-
TIN:
Form
990-T
List of Attached Documents:
// Content
Department of the Treasury
Internal Revenue Service
Exempt Organization Business Income Tax Return
(and proxy tax under section 6033(e))
For calendar year 2023 or other tax year beginning
01-01-2023
and ending
12-31-2023
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
23
Open to Public Inspection for 501(c)(3) Organizations Only
A
Check box if address changed.
B
Exempt under section
501(
c3
)
408(e)
220(e)
408A
530(a)
529(a)
529A
Print or Type
Name of organization (
Check box if name changed and see instructions.)
IHC HEALTH SERVICES INC
Number, street, and room or suite no. If a P.O. box, see instructions.
36 S STATE STREET SUITE 2200
City or town, state or province, and ZIP or foreign postal code
SALT LAKE CITY
,
UT
84111
C
Book value of all assets at end of year
.....
16,785,610,654
D
Employer identification number
94-2854057
E
Group exemption number
(see instructions)
F
Check box if an amended return.
G
Check organization type
501(c) corporation
501(c) trust
401(a) trust
Other trust
State college/university
6417(d)(1)(A) Applicable entity
H
Check if filing only to claim
Credit from Form 8941
Refund shown on Form 2439
Elective payment amount from Form 3800
I
Check if a 501(c)(3) organization filing a consolidated return with a 501(c)(2) titleholding corporation
.........
J
Enter the number of attached Schedules A (Form 990-T)
...............
13
K
During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group?
...
Yes
No
If "Yes," enter the name and identifying number of the parent corporation
INTERMOUNTAIN HEALTH
87-0269232
L
The books are in care of
COLIN QUINCY
36 SOUTH STATE STREET SUITE 1600
SALT LAKE CITY
,
UT
84111
Telephone number
(801) 442-3491
Part I
Total Unrelated Business Taxable Income
1
Total of unrelated business taxable income computed from all unrelated trades or businesses (see instructions)
..............................
1
31,527,878
2
Reserved
..............................
2
3
Add lines 1 and 2
............................
3
31,527,878
4
Charitable contributions (see instructions for limitation rules)
..............
4
3,060,317
5
Total unrelated business taxable income before net operating losses. Subtract line 4 from line 3
....
5
28,467,561
6
Deduction for net operating loss. See instructions
List of Attached Documents:
// Content
.................
6
924,716
7
Total of unrelated business taxable income before specific deduction and section 199A deduction.
Subtract line 6 from line 5
.........................
7
27,542,845
8
Specific deduction (generally $1,000, but see instructions for exceptions)
..........
8
1,000
9
Trusts.
Section 199A deduction. See instructions
.................
9
10
Total deductions.
Add lines 8 and 9
......................
10
1,000
11
Unrelated business taxable income.
Subtract line 10 from line 7. If line 10 is greater than line 7, enter zero
................................
11
27,541,845
Part II
Tax Computation
1
Organizations taxable as corporations.
Multiply Part I, line 11 by 21% (0.21)
.......
1
5,783,787
2
Trusts taxable at trust rates.
See instructions for tax computation. Income tax on the amount on
Part I, line 11 from:
Tax rate schedule or
Schedule D (Form 1041)
........
2
3
Proxy tax.
See instructions
.......................
3
4
Other tax amounts. See instructions
....................
4
5
Alternative minimum tax
.........................
5
6
Tax on noncompliant facility income.
See instructions
................
6
7
Total.
Add lines 3 through 6 to line 1 or 2, whichever applies
...............
7
5,783,787
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11291J
Form
990-T
(2023)
Form 990-T (2023)
Page
2
Part III
Tax and Payments
1a
Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116)
1a
b
Other credits (see instructions)
..............
1b
List of Attached Documents:
// Content
150,000
c
General business credit. Attach Form 3800 (see instructions)
.....
1c
d
Credit for prior year minimum tax (attach Form 8801 or 8827)
....
1d
e
Total credits.
Add lines 1a through 1d
.....................
1e
150,000
2
Subtract line 1e from Part II, line 7
.......................
2
5,633,787
3a
Amount due from Form 4255
...............
3a
b
Amount due from Form 8611
...............
3b
List of Attached Documents:
// Content
150,000
c
Amount due from Form 8697
...............
3c
d
Amount due from Form 8866
...............
3d
e
Other amounts due (see instructions)
............
3e
f
Total credits.
