POLK COUNTY MEDICAL ASSOICATION INC: Form 990EZ, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- POLK COUNTY MEDICAL ASSOICATION INC (EIN 59-6137315)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2023-04-11
- IRS object ID
- 202341019349200204
- Schema version
- 2021v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-04-11T08:26:17-04:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 593188484 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEASLEY BRYANT & COMPANY CPA'S PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4940 SOUTHFORK DR | AddressLine1Txt |
| City | LAKELAND | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 338132042 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 596137315 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | POLK COUNTY MEDICAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | POLK | BusinessNameControlTxt |
| Phone | 8636444051 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4315 HIGHLAND PARK BLVD SUITE B | AddressLine1Txt |
| City | LAKELAND | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33813 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JACKIE COURTNEY | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 8636444051 | PhoneNum |
| Signature | 2023-03-28 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JACKIE | PersonFirstNm |
| Person Last | COURTNEY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RYAN BEASLEY | PreparerPersonNm |
| PTIN | P01408459 | PTIN |
| Phone | 8636461373 | PhoneNum |
| Preparation | 2023-03-28 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amended Return | Yes (X) | AmendedReturnInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | WWW.POLKCOUNTYDOCTORS.COM | WebsiteAddressTxt |
| Organization501c | Yes (X) | Organization501cInd |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $19,393 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $6,248 | ContributionsGiftsGrantsEtcAmt |
| Other Revenue Total | $13,145 | OtherRevenueTotalAmt |
| Total Revenue | $19,393 | TotalRevenueAmt |
| Salaries Other Comp Empl Bnft | $23,320 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $2,650 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $2,488 | OccupancyRentUtltsAndMaintAmt |
| Other Expenses Total | $1,873 | OtherExpensesTotalAmt |
| Total Expenses | $30,331 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$10,938 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | -$17,394 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$28,332 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,026 | BOYAmt |
| EOY | $26,954 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,981 | BOYAmt |
| EOY | $18,576 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,007 | BOYAmt |
| EOY | $45,530 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,401 | BOYAmt |
| EOY | $73,862 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$17,394 | BOYAmt |
| EOY | -$28,332 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | THE ASSOCIATION SERVES AS AN ADVOCATE FOR PHYSICIANS AND THEIR PATIENTS TO PROMOTE HIGH STANDARDS IN MEDICAL ETHICS, PROMOTE PUBLIC HEALTH, AND TO ENHANCE THE QUALITY AND ACCESSIBILITY OF HEALTH CARE IN OUR COMMUNITIES. THE ASSOCIATION ALSO PROVIDES FREE PHYSICIAN REFERRALS AND CAN BE OF ASSISTANCE IN HELPING GROUPS SECURE A SPEAKER ON A MEDICAL TOPIC. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | THE ASSOCIATION SERVES AS AN ADVOCATE FOR PHYSICIANS AND THEIR PATIENTS TO PROMOTE HIGH STANDARDS IN MEDICAL ETHICS, PROMOTE PUBLIC HEALTH, AND TO ENHANCE THE QUALITY AND ACCESSIBILITY OF HEALTH CARE IN OUR COMMUNITIES. THE ASSOCIATION ALSO PROVIDES FREE PHYSICIAN REFERRALS AND CAN BE OF ASSISTANCE IN HELPING GROUPS SECURE A SPEAKER ON A MEDICAL TOPIC. | DescriptionProgramSrvcAccomTxt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (4 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| JACKIE COURTNEY | ||
| EXECUTIVE DI | 000.00 | $0 |
| RALPH NOBO MD | ||
| BOARD CHAIR | 000.00 | $0 |
| JAMES BOOKER MD | ||
| PRESIDENT | 000.00 | $0 |
| STUART PATTERSON MC | ||
| TREASURER | 000.00 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | Yes (true) | OrganizationHadUBIInd |
| Organization Filed990 T | Yes (true) | OrganizationFiled990TInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JACKIE COURTNEY | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4315 HIGHLAND PARK BLVD STE B | AddressLine1Txt |
| City | LAKELAND | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33813 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8636444051 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PAGE 1, ITEM B | TAXPAYER RECEIVED 4,375.01 FOR ERC, RETURN AMENDED TO REFLECT THIS CREDIT. |
| FORM 990-EZ, PART I, LINE 8 | ENDORSEMENT INCOME 13,145 TOTAL 13,145 |
| FORM 990-EZ, PART I, LINE 16 | EXPENSES 756 295 BANK CHARGES 144 DUES & SUBSCRIPTIONS 600 TAXES & LICENSES 78 TOTAL 1,873 |
| FORM 990-EZ, PART II, LINE 24 | 12,791 14,011 3,872 3,872 LESS ACCUMULATED DEPRECIATION 3,872 3,872 ERC REFUND RECEIVABLE 0 4,375 UTILITY DEPOSIT 190 190 TOTAL 12,981 18,576 |
| FORM 990-EZ, PART II, LINE 26 | DEFERRED REVENUE 58,584 72,672 PAYROLL LIABILITIES 817 1,190 |
| FORM 990-EZ, PART III | THE ASSOCIATION SERVES AS AN ADVOCATE FOR PHYSICIANS AND THEIR PATIENTS TO PROMOTE HIGH STANDARDS IN MEDICAL ETHICS, PROMOTE PUBLIC HEALTH, AND TO ENHANCE THE QUALITY AND ACCESSIBILITY OF HEALTH CARE IN OUR COMMUNITIES. THE ASSOCIATION ALSO PROVIDES FREE PHYSICIAN REFERRALS AND CAN BE OF ASSISTANCE IN HELPING GROUPS SECURE A SPEAKER ON A MEDICAL TOPIC. |
| FORM 990-EZ, PART III, LINE 28 | THE ASSOCIATION SERVES AS AN ADVOCATE FOR PHYSICIANS AND THEIR PATIENTS TO PROMOTE HIGH STANDARDS IN MEDICAL ETHICS, PROMOTE PUBLIC HEALTH, AND TO ENHANCE THE QUALITY AND ACCESSIBILITY OF HEALTH CARE IN OUR COMMUNITIES. THE ASSOCIATION ALSO PROVIDES FREE PHYSICIAN REFERRALS AND CAN BE OF ASSISTANCE IN HELPING GROUPS SECURE A SPEAKER ON A MEDICAL TOPIC. |
| FORM 990-EZ, PART VI | PART VI SECTION (C) (3) ORGANIZATIONS ONLY 47- DID THE ORGANIZATION ENGAGE IN LOBBYING ACTIVITIES OR HAVE SECTION 501 H ELECTION IN EFFECT DURING THE TAX YEAR? ANSWER: NO 48- IS THE ORGANIZATION A SCHOOL AS DESCRIBED IN SECTION 170(B)(1)(A)(II)? ANSWER: NO 49A- DID THE ORGANIZATION MAKE ANY TRANSFERS TO AN EXEMPT NON-CHARITABLE RELATED ORGANIZATION? ANSWER: NO 50- COMPLETE THIS TABLE FOR THE ORGANIZATION'S FIVE HIGHEST COMPENSATED EMPLOYEES WHO EACH RECEIVED MORE THAN 100,000 OF COMPENSATION FROM THE ORGANIZATION. IF THERE IS NONE, ENTER "NONE". ANSWER: NONE |