2015-07-28T13:56:03-05:00 2014-12-31 581763439 WINDHAM BRANNON PC 3630 PEACHTREE RD NE SUITE 600 ATLANTA GA 30326 990 2014-01-01 030429253 SOCIETY FOR THE PRESERVATION OF PHYSICIAN ASSISTANT HISTORY INC SOCI 6784178100 12000 FINDLEY ROAD NO 160 JOHNS CREEK GA 30097 ALFRED M SADLER JR MD PRESIDENT 6784178100 2015-07-21 1 CARLYE W DOOLEY P00292964 4048982000 2015-07-21 2014 2016-02-25 16:41:14Z ALFRED M SADLER JR MD 12000 FINDLEY ROAD SUITE 100 JOHNS CREEK GA 300971409 267910 0 X WWW.PAHX.ORG X 2002 NC TO PRESERVE AND SHARE THE HISTORY OF THE DEVELOPMENT OF THE PHYSICIAN ASSISTANT PROFESSION AND ILLUSTRATE HOW PHYSICIAN ASSISTANTS CONTINUE TO MAKE A DIFFERENCE IN OUR SOCIETY. 9 9 0 11 0 0 169986 267910 0 0 0 0 0 0 169986 267910 0 0 0 0 95115 90394 0 0 0 56889 169498 152004 259892 17982 8018 30865 39075 4711 4903 26154 34172 TO SUPPORT THE WORK OF THE NCCPA TO PRESERVE THE HISTORY OF THE PHYSICIAN ASSISTANT PROFESSION THROUGH EDUCATION, PRESERVATION OF ARCHIVES, AND OTHER INITIATIVES AS A BENEFIT TO THE PUBLIC. 0 0 158168 THE PA HISTORY SOCIETY MAINTAINS A COLLECTION OF ARCHIVAL DOCUMENTS, REFERENCE MATERIALS, AUDIO & VIDEO CLIPS, AND MUSEUM ITEMS FROM THE DEVELOPMENT OF THE PA PROFESSION. THE SOCIETY SHARES THESE MATERIALSVIA ITS ILLUSTRATED WEBSITE AND DEVELOPS ADDITIONAL EDUCATIONAL RESOURCES USED TO TEACH THE HISTORY OF PA PROFESSION. EDUCATIONAL MATERIALS INCLUDE: A PUBLISHED THE PHYSICIAN ASSISTANT: AN ILLUSTRATED HISTORY BOOK; A PRODUCED DVD ABOUT THE CREATION OF THE NATIONAL PA ORGANIZATIONS TITLED THE WAY WE WERE: A CONVERSATION WITH THE PA PROFESSION'S EARLY LEADERS; A DEVELOPED EDUCATIONAL TOOLKIT WITH LEARNING MODULES AND INSTRUCTORS GUIDE FOR PA FACULTY TO ASSIST THEM WITH TEACHING THE HISTORY OF THE PROFESSION. EACH YEAR THE SOCIETY CREATES ADDITIONAL EDUCATIONAL MATERIALS FROM ITS GROWING COLLECTION. 158168 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NC X SONIA RATLIFF 6784178100 12000 FINDLEY ROAD SUITE 100 JOHNS CREEK GA 30097 ALFRED M SADLER JR MD PRESIDENT 8.00 X 0 0 0 ANN BLISS RN MSW TRUSTEE 2.00 X 0 0 0 F J GINO GIANOLA PA TRUSTEE 2.00 X 0 0 0 GRETCHEN M PARUCH MHS PA-C TRUSTEE 2.00 X 0 0 0 KAREN MULITALO MPAS PA-C SECRETARY/TREASURER 2.00 X 0 0 0 THOMAS E PIEMME MD IMMEDIATE PAST PRESIDENT 8.00 X 0 0 0 WILLIAM H MARQUARDT MA PA-C DFAAPA TRUSTEE 2.00 X 0 0 0 WILLIAM D STANHOPE MS PA TRUSTEE 1.00 X 0 0 0 RAISA POLACEK MPAS PA-C TRUSTEE 2.00 X 0 0 0 MARY WARNER MMSC PA-C TRUSTEE 2.00 X 0 0 0 GLORIA STEWART EDD PA TRUSTEE 2.00 X 0 0 0 DAWN MORTON-RIAS EDD PA-C EX-OFFICIO TRUSTEE 2.00 40.00 X 0 232659 191 PAMELA M DEAN MBA FORMER EX-OFFICIO TRUSTEE 2.00 40.00 X 0 247772 8203 0 480431 