Add lines 3a through 3e
.....................
3f
150,000
4
Total tax.
Add lines 2 and 3f (see instructions).
Check if includes tax previously deferred under
section 1294. Enter the tax amount here
4
5,633,787
5
Current net 965 tax liability paid from Form 965-A, Part II, column (k)
...........
5
0
6a
Payments: Preceding year's overpayment credited to the current year
..
6a
1,186,574
b
Current Year's estimated tax payments. Check if section 643(g) election applies
6b
6,500,000
c
Tax deposited with Form 8868
..............
6c
d
Foreign organizations: Tax paid or withheld at source (see instructions)
.
6d
e
Backup withholding (see instructions)
............
6e
7
f
Credit for small employer health insurance premiums (attach Form 8941)
.
6f
g
Elective payment election amount from Form 3800
........
6g
h
Payment from Form 2439
................
6h
i
Credit from Form 4136
.................
6i
j
Other (see instructions)
................
6j
7
Total payments.
Add lines 6a through 6j
.....................
7
7,686,581
8
Estimated tax penalty (see instructions). Check if Form 2220 is attached
List of Attached Documents:
// Content
........
8
18,869
9
Tax due.
If line 7 is smaller than the total of lines 4, 5, and 8, enter amount owed
.......
9
10
Overpayment.
If line 7 is larger than the total of lines 4, 5, and 8, enter amount overpaid
....
10
2,033,925
11
Enter the amount of line 10 you want:
Credited to 2024 estimated tax
2,033,925
Refunded
11
0
Part IV
Statements Regarding Certain Activities and Other Information
(see instructions)
1
At any time during the 2023 calendar year, did the organization have an interest in or a signature or other authority over a financial account (bank, securities, or other) in a foreign country? If "Yes," the organization may have to file FinCEN Form 114, Report of Foreign Bank and Financial Accounts. If "Yes," enter the name of the foreign country here
BR
AR
Yes
No
Yes
2
During the tax year, did the organization receive a distribution from, or was it the grantor of, or transferor to, a foreign trust?
No
If "Yes," see instructions for other forms the organization may have to file.
3
Enter the amount of tax-exempt interest received or accrued during the tax year
.....
$
30
4
Enter available pre-2018 NOL carryovers here. $
924,716
. Do not include any post-2017 NOL carryover shown on Schedule A (Form 990-T). Don't reduce the NOL carryover shown here by any deduction reported on Part I, line 4.
5
Post-2017 NOL carryovers. Enter the Business Activity Code and available post-2017 NOL carryovers. Don't reduce the amounts shown below by any NOL claimed on any Schedule A, Part II, line 17 for the tax year. See instructions.
Business activity code
Available post-2017 NOL carryover
901101
$
11,163,840
810000
$
71,687
540000
$
261,954
620000
$
6,945,890
903003
$
20,168
6a
Reserved for future use
.................................
b
Reserved for future use
.................................
Part V
Supplemental Information
Provide any additional information. See instructions.
Part Number
Line Number
Explanation
Amount
990T
PART V
IHC HEALTH SERVICES, INC.94-2854057SECTION 1.263(A)-3(N) ELECTIONDECEMBER 31, 2023SECTION 1.263(A)-3(N) ELECTION STATEMENTIHC HEALTH SERVICES, INC. ("TAXPAYER")36 S. STATE STREET, SUITE 2200SALT LAKE CITY, UT 84111EIN: 94-2854057THE ABOVE REFERENCED TAXPAYER IS MAKING THE ELECTION TO CAPITALIZE REPAIR AND MAINTENANCE COSTS UNDER SECTION 1.263(A)-3(N) FOR ITS TAX YEAR ENDING DECEMBER 31, 2023.
990T
PART V
IHC HEALTH SERVICES, INC.94-2854057SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTIONDECEMBER 31, 2023SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION STATEMENTIHC HEALTH SERVICES, INC. ("TAXPAYER")36 S. STATE STREET, SUITE 2200SALT LAKE CITY, UT 84111EIN: 94-2854057THE ABOVE REFERENCED TAXPAYER, WHICH HAS AN APPLICABLE FINANCIAL STATEMENT, AS DEFINED UNDER TREAS. REG. SECTION 1.263(A)-1(F)(4), ELECTS TO APPLY THE DE MINIMIS SAFE HARBOR UNDER TREAS. REG. SECTION 1.263(A)-1(F)(1)(I) TO NOT CAPITALIZE UNDER TREAS. REG. SECTION 1.263(A)-2(D)(1) OR 3(D), NOR TREAT AS A MATERIAL OR SUPPLY UNDER TREAS. REG. SECTION 1.162-3(A), AMOUNTS NOT EXCEEDING $5,000, CONSISTENT WITH ITS BOOK METHODS OF EXPENSING AMOUNTS PAID FOR THE ACQUISITION OR PRODUCTION OF CERTAIN TANGIBLE PROPERTY FOR THE TAX YEAR ENDING DECEMBER 31, 2023.
