN COMMONS LLC

1601 TOWN COMMONS DR SUITE 104
HOWELL,MI48855
38-3493886 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MI  
        No     No  
(61) TRINITY MANOR SENIOR HOUSING LIMITED PARTNERSHIP

301 CLARK ST
MIDDLETOWN,OH450428158
26-0072500 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(62) TRINITY TOWERS LIMITED PARTNERSHIP LP

2611 SPRINGDALE RD SW
ATLANTA,GA303157137
52-2405847 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS GA  
        No     No  
(63) TSCHIRLEY SENIOR HOUSING II LIMITED PARTNERSHIP

107 S TSCHIRLEY RD
GREENACRES,WA990169317
81-0636765 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS WA  
        No     No  
(64) TSCHIRLEY SENIOR HOUSING LIMITED PARTNERSHIP

111 S TSCHIRLEY RD
GREENACRES,WA990169342
91-2177168 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS WA  
        No     No  
(65) VANDERBILT SENIOR HOUSING LIMITED PARTNERSHIP

75 HAYWOOD STREET
ASHEVILLE,NC288012846
20-2635801 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS NC  
        No     No  
(66) VIEWPOINT SENIOR HOUSING LIMITED PARTNERSHIP

215 EAST SHORELINE DRIVE
SANDUSKY,OH44870
20-2471408 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(67) VILLA ESPERANZA APARTMENTS LIMITED PARTNERSHIP SE

ADMINISTRATION BOX 111 ST 35 BLOQ 2
CAROLINA,PR009830000
20-2907561 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(68) VILLA PROVIDENCIA APARTMENTS LIMITED PARTNERSHIP SE

350 CARR 837
GUAYNABO,PR009696238
20-2907579 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(69) VISION CENTER II LIMITED PARTNERSHIP

3400 VISION CENTER COURT
COLUMBUS,OH432272262
31-1364056 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(70) WAGGONER SENIOR HOUSING LIMITED PARTNERSHIP

831 ACORN GROVE DR
BLACKLICK,OH430045044
31-1812222 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(71) WAGGONER WOODS LIMITED PARTNERSHIP

751 CHESTNUT GROVE DR
BLACKLICK,OH430045024
31-1808115 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(72) WARREN ELDERLY HOMES II LIMITED PARTNERSHIP

1330 BLAKELY CIRCLE SW
WARREN,OH444853875
34-1885076 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(73) WARREN ELDERLY HOMES LIMITED PARTNERSHIP

1330 BLAKELY CIRCLE SW
WARREN,OH444853875
31-1501031 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(74) WAYNE WIN LIMITED DIVIDEND HOUSING ASSOCIATION LIMITED PARTNERSHIP

35200 SIMS
WAYNE,MI48184
42-1674508 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS MI  
        No     No  
(75) WESTERVILLE SENIOR HOUSING II LLC

622 SOUTH SUNBURY ROAD
WESTERVILLE,OH43081
20-2489049 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(76) WESTERVILLE SENIOR HOUSING LIMITED PARTNERSHIP

630 SOUTH SUNBURY RD
WESTERVILLE,OH430819344
45-0470538 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(77) WHITE BIRCH I HOUSING LIMITED PARTNERSHIP

9239 N 75TH UNIT 1
MILWAUKEE,WI532232065
76-0752024 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS WI  
        No     No  
(78) WHITE BIRCH II HOUSING LIMITED PARTNERSHIP

9239 N 75TH UNIT 1
MILWAUKEE,WI532232065
76-0752031 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS WI  
        No     No  
(79) WHITEHALL SENIOR HOUSING LIMITED PARTNERSHIP

851 COUNTRY CLUB RD
WHITEHALL,OH432132442
31-1592973 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
(80) WYSONG VILLAGE APARTMENTS LIMITED PARTNERSHIP

111 N CHAPEL AVE
ALHAMBRA,CA918013565
20-2869668 		RENTAL ACTIVITY FOR LOW INCOME FAMILIES/SENIORS OH  
        No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) ABBEY CHURCH ROAD INC
6003 ABBEY CHAPEL DR
DUBLIN,OH430171529
31-1416121 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(2) CHANTRY PLACE HOUSING INC
5500 MILLERSFIELD DRIVE
COLUMBUS,OH432327764
20-1891592 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(3) COUNTRY RIDGE APARTMENTS INC
5656 FARMHOUSE LANE
HILLIARD,OH430267846
31-1504166 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(4) HARVARD SCHOOL INC
6900 HARVARD AVE
CLEVELAND,OH441055016
31-1740172 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(5) HILLTOP II SENIOR HOUSING INC
3630 MOORES TRAIL RD
COLUMBUS,OH432284345
02-0633437 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(6) HILLTOP SENIOR HOUSING INC
300 OVERSTREET WAY
COLUMBUS,OH432284335
31-1592982 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(7) MANSFIELD WOODS INC
382 WOODRIDGE DR
MANSFIELD,OH449062103
31-1592986 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(8) NCR OF WARREN SENIOR HOUSING II INC
1330 BLAKELY CIRCLE SW
WARREN,OH444853875
31-1721646 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(9) NCR OF WARREN SENIOR HOUSING INC
1330 BLAKELY CIRCLE SW
WARREN,OH444853875
31-1743897 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(10) RIVERCREST SENIOR HOUSING LLC
7210 WILLIAMS RD
NIAGARA FALLS,NY143043735
61-1462286 		RENTAL ACTIVITY FOR SENIORS/FAMILIES NY  
C      
(11) ROOSEVELT TOWNE HOUSING INC
711 N EUCLID AVE
ST LOUIS,MO631081632
54-2086755 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(12) SAN ANTONIO SENIOR HOUSING INC
3503 CAMINO REAL
SAN ANTONIO,TX782383401
31-1592978 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(13) ST GEORGE HOUSING FOR SENIORS INC
16400 DIX-TOLEDO HWY
SOUTHGATE,MI48195
20-0509633 		RENTAL ACTIVITY FOR SENIORS/FAMILIES MI  
C      
(14) VISION CENTER II INC
3400 VISION CENTER COURT
COLUMBUS,OH432272262
31-1363226 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(15) WAGGONER WOODS INC
751 CHESTNUT GROVE DR
BLACKLICK,OH430045024
31-1808113 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(16) WESTERVILLE SENIOR HOUSING INC
630 SOUTH SUNBURY RD
WESTERVILLE,OH430819344
73-1631614 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(17) WHITEHALL SENIOR HOUSING INC
851 COUNTRY CLUB RD
WHITEHALL,OH432132442
31-1592976 		RENTAL ACTIVITY FOR SENIORS/FAMILIES OH  
C      
(18) WINGATE MANAGEMENT CORP
29777 TELEGRAPH RD SUITE 2611
SOUTHFIELD,MI48034
38-2060029 		MANAGEMENT OF RENTAL ACTIVITY MI  
S      
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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