8394 0 0 1 0 0 200000 67910 267910 267910 0 0 0 63864 32724 31140 26530 13594 12936 6050 6050 25516 12758 12758 88180 82406 5774 2400 2400 43592 16686 26906 1313 1313 MISCELLANEOUS 1276 1276 CREDIT CARD PROCESSING 1171 1171 259892 158168 101724 0 29837 32540 5500 170 1298 433 1028 865 30865 39075 4711 4903 4711 4903 X 26154 31178 2994 26154 34172 30865 39075 8018 0 X 0 1 X 1 0 X X 1 NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIANS ASSISTANTS INC 581218672 501(C)(6) 1 158168 0 1 158168 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART IV, LINE 3B THE SUPPORTED ORGANIZATION, THE NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS INC. (NCCPA), RECEIVES THE MAJORITY OF ITS SUPPORT FROM EXEMPT ACTIVITY FUNCTIONS WHICH ARE DERIVED DIRECTLY FROM THE ADMINISTRATION OF EXAMS REQUIRED TO RECEIVE PHYSICIAN ASSISTANT CERTIFICATION. CONSEQUENTLY, NCCPA, A 501(C)(6) ORGANIZATION, WILL CONTINUE TO PASS THE PUBLIC SUPPORT TESTS UNDER SECTION 509(A)(2) INDEFINITELY (96.75% IN FYE 2014). SHOULD THERE EVER BE A SIGNIFICANT CHANGE IN PROGRAM FUNCTIONS, THE SOCIETY WILL BE NOTIFIED IMMEDIATELY. PART IV, LINE 3C THE EXPENSES SHOWN GOING TO THE SUPPORTED ORGANIZATION (NCCPA) ARE IN FACT EXPENSES SPENT BY THE SOCIETY TO SUPPORT ITS PROGRAM INITIATIVES WHICH ARE ORIGINALLY DIRECTED TO THE SOCIETY BY NCCPA. THE SOCIETY OPERATES ITS OWN PROGRAMS AND HAS THE CONTROL OVER WHERE THE FUNDS ARE DIRECTED, WHICH ARE FOR CHARITABLE AND EDUCATIONAL PURPOSES UNDER SECTION 170(C)(2)(B). THE SOCIETY PROVIDES WRITTEN REPORTS ABOUT ITS PROGRAM ACTIVITIES TO NCCPA ON A QUARTERLY BASIS. THE NCCPA BOARD OF DIRECTORS ALSO PROVIDES DIRECTION FOR THE SOCIETY'S FUTURE PROGRAM ACTIVITIES, AND THE SOCIETY WILL PRESENT ITS STRATEGIC INITIATIVES FOR 2016 TO NCCPA AT THE BOARD MEETING IN NOVEMBER 2015. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1298 433 865 865 DUE TO NCCPA 4903 4903 X PART X, LINE 2: THE COMMISSION IS EXEMPT FROM INCOME TAXATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(6), AND THE FOUNDATION AND THE PA HISTORY SOCIETY ARE EXEMPT UNDER SECTION 501(C)(3). MANAGEMENT OF THE ORGANIZATION CONSIDERS THE LIKELIHOOD OF CHANGES BY TAXING AUTHORITIES IN ITS FILED INCOME TAX RETURNS AND RECOGNIZES A LIABILITY FOR OR DISCLOSES POTENTIAL SIGNIFICANT CHANGES THAT MANAGEMENT BELIEVES ARE MORE LIKELY THAN NOT TO OCCUR, INCLUDING CHANGES TO THE ENTITY'S STATUS AS A NOT-FOR-PROFIT ENTITY. MANAGEMENT BELIEVES THE ENTITIES WITHIN THE ORGANIZATION MET THE REQUIREMENTS TO MAINTAIN THEIR TAX-EXEMPT STATUS AND HAVE NO INCOME SUBJECT TO UNRELATED BUSINESS INCOME TAX; THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THESE