990T
PART V
IHC HEALTH SERVICES, INC.94-2854057IRC SECTION 172(B)(3) ELECTION TO FOREGO THE CARRYBACK PERIOD FOR NET OPERATING LOSSDECEMBER 31, 2023IHC HEALTH SERVICES, INC. ("TAXPAYER")36 S. STATE STREET, SUITE 2200SALT LAKE CITY, UT 84111EIN: 94-2854057UNDER IRC REGULATION SECTION 172(B) (3), THE TAXPAYER HEREBY ELECTS TO RELINQUISH THE ENTIRE CARRYBACK PERIOD FOR ANY OF THE CHARITABLE CONTRIBUTIONS CONVERTED TO NET OPERATING LOSS UNDER 170(D)(2)(B)(II).
990T, SCH A
LINE 5
990T, SCHEDULE A, K-1 INVESTMENT FLOW-THROUGH 901101PART I, LINE 5 - INCOME (LOSS) FROM PARTNERSHIPS12/31/20238 PERFORMANCE VENTURE CAPITAL II, LP 26-1895337 (724)10 EUROPEAN STRATEGIC PARTNERS 2008 'B', LP 98-0624885 (93)13 CROSS CREEK CAPITAL PARTNERS, LLC 26-1917867 (1)14 SOLAMERE FOUNDERS FUND I, LP 26-2562137 5,513 15 CROSS CREEK CAPITAL PARTNERS II, LP 27-3037833 786 16 EIG ENERGY FUND XV-A, LP 27-2688983 59,936 92 CATTERTON PARTNERS VII, LP 45-4869547 (2,994)94 CROSS CREEK CAPITAL PARTNERS III, LP 46-3445880 (5,636)95 EIG ENERGY FUND XVI, LP 46-2825629 198,697 106 BAIN CAPITAL MIDDLE MARKET CREDIT 2014, LP 46-2389040 (8,082)107 SOLAMERE CAPITAL FUND II, LP 46-2502981 28,814 108 SOLAMERE CAPITAL FUND II-A, LP 46-2509123 24,677 109 TRIVENTURES III FUND, LP 98-1200976 9,241 121 PARTNERS GROUP REAL ESTATE SECONDARY 2013 (USD) A, LP INC. 98-1158648 (210,585)125 COLUMBIA CAPITAL EQUITY PARTNERS VI (QP), LP 47-0978685 (492,169)129 AEW PARTNERS VII, LP 46-2156215 (226,494)140 CP7 INTERNATIONAL AIV, LP 98-1168648 (24,448)162 AEW PARTNERS REAL ESTATE FUND VIII, LP 81-3286462 (223,881)165 CROSS CREEK CAPITAL PARTNERS IV LP 81-1341948 (10)169 KOHLBERG TE INVESTORS VIII, LP 81-3324873 (81,449)176 L CATTERTON GROWTH PARTNERS III, LP 47-4283473 (94,764)187 SOLAMERE PORTFOLIO COMPANY INVESTMENTS II, LLC 46-4628417 13,094 188 L CATTERTON VIII, LP 47-4343290 (160,564)189 ENCAP ENERGY CAPITAL FUND XI, LP 81-4648210 1,368,530 193 STEPSTONE VC SECONDARIES FUND III, LP 82-3578905 (31,038)195 LEAVITT EQUITY PARTNERS II, LP 82-3207762 (86,518)204 SOLAMERE CAPITAL FUND III, LP 82-1677137 (32,219)205 PARTNERS GROUP REAL ESTATE SECONDARY 2017 (USD) A, LP 81-4060468 (312,621)208 GOLD HOLDINGS, LLC 61-1852444 (320)211 ENCAP FLATROCK MIDSTREAM FUND IV, LP 82-2890021 991,259 220 COLUMBIA CAPITAL EQUITY PARTNERS VII (QP), LP 83-0729187 (1,537,750)228 INFRABRIDGE GLOBAL INFRASTRUCTURE FUND II A 98-1398614 (248,868)240 EIG ENERGY FUND XVII, LP 81-5439747 1,459,946 243 BRIDGE WORKFORCE AND AFFORDABLE HOUSING FUND, LP 82-2036221 63,526 252 L CATTERTON GROWTH IV, LP 83-2097211 (242,604)255 CREEK CAPITAL DENTAL HOLDINGS 82-1668064 (90,707)256 HIG MIDDLE MARKET LBO FUND III, LP 83-4172688 (10,247)261 SOLAMERE PORTFOLIO COMPANY INVESTMENTS III, LLC 83-0533713 3,209 265 AACP CHINA GROWTH INVESTORS