2023-11-14T11:50:13-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 5001 SPRING VALLEY ROAD SUITE 600W DALLAS TX 75244 990 2022-01-01 340787715 AMERICAN BOARD OF OBSTETRICS & GYNECOLOGY INC AMER 2148711619 2727 LACLEDE ST DALLAS TX 75204 AMY YOUNG MD EXECUTIVE DIRECTOR 2148711619 2023-11-13 1 AMY YOUNG MD 999009999 0 LACEY M QUATSOE P01300865 9723835700 2023-11-13 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z X AMY YOUNG MD 2727 LACLEDE ST DALLAS TX 75204 48370166 0 X WWW.ABOG.ORG X 1930 DE CERTIFICATION FOR PHYSICIANS PRACTICING IN THE AREAS OF OB/GYN AND ITS AFFILIATED SPECIALTIES. 18 0 54 582 0 0 0 234550 20173215 19187190 2901136 -332272 44290 35238 23118641 19124706 800000 475000 0 0 7341730 7507108 0 0 0 8620471 12081523 16762201 20063631 6356440 -938925 79504335 69977641 7247503 6069385 72256832 63908256 OUR MISSION IS TO DEFINE THE STANDARDS, CERTIFY OBSTETRICIANS AND GYNECOLOGISTS, AND FACILITATE CONTINUOUS LEARNING TO ADVANCE KNOWLEDGE, PRACTICE, AND PROFESSIONALISM IN WOMEN'S HEALTH. 0 0 9330103 237500 10107350 SPECIALTY COMPETENCY EXAMINATIONS - GYNECOLOGIC ONCOLOGY, MATERNAL FETAL MEDICINE, REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY, FEMALE PELVIC MEDICINE AND REPRODUCTIVE SURGERY. 5099135 237500 9079840 PREPARATION, ADMINISTRATION, AND MAINTENANCE OF RECORDS OF EXAMINATIONS TAKEN BY PHYSICIANS AS PROOF OF CONTINUING EDUCATION IN THE FIELD OF OBSTETRICS AND GYNECOLOGY. 14429238 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 415 0 1 54 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X X JAMES KUNKO 2148711619 2727 LACLEDE ST DALLAS TX 75204 GEORGE D WENDEL JR MD EXECUTIVE DIRECTOR 50.00 2.00 X 629871 0 19598 SUSAN RAMIN MD ASSOCIATE EXECUTIVE DIRECTOR 50.00 2.00 X 513069 0 60082 KIRK DIEPENBROCK CHIEF INFORMATION OFFICER 45.00 0.00 X 254137 0 64503 LACEY HAMMONS CFO AND COO THRU 3/2022 45.00 2.00 X 252137 0 15698 WILMA LARSEN MD ASSOC EXEC DIRECTOR THRU 4/2022 50.00 2.00 X 233648 0 27389 JAMES KUNKO CFO AS OF 4/2022 45.00 2.00 X 191096 0 49310 POOJA SHRIVAJ CHIEF OF ASSESSMENTS 45.00 0.00 X 198969 0 31350 AMANDA NOVAK COO AS OF 7/2022 45.00 0.00 X 168343 0 32776 RAJAT CHADHA MANAGER OF PSYCHOMETRICS 40.00 0.00 X 151770 0 37437 KAREN MONGO MOC PROGRAM MANAGER 40.00 0.00 X 121533 0 51018 DENTON PFISTER SOFTWARE ARCHITECT 40.00 0.00 X 134288 0 29489 KAY NELSON EXAM PUBLISHER 40.00 0.00 X 111954 0 45364 STEPHEN SCRUGGS SOFTWARE DEVELOPER 40.00 0.00 X 125524 0 22499 ANDREW SATIN MD PRES. THRU 6/22; P. PRES. AS 7/22 10.00 2.00 X X 24000 0 0 GEORGE MACONES MD DIR. THRU 6/2022; PRES. AS 7/2022 10.00 2.00 X X 24000 0 0 DAVID SOPER MD VICE PRESIDENT THRU 6/2022 10.00 2.00 X X 12625 0 0 WANDA NICHOLSON MD DIR. THRU 6/2022; VP AS 7/2022 