SOCIETY FOR THE PRESERVATION OF PHYSICIAN ASSISTANT HISTORY INC: Form 990EZ, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SOCIETY FOR THE PRESERVATION OF PHYSICIAN ASSISTANT HISTORY INC (EIN 03-0429253)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-05-13
- IRS object ID
- 201301339349201060
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2013-05-13T09:55:32-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581763439 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINDHAM BRANNON PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3630 PEACHTREE RD NE SUITE 600 | AddressLine1 |
| City | ATLANTA | City |
| State | GA | State |
| ZIP Code | 30326 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030429253 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOCIETY FOR THE PRESERVATION OF | BusinessNameLine1 |
| Business Name Line2 | PHYSICIAN ASSISTANT HISTORY INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SOCI | NameControl |
| Phone | 6784178100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12000 FINDLEY ROAD NO 100 | AddressLine1 |
| City | JOHNS CREEK | City |
| State | GA | State |
| ZIP Code | 30097 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | THOMAS E PIEMME | Name |
| Title | PRESIDENT | Title |
| Phone | 6784178100 | Phone |
| Date Signed | 2013-05-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CARLYE W BUCHANAN | Name |
| PTIN | P00292964 | PTIN |
| Phone | 4048982000 | Phone |
| Date Prepared | 2013-05-07 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Web Site | WWW.PAHX.ORG | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 163460 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 162479 | ContributionsGiftsGrantsEtc |
| Other Revenue Total | 981 | OtherRevenueTotal |
| Total Revenue | 163460 | TotalRevenue |
| Salaries Other Comp Empl Benefits | 15406 | SalariesOtherCompEmplBenefits |
| Fees And Oth Pymt To Ind Contractors | 73002 | FeesAndOthPymtToIndContractors |
| Occupancy Rent Utilities And Maint | 5449 | OccupancyRentUtilitiesAndMaint |
| Printing Publications Postage | 17595 | PrintingPublicationsPostage |
| Other Expenses Total | 63116 | OtherExpensesTotal |
| Total Expenses | 174568 | TotalExpenses |
| Excess Or Deficit For Year | -11108 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 19280 | NetAssetsOrFundBalancesBOY |
| Other Changes In Net Assets | 0 | OtherChangesInNetAssets |
| Net Assets Or Fund Balances EOY | 8172 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46594 | BOY |
| EOY | 12951 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 1190 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46594 | BOY |
| EOY | 14141 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27314 | BOY |
| EOY | 5969 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19280 | BOY |
| EOY | 8172 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Primary Exempt Purpose | PRESERVATION OF PHYSICIANS ASSISTANT'S HISTORY. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | TO SHARE THE HISTORY OF THE DEVELOPMENT OF THE PHYSICIAN ASSISTANT PROFESSION AND ILLUSTRATE HOW PHYSICIAN ASSISTANTS CONTINUE TO MAKE A DIFFERENCE IN OUR SOCIETY THROUGH THE IDENTIFICATION AND COLLECTION OF APPROPRIATE PAPERS, MANUSCRIPTS, MAGAZINE AND NEWSPAPER CLIPPINGS, NEWSLETTERS, REPORTS, DISSERTATIONS, ORAL HISTORIES, AND VISUAL ARTIFACTS, SUCH AS FILMS, SLIDES, VIDEOS, PHOTOGRAPHS, AND DIGITAL IMAGES. | DescriptionProgramServiceAccom |
| Grants And Allocations | 0 | GrantsAndAllocations |
| Program Service Expenses | 90781 | ProgramServiceExpenses |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 90781 | TotalProgramServiceExpenses |
| Info In Schedule O Part IV | X | InfoInScheduleOPartIV |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (12 entries)
| TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|
| ALFRED M SADLER JR MD | ||||
| TRUSTEE | 2.00 | 0 | 0 | 0 |
| ANN BLISS RN MSW | ||||
| TRUSTEE | 2.00 | 0 | 0 | 0 |
| BARBARA BARZANSKY PH D MHPE | ||||
| TRUSTEE | 2.00 | 0 | 0 | 0 |
| F J GINO GIANOLA PA | ||||
| TRUSTEE | 2.00 | 0 | 0 | 0 |
| GRETCHEN M PARUCH MHS PA-C | ||||
| TRUSTEE | 2.00 | 0 | 0 | 0 |
| JANET J LATHROP MBA | ||||
| EXECUTIVE DIRECTOR | 2.00 | 9360 | 0 | 0 |
| JUDITH E COLVER MMS PA-C | ||||
| SECRETARY/TREASURER | 2.00 | 0 | 0 | 0 |
| KAREN MULITALO MPAS PA-C | ||||
| TRUSTEE | 2.00 | 0 | 0 | 0 |
| LORI G LEAL CPA MBA | ||||
| MANAGING DIRECTOR/CFO | 2.00 | 6046 | 0 | 0 |
| P REA KATZ PH D PA-C | ||||
| TRUSTEE | 2.00 | 0 | 0 | 0 |
| PAM DEAN MBA | ||||
| EX-OFFICIO TRUSTEE | 2.00 | 0 | 0 | 0 |
| SHEILA MAULDIN | ||||
| MANAGING DIRECTOR | 2.00 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | 0 | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | 0 | OrganizationHadUBI |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtc |
| Direct Indirect Political Expend | 0 | DirectIndirectPoliticalExpend |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficers |
| Tax Imposed Under IRC4911 | 0 | TaxImposedUnderIRC4911 |
| Tax Imposed Under IRC4912 | 0 | TaxImposedUnderIRC4912 |
| Tax Imposed Under IRC4955 | 0 | TaxImposedUnderIRC4955 |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTrans |
| Amount Of Tax Imposed On Org Mgr | 0 | AmountOfTaxImposedOnOrgMgr |
| Amount Of Tax Reimbursed By Org | 0 | AmountOfTaxReimbursedByOrg |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| States Where Copy Of Return Is Filed | NC | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SONIA RATLIFF | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12000 FINDLEY ROAD SUITE 100 | AddressLine1 |
| City | JOHNS CREEK | City |
| State | GA | State |
| ZIP Code | 30097 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6784178100 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Foreign Office | 0 | ForeignOffice |
| Maintain Any Donor Advised Funds | 0 | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | 0 | DoesOrgHaveHospital |
| Tanning Services Provided | 0 | TanningServicesProvided |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Engage Political Cmpgn Activities | 0 | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | 0 | EngageInLobbyingActivities |
| Operating School | 0 | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | 0 | TrnsfrsExemptNonCharRelatedOrg |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Part VIA Hghst Paid Cntrct Prof Ser | NONE | PartVIAHghstPaidCntrctProfSer |
| Filed Schedule A | 1 | FiledScheduleA |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIANS ASSISTANTS INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581218672 | EIN |
| Type Of Organization | 501(C)(6) | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 1 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $90,781 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 90781 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER REVENUE | FORM 990-EZ, PART I, LINE 8 | DESCRIPTION: OTHER INCOME. AMOUNT: 981. |
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | DESCRIPTION: TRAVEL EXPENSES. AMOUNT: 57,445. DESCRIPTION: MISCELLANEOUS. AMOUNT: 1,043. DESCRIPTION: SUPPLIES. AMOUNT: 3,574. DESCRIPTION: TELEPHONE. AMOUNT: 54. DESCRIPTION: INSURANCE. AMOUNT: 1,000. TOTAL TO FORM 990-EZ, LINE 16: 63,116. |
| OTHER ASSETS | FORM 990-EZ, PART II, LINE 24 | DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 1,190. |
| OTHER LIABILITIES | FORM 990-EZ, PART II, LINE 26 | DESCRIPTION: ACCOUNTS PAYABLE. BEG. OF YEAR AMOUNT: 27,314. END OF YEAR AMOUNT: 5,969. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | Declaration |