X, LP 83-2418411 (461)284 STEPSTONE VC SECONDARIES FUND IV, LP 06/06/22 (21,577)286 CROSS CREEK PARTNERS V, LP 82-4726924 (12,214)287 CROSS CREEK PARTNERS VI, LP 85-0557513 (2,865)292 SWEETWATER SECONDARIES FUND II, LP 82-5419161 1,216 302 PARTNERS GROUP REAL ESTATE OPPORTUNITIES 2019 (USD) A OPCO, LP 84-3522755 (213,707)303 LCGIV INTERNATIONAL AIV, LP 98-1579329 (10,296)306 L CATTERTON IX OFFSHORE, LP 98-1504257 (663,101)307 LC9 INTERNATIONAL AIV, LP 98-1503032 (18,383)311 H.I.G. MIDDLE MARKET III AIV I, LP 98-1587808 2,240 316 H.I.G. CAPITAL PARTNERS VI, LP 85-0872719 (204,635)324 COLLABORATIVE HEALTH VENTURES V, LP 84-4668723 34,357 325 CATALYST OPPORTUNITY RE FUND IV, LP 85-3444752 (122,276)
990T, SCH A
LINE 5
(CONTINUED)342 BRIDGE WORKFORCE AND AFFORDABLE HOUSING FUND II, LP 84-4839596 (230,842)352 SOF-XII US TE/NON-US FEEDER, LP 85-1404152 (461)353 SOF-XII US TE/QFPF REIT FEEDER, LP 85-1434132 (17,594)358 AEW PARTNERS REAL ESTATE FUND IX, LP 84-2867535 (267,847)364 TA XIV-B, LP 98-1593568 2,411 381 CRESTLINE PORTFOLIO FINANCING FUND II (TE/FNT), LP 98-1541562 763,621 382 CB OFFSHORE EQUITY OVERAGE FUND X, LP 85-3178133 (11,462)384 LEAVITT EQUITY PARTNERS III, LP 87-2495064 (27,526)386 PERFORMANCE DIRECT INVESTMENTS IV, LP 83-1171717 (17,954)388 CB OFFSHORE EQUITY EQUITY FUND X, LP 85-3126096 (129,054)391 H.I.G. CAPITAL PARTNERS VI-AIV I, LP 87-0923143 (26,606)393 PARTNERS GROUP DIRECT EQUITY IV (USD) A, LP 83-1270003 (105,456)396 H.I.G. MIDDLE MARKET III AIV IV, LP 87-0866050 (34,197)409 HIG MIDDLE MARKET LBO FUND IV, LP 88-3224176 (544,834)417 ACORE CAPITAL SS AIV, LP 85-4323616 2,309,161 419 PIX OAKLAND PARK CO-INVEST, LP 87-4614774 (9,836)437 BATTERY VENTURES XIV AIV I CAYMAN, LP 98-1656106 70 438 H.I.G. MIDDLE MARKET III AIV V, LP 88-3178457 9 441 CROSS CREEK PARTNERS VII, LP 88-1502504 (121)442 PARTNERS GROUP DIRECT EQUITY V (USD) A, LP 87-2963581 (303,795)446 L CATTERTON GROWTH V, LP 87-3313389 (293,098)447 LCG5 INTERNATIONAL AIV, LP 98-1647123 (45,861)448 L CATTERTON X OFFSHORE, LP 98-1651276 (208,608)449 TOWER AIV, LP 92-0438029 (44,896)482 COLUMBIA CAPITAL EQUITY PARTNERS VIII-B, LP 88-2375981 (45,767)483 PHARMALOGIC SALT LAKE CITY, LLC 86-1181199 (86,573)488 MOUNTAIN VIEW HOSPITAL, LLC 82-0516012 8,586,422 491 PIX GCP CO-INVEST, LP 88-3421419 (99,578)497 SOLAMERE SERIES IV FLAGSHIP FUND, LP 87-4572430 (21,703)SECTION 1250 GAINS REPORTED ON FORM 4797 124,427SUBTOTAL K-1 UNRELATED BUSINESS INCOME (LOSS) 7,721,991LESS: CAPITAL GAINS REPORTED ON SCHEDULE D - $115,847LESS: SALES OF BUSINESS PROPERTY REPORTED ON 4797 - $1,101,096TOTAL K-1 UNRELATED BUSINESS INCOME (LOSS) 6,505,041
Sign Here
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 taxpayer) is based on all information of which preparer has any knowledge.