FINANCIAL STATEMENTS. THE INCOME TAX RETURNS FOR THE PAST THREE YEARS ARE SUBJECT TO EXAMINATION BY TAX AUTHORITIES, AND MAY CHANGE UPON EXAMINATION. X 1 1 X X X X X 1 0 0 0 0 0 0 0 0 DAWN MORTON-RIAS EDD PA-C EX-OFFICIO TRUSTEE 0 167259 0 65400 0 0 0 0 0 191 0 232850 0 0 PAMELA M DEAN MBA FORMER EX-OFFICIO TRUSTEE 0 244126 0 0 0 3646 0 5729 0 2474 0 255975 0 0 PART I, LINE 1A HEALTH CLUB DUES ARE REIMBURSED UP TO $1,000 FOR ALL EMPLOYEES. PART I, LINE 4A PAMELA DEAN - $197,923 FORM 990, PART VI, SECTION A, LINE 1 NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS, INC. (NCCPA) IS THE SOLE MEMBER OF THE SOCIETY FOR THE PRESERVATION OF PHYSICIAN ASSISTANT HISTORY, INC. AS THE SOLE MEMBER, THE NCCPA BOARD OF DIRECTORS ELECTS THE MEMBERS OF THE SOCIETY'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 NCCPA (THE CORPORATE MEMBER) IS THE SOLE MEMBER OF THE SOCIETY FOR THE PRESERVATION OF PHYSICIAN ASSISTANT HISTORY, INC. AS THE SOLE MEMBER, THE NCCPA BOARD OF DIRECTORS ELECTS THE MEMBERS OF THE SOCIETY'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A NCCPA (THE CORPORATE MEMBER) IS THE SOLE MEMBER OF THE SOCIETY FOR THE PRESERVATION OF PHYSICIAN ASSISTANT HISTORY, INC. AS THE SOLE MEMBER, THE NCCPA BOARD OF DIRECTORS ELECTS THE MEMBERS OF THE SOCIETY'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE CHIEF FINANCIAL OFFICER REVIEWED THE FORM 990 PRIOR TO ITS FILING. THE FORM 990 WAS SUPPLIED TO THE BOARD OF DIRECTORS VIA EMAIL WITH RETURN RECEIPT REQUESTED TO ENSURE EACH MEMBER HAD RECEIVED THEIR COPY. EACH BOARD MEMBER IS REQUIRED TO REVIEW THE FORM 990 AND VOTE TO APPROVE FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS REVIEW AND SIGN A STATEMENT OF FIDUCIARY OBLIGATIONS, INCLUDING CONFLICT OF INTEREST ISSUES, ON AN ANNUAL BASIS. BOARD MEMBERS RECUSE THEMSELVES FROM DISCUSSIONS OR VOTES ON ISSUES ON WHICH THEY HAVE A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE NCCPA DETERMINES PAY BASED ON COMPENSATION STUDIES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AT THE SOCIETY FOR THE PRESERVATION OF PHYSICIAN ASSISTANT HISTORY, INC. NAITONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS 12000 FINDLEY ROAD SUITE 100 JOHNS CREEK GA 30097 581218672 CERTIFICATION OF PHYSICIAN ASSISTANTS GA 501(C)(6) 0 NCCPA HEALTH FOUNDATION INC 12000 FINDLEY ROAD SUITE 100 JOHNS CREEK GA 30097 204318466 SUPPORTING ORGANIZATION IL 501(C)(3) LINE 11A, I NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS INC 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS INC P 104198 PERSONNEL RELATED COST NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS INC C 200000 AMOUNT CONTRIBUTED