10.00 2.00 X X 24000 0 0 LAUREL RICE MD TREASURER THRU 6/2022 10.00 2.00 X X 12000 0 0 RONALD ALVAREZ MD DIR. THRU 6/2022; TREAS. AS 7/2022 10.00 2.00 X X 24000 0 0 MATTHEW BARBER MD DIRECTOR 10.00 1.00 X 24000 0 0 SEINE CHIANG MD DIRECTOR 9.00 1.00 X 24000 0 0 MARLENE CORTON MD DIRECTOR 9.00 1.00 X 24000 0 0 ABIMBOLA FAMUYIDE MD DIRECTOR 9.00 1.00 X 24000 0 0 RAJIV GALA MD DIRECTOR AS OF 7/2022 9.00 1.00 X 17000 0 0 WILLIAM GROBMAN MD DIRECTOR 9.00 1.00 X 24000 0 0 DENISE JAMIESON MD DIRECTOR 9.00 1.00 X 24000 0 0 EMILY JUNGHEIM MD DIRECTOR AS OF 7/2022 9.00 1.00 X 15500 0 0 KIMBERLY KENTON MD DIRECTOR 9.00 1.00 X 24000 0 0 MARY NORTON MD DIRECTOR 9.00 1.00 X 24000 0 0 STEPHEN PLAXE MD DIRECTOR 9.00 1.00 X 24000 0 0 MEGHAM TWISS PUBLIC MEMBER 9.00 1.00 X 24000 0 0 COURTNEY SCHREIBER MD DIRECTOR 9.00 1.00 X 24000 0 0 JEANNE SHEFFIELD MD DIRECTOR 9.00 1.00 X 24000 0 0 MICHAEL THOMAS DIRECTOR THRU 6/2022 9.00 1.00 X 12000 0 0 3539464 0 486513 16 0 1 0 DUANE MORRIS LLP 100 CRESCENT COURT 1200 DALLAS TX 75201 LEGAL SERVICES 973212 JIM HENRY INC 435 THIRTY-SEVENTH AVE ST CHARLES IL 60174 PRINTING AND MAILING CERTIFICATES 725253 MCI USA 6100 W PLANO PKWY 3500 PLANO TX 75093 MEETING PLANNING 394857 AMERICAN BOARD OF MEDICAL SPECIALTIES 353 NORTH CLARK ST 1400 CHICAGO IL 60654 GOVERNANCE 373522 NCS PEARSON INC 13036 COLLECTION CENTER DRIVE CHICAGO IL 60693 TESTING CENTERS 324771 8 234550 234550 APPLICATION FEES 541380 16474810 16474810 EXAM FEES 541380 2712380 2712380 19187190 1330018 1330018 27583170 29245460 -1662290 -1662290 -1662290 REFUNDS 900099 20670 20670 MISCELLANEOUS INCOME 900099 12207 12207 REBATES AND REWARDS 900099 2361 2361 35238 19124706 19187190 0 -297034 475000 475000 3195101 1449313 1745788 3008917 2546383 462534 245341 189141 56200 707882 511529 196353 349867 244907 104960 1072593 504695 567898 15988 15988 141996 141996 975027 463412 511615 7182 7182 68389 39246 29143 126154 81571 44583 1797997 1248295 549702 1037249 499516 537733 413087 8057 405030 355622 355622 387086 270960 116126 89784 62848 26936 EXAMINATIONS 4661367 4661219 148 SERVICE FEES 374857 361484 13373 HONORARIA 261000 261000 REPAIRS & MAINTENANCE 189500 146496 43004 106645 48544 58101 20063631 14429238 5634393 0 4378207 196385 6298787 5747662 29061 290088 271171 7352951 1194518 3920896 6158433 56280022 29447157 8307274 28156833 79504335 69977641 1263358 3799226 5984145 884350 1000 0 1384809 7247503 6069385 X 72256832 63908256 72256832 63908256 79504335 69977641 -938925 -7409651 0 X 0 1 X 1 0 X 234550 234550 19187190 19187190 19421740 19421740 234550 234550 0 234550 234550 19187190 1330018 1330018 1330018 1330018 35238 35238 20786996 20786996 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: REFUNDS - 2022 AMOUNT: $ 20,670. MISCELLANEOUS INCOME - 2022 AMOUNT: $ 12,207. REBATES AND REWARDS - 2022 AMOUNT: $ 2,361. SCHEDULE A, PART III THE AMERICAN BOARD OF OBSTETRICS & GYNECOLOGY, INC. WAS GRANTED EXEMPTION FROM INCOME TAX UNDER SECTION 501(C)(6) OF THE INTERNAL REVENUE CODE AND OPERATED UNDER THAT EXEMPTION FOR ALL OF THE 2021 TAX YEAR. IN 2022, THE ORGANIZATION APPLIED FOR AND WAS GRANTED EXEMPTION UNDER SECTION 501(C)(3) EFFECTIVE MARCH 8, 2022. AS SUCH, THE 2022 RETURN IS BEING FILED AS A 501(C)(3) EXEMPT ORGANIZATION TO MATCH THE IRS' RECORDS AND DATABASE AT THE TIME OF FILING. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1309166 1309166 896224 592981 303243 260245 228288 31957 4887316 373249 4514067 6158433 DUE FROM ABOG EDUCATION FOUNDATION 27008750 RIGHT-OF-USE ASSET 1009986 DEPOSITS 138097 28156833 LEASE INCENTIVE LIABILITY 180555 LEASE LIABILITY 1204254 1384809 X PART X, LINE 2: THE BOARD IS A NONPROFIT ORGANIZATION THAT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE IRC AS A 501(C)(3) ORGANIZATION. HOWEVER, THE BOARD IS SUBJECT TO UNRELATED BUSINESS INCOME TAX ON CERTAIN REVENUE STREAMS AND TAX BASES. IN ADDITION, THE ENTITY IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO THEIR EXEMPT PURPOSES. THE BOARD HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE COMBINED FINANCIAL STATEMENTS. THE ORGANIZATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. 1 AMERICAN BOARD OF OBGYN EDUCATIONAL FOUNDATION 2727 LACLEDE ST DALLAS TX 75204 752619323 501(C)(3) 475000 0 SCHOLARSHIPS 1 PART I, LINE 2: THE GRANT RECIPIENT IS A RELATED ORGANIZATION. THE EXECUTIVE DIRECTOR OF THE ORGANIZATION MONITORS THE DISTRIBUTIONS AND WHAT THESE FUNDS ARE USED FOR. X 1 1 X X X X 1 0 0 0 0 0 0 1 0 GEORGE D WENDEL JR MD EXECUTIVE DIRECTOR 619871 0 10000 0 0 0 19598 0 0 0 649469 0 0 0 SUSAN RAMIN MD ASSOCIATE EXECUTIVE DIRECTOR 493069 0 20000 0 0 0 23587 0 36495 0 573151 0 0 0 KIRK DIEPENBROCK CHIEF INFORMATION OFFICER 236414 0 17723 0 0 0 21625 0 42878 0 318640 0 0 0 LACEY HAMMONS CFO AND COO THRU 3/2022 124845 0 2000 0 125292 0 8479 0 7219 0 267835 0 0 0 WILMA LARSEN MD ASSOC EXEC DIRECTOR THRU 4/2022 231458 0 2190 0 0 0 18274 0 9115 0 261037 0 0 0 JAMES KUNKO CFO AS OF 4/2022 181402 0 9694 0 0 0 16074 0 33236 0 240406 0 0 0 POOJA SHRIVAJ CHIEF OF ASSESSMENTS 188498 0 10471 0 0 0 13066 0 18284 0 230319 0 0 0 AMANDA NOVAK COO AS OF 7/2022 157635 0 10708 0 0 0 14064 0 18712 0 201119 0 0 0 RAJAT CHADHA MANAGER OF PSYCHOMETRICS 149770 0 2000 0 0 0 13643 0 23794 0 189207 0 0 0 KAREN MONGO MOC PROGRAM MANAGER 119533 0 2000 0 0 0 10522 0 40496 0 172551 0 0 0 DENTON PFISTER SOFTWARE ARCHITECT 128288 0 6000 0 0 0 11459 0 18030 0 163777 0 0 0 KAY NELSON EXAM PUBLISHER 108954 0 3000 0 0 0 9693 0 35671 0 157318 0 0 0 PART I, LINE 1A DIRECTORS ARE PROVIDED FIRST-CLASS TRAVEL TO ATTEND BOARD FUNCTIONS IN ACCORDANCE WITH THE ORGANIZATION'S TRAVEL POLICIES. PART I, LINE 4A AN INDIVIDUAL LEFT THE ORGANIZATION IN 2022 AND RECEIVED SEVERANCE, WHICH IS INCLUDED ON SCHEDULE J, PART II, COLUMN B(III). DUE TO A CONFIDENTIALITY AGREEMENT, NEITHER THE NAME NOR THE AMOUNT WILL BE LISTED. PART I, LINE 7 BONUSES WERE DETERMINED BY PERFORMANCE-BASED EMPLOYEE EVALUATIONS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE A COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE TAX RETURN IS MADE AVAILABLE TO ALL BOARD MEMBERS AND THE EXECUTIVE DIRECTOR FOR REVIEW PRIOR TO FILING. AFTER THIS REVIEW PERIOD, THE TAX RETURN IS SUBMITTED FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO DIRECTORS, OFFICERS, EXECUTIVE DIRECTORS, EXAMINERS, EMPLOYEES, VOLUNTEERS AND AGENTS. THE ORGANIZATION WORKS TO AVOID REAL OR PERCEIVED CONFLICTS OF INTEREST IN ITS ACTIVITIES. ACCORDINGLY, THE BOARD HAS ADOPTED A CONFLICT OF INTEREST POLICY FOR THE BOARD AND FOR THE STAFF, OFFICERS, EXAMINERS AND VOLUNTEERS AND OTHER AGENTS ARE ASKED ON AN ANNUAL BASIS TO REVIEW THE POLICY AND HAVE A CONTINUING DUTY TO DISCLOSE ANY POTENTIAL CONFLICTS THEY MAY HAVE. EACH AGENT IS CHARGED WITH THE PERSONAL RESPONSIBILITY, SUBJECT TO THE OVERSIGHT OF THE ORGANIZATION, OF DETERMINING WHEN A CONFLICT OF INTEREST EXISTS, OR APPEARS TO EXIST, AND FOR TAKING APPROPRIATE ACTION TO ELIMINATE THE CONFLICT OR ITS APPEARANCE. IF THE AGENT IS UNSURE AS TO WHETHER OR NOT A CONFLICT OF INTEREST EXISTS, THE AGENT SHOULD, AS SOON AS THE POTENTIAL OR PERCEIVED CONFLICT BECOMES EVIDENT, ADVISE THE EXECUTIVE DIRECTOR OF ALL RELEVANT FACTS AND CIRCUMSTANCES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION ANNUALLY HAS COMPENSATION STUDIES DONE FOR THE ENTIRE ORGANIZATION BY AN OUTSIDE HR COMPANY. THE BOARD USES THE COMPENSATION STUDY AND THEIR ASSESSMENT OF THE EXECUTIVE DIRECTOR'S PERFORMANCE TO DETERMINE COMPENSATION. OTHER OFFICER AND KEY EMPLOYEE COMPENSATION IS DETERMINED BY THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. AMERICAN BOARD OF OBGYN EDUCATION FOUNDATION 2727 LACLEDE ST DALLAS TX 75204 752619323 SCHOLARSHIPS & EDUCATION TX 501(C)(3) LINE 12A, I AMERICAN BOARD OF OBSTETRICS & GYNECOLOGY 1 ABOG INTERNATIONAL INC 2727 LACLEDE ST DALLAS TX 75204 462166475 TESTING & MAINTAINING CERTIFICATION STANDARDS TX 501(C)(6) N/A AMERICAN BOARD OF OBSTETRICS & GYNECOLOGY 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 AMERICAN BOARD OF OBGYN EDUCATIONAL FOUNDATION INC B 475000 COST AMERICAN BOARD OF OBGYN EDUCATIONAL FOUNDATION INC D 27008750 COST ABOG INTERNATIONAL INC C 234550 COST