Signature of officer
Date
Title
May the IRS discuss this return with the preparer shown below (see instructions)?
Yes
No
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
Check
if
self-employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-T
(2023)
Additional Data
Software ID:
Software Version:
Line K - Parent Corporation Name Control:
INTE
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
Go to
www.irs.gov/Form990T
for instructions and the latest information.
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
IHC HEALTH SERVICES INC
B
Employer identification number
94-2854057
C
Unrelated business activity code (see instructions)
901101
D
Sequence:
1
of
13
E
Describe the unrelated trade or business
QPI
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
483,578
b
Less returns and allowances
c
Balance
1c
483,578
2
Cost of goods sold (Part III, line 8)
.........
2
3,944,448
3
Gross profit. Subtract line 2 from line 1c
.......
3
483,578
483,578
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
1,216,942
1,216,942
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
List of Attached Documents:
// Content
-17,017
-17,017
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
6,505,041
6,505,041
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
-16,706
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
7,721,983
0
7,721,983
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
98,492
3
Repairs and maintenance
..........................
3
2,476
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
List of Attached Documents:
// Content
...................
5
49
6
Taxes and licenses
.............................
6
1,573,589
7
Depreciation (attach Form 4562) (see instructions)
List of Attached Documents:
// Content
.........
7
26,508
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
43,431
8b
26,508
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
314,116
11
Employee benefit programs
..........................
11
29,548
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
4,123,731
15
Total deductions.
Add lines 1 through 14
.....................
15
5,825,360
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
1,896,623
17
Deduction for net operating loss (see instructions)
List of Attached Documents:
// Content
..................
17
1,517,305
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
379,318
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation
1
Inventory at beginning of year
........................
1
0
2
Purchases
...............................
2
0
3
Cost of labor
..............................
3
0
4
Additional section 263A costs (attach statement)
..................
4
0
5
Other costs (attach statement)
List of Attached Documents:
// Content
........................
5
3,944,448
6
Total.
Add lines 1 through 5
..........................
6
3,944,448
7
Inventory at end of year
...........................
7
0
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
3,944,448
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
241,821
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
List of Attached Documents:
// Content
135,806
b
Other deductions (attach statement)
...
List of Attached Documents:
// Content
158,230
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
294,036
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
List of Attached Documents:
// Content
1,154,017
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
List of Attached Documents:
// Content
3,606,941
6
Divide line 4 by line 5
.......
31.994 %
7
Gross income reportable. Multiply line 2 by line 6
77,368
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....
0
9
Allocable deductions. Multiply line 3c by line 6
94,074
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..
0
11
Total dividends-received deductions
included in line 10
.................
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE D
(Form 1120)
List of Attached Documents:
// Content
Department of the Treasury
Internal Revenue Service
Capital Gains and Losses
Attach to Form 1120, 1120-C, 1120-F, 1120-FSC, 1120-H, 1120-IC-DISC, 1120-L,
1120-ND, 1120-PC, 1120-POL, 1120-REIT, 1120-RIC, 1120-SF, or certain Forms 990-T.
Go to
www.irs.gov/Form1120
for instructions and the latest information.
OMB No. 1545-0123
20
23
Name
IHC HEALTH SERVICES INC
Employer identification number
94-2854057
Did the corporation dispose of any investment(s) in a qualified opportunity fund during the tax year?
.......
Yes
No
If “Yes,” attach Form 8949 and see its instructions for additional requirements for reporting your gain or loss.
Part I
Short–Term Capital Gains and Losses –– Generally Assets Held One Year or Less (see instructions)
See instructions for how to figure the amounts to enter on the lines below.
This form may be easier to complete if you round off cents to whole dollars.
(d)
Proceeds
(e)
Cost
(g)
Adjustments to gain or loss from Form(s) 8949, Part 1, line 2, column (g)
(h) Gain or (loss)
Subtract column (e) from column (d) and combine the result with column (g)
1a
Totals for all short-term transactions reported on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 8949, leave this line blank and go to line 1b
1b
Totals for all transactions reported on
Form(s) 8949 with
Box A
checked
2
Totals for all transactions reported on
Form(s) 8949 with
Box B
checked
3
Totals for all transactions reported on
Form(s) 8949 with
Box C
checked
26,897
4
Short-term capital gain from installment sales from Form 6252, line 26 or 37
...........
4
5
Short-term capital gain or (loss) from like-kind exchanges from Form 8824
...........
5
6
Unused capital loss carryover (attach computation)
..................
6
(
)
7
Net short-term capital gain or (loss). Combine lines 1a through 6 in column h
...........
7
26,897
Part II
Long–Term Capital Gains and Losses –– Generally Assets Held More Than One Year (see instructions)
See instructions for how to figure the amounts to enter on the lines below.
This form may be easier to complete if you round off cents to whole dollars.
(d)
Proceeds
(e)
Cost
(g)
Adjustments to gain or loss from Form(s) 8949, Part II, line 2, column (g)
(h) Gain or (loss)
Subtract column (e) from column (d) and combine the result with column (g)
8a
Totals for all long-term transactions reported on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 8949, leave this line blank and go to line 8b
8b
Totals for all transactions reported on
Form(s) 8949 with
Box D
checked
9
Totals for all transactions reported on
Form(s) 8949 with
Box E
checked
10
Totals for all transactions reported on
Form(s) 8949 with
Box F
checked
120,130
11
Enter gain from Form 4797, line 7 or 9
.......................
11
1,101,096
12
Long-term capital gain from installment sales from Form 6252, line 26 or 37
...........
12
13
Long-term capital gain or (loss) from like-kind exchanges from Form 8824
...........
13
14
Capital gain distributions (see instructions)
.....................
14
15
Net long-term capital gain or (loss). Combine lines 8a through 14 in column h
..........
15
1,221,226
Part III
Summary of Parts I and II
16
Enter excess of net short-term capital gain (line 7) over net long-term capital loss (line 15)
......
16
26,897
17
Net capital gain. Enter excess of net long-term capital gain (line 15) over net short-term capital loss (line 7)
.
17
1,221,226
18
Add lines 16 and 17. Enter here and on Form 1120, page 1, line 8, or the applicable line on other returns
..
18
1,248,123
Note:
If losses exceed gains, see
Capital losses
in the instructions.
For Paperwork Reduction Act Notice, see the Instructions for Form 1120.
Cat. No. 11460M
Schedule D (Form 1120) 2023
Additional Data
Software ID:
Software Version:
-
TIN:
Form
8949
Department of the Treasury
Internal Revenue Service
Sales and Other Dispositions of Capital Assets
File with your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 10 of Schedule D.
Go to
www.irs.gov/Form8949
for instructions and the latest information.
OMB No. 1545-0074
20
23
Attachment
Sequence No.
12A
Name(s) shown on return
IHC HEALTH SERVICES INC
Social security number or taxpayer identification number
94-2854057
Before you check Box A, B, or C below, see whether you received any Form(s) 1099-B or substitute statement(s) from your broker. A substitute statement will have the same information as Form 1099-B. Either will show whether your basis (usually your cost) was reported to the IRS by your broker and may even tell you which box to check.
Part I
Short-Term.
Transactions involving capital assets you held 1 year or less are generally short term (see instructions). For long-term transactions, see page 2.
Note:
You may aggregate all short-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS and for which no adjustments or codes are required. Enter the totals directly on Schedule D, line 1a; you aren't required to report these transactions on Form 8949 (see instructions).
You
must
check Box A, B,
or
C below. Check only one box.
If more than one box applies for your short-term transactions, complete a separate Form 8949, page 1, for each applicable box. If you have more short-term transactions than will fit on this page for one or more of the boxes, complete as many forms with the same box checked as you need.
(A)
Short-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS (see
Note
above)
(B)
Short-term transactions reported on Form(s) 1099-B showing basis
wasn't
reported to the IRS
(C)
Short-term transactions not reported to you on Form 1099-B
1
(a)
Description of property
(Example: 100 sh. XYZ Co.)
(b)
Date acquired
(Mo., day, yr.)
(c)
Date sold or
disposed of
(Mo., day, yr.)
(d)
Proceeds
(sales price)
(see instructions)
(e)
Cost or other basis
See the
Note
below
and see
Column (e)
in the separate
instructions.
Adjustment, if any, to gain or loss.
If you enter an amount in column (g),
enter a code in column (f).
See the separate instructions.
(h)
Gain or (loss)
Subtract column (e)
from column (d) and
combine the result
with column (g).
(f)
Code(s) from
instructions
(g)
Amount of
adjustment
SEE ATTACHED
(
)
-3,345
SEE ATTACHED
(
)
30,237
FORM 6781, PART I
(
)
5
2 Totals
. Add the amounts in columns (d), (e), (g), and (h)
(subtract negative amounts). Enter each total here and include on your Schedule D,
line 1b
(if
Box A
above is checked),
line 2
(if
Box B
above is checked), or
line 3
(if
Box C
above is checked).
.......
(
)
26,897
Note:
If you checked Box A above but the basis reported to the IRS was incorrect, enter in column (e) the basis as reported to the IRS, and enter an adjustment in column (g) to correct the basis. See
Column
(g) in the separate instructions for how to figure the amount of the adjustment.
For Paperwork Reduction Act Notice, see your tax return instructions.
Cat. No. 37768Z
Form
8949
(2023)
Form 8949 (2023)
Attachment Sequence No.
12A
Page
2
Name(s) shown on return. Name and SSN or taxpayer identification no. not required if shown on other side
IHC HEALTH SERVICES INC
Social security number or taxpayer identification number
94-2854057
Before you check Box D, E, or F below, see whether you received any Form(s) 1099-B or substitute statement(s) from your broker. A substitute statement will have the same information as Form 1099-B. Either will show whether your basis (usually your cost) was reported to the IRS by your broker and may even tell you which box to check.
Part II
Long-Term.
Transactions involving capital assets you held more than 1 year are generally long term (see instructions). For short-term transactions, see page 1.
Note:
You may aggregate all long-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS and for which no adjustments or codes are required. Enter the totals directly on Schedule D, line 8a; you aren't required to report these transactions on Form 8949 (see instructions).
You
must
check Box D, E,
or
F below. Check only one box.
If more than one box applies for your long-term transactions, complete a separate Form 8949, page 2, for each applicable box. If you have more long-term transactions than will fit on this page for one or more of the boxes, complete as many forms with the same box checked as you need.
(D)
Long-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS (see
Note
above)
(E)
Long-term transactions reported on Form(s) 1099-B showing basis
wasn't
reported to the IRS
(F)
Long-term transactions not reported to you on Form 1099-B
1
(a)
Description of property
(Example: 100 sh. XYZ Co.)
(b)
Date acquired
(Mo., day, yr.)
(c)
Date sold or
disposed of
(Mo., day, yr.)
(d)
Proceeds
(sales price)
(see instructions)
(e)
Cost or other basis
See the
Note
below
and see
Column (e)
in the separate
instructions.
Adjustment, if any, to gain or loss.
If you enter an amount in column (g),
enter a code in column (f).
See the separate instructions.
(h)
Gain or (loss)
Subtract column (e)
from column (d) and
combine the result
with column (g).
(f)
Code(s) from
instructions
(g)
Amount of
adjustment
SEE ATTACHED
(
)
119,178
SEE ATTACHED
(
)
944
FORM 6781, PART I
(
)
8
2 Totals
. Add the amounts in columns (d), (e), (g), and (h)
(subtract negative amounts). Enter each total here and include on your Schedule D,
line 8b
(if
Box D
above is checked),
line 9
(if
Box E
above is checked), or
line 10
(if
Box F
above is checked)
..........
(
)
120,130
Note:
If you checked Box D above but the basis reported to the IRS was incorrect, enter in column (e) the basis as reported to the IRS, and enter an adjustment in column (g) to correct the basis. See
Column
(g) in the separate instructions for how to figure the amount of the adjustment.
Form
8949
(2023)
Additional Data
Software ID:
Software Version: