POLK COUNTY MEDICAL ASSOICATION INC: Form 990EZ, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- POLK COUNTY MEDICAL ASSOICATION INC (EIN 59-6137315)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-06-13
- IRS object ID
- 201231659349200323
- Schema version
- 2011v1.2
- 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 | 2012-06-13T16:01:25-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEASLEY BRYANT & COMPANY CPA'S PA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4940 SOUTHFORK DR | AddressLine1 |
| City | LAKELAND | City |
| State | FL | State |
| ZIP Code | 338132042 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 596137315 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | POLK COUNTY MEDICAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | POLK | NameControl |
| Phone | 8636444051 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5110 S FLORIDA AVE BLDG A | AddressLine1 |
| Address Line2 | ROOM/SUITE 111 | AddressLine2 |
| City | LAKELAND | City |
| State | FL | State |
| ZIP Code | 33813 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JACKIE COURTNEY | Name |
| Title | DIRECTOR | Title |
| Phone | 8636444051 | Phone |
| Date Signed | 2012-05-08 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DENNIS E BEASLEY | Name |
| Phone | 8636461373 | Phone |
| Date Prepared | 2012-06-05 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Schedule B Not Required | X | ScheduleBNotRequired |
| Web Site | WWW.POLKCOUNTYDOCTORS.COM | WebSite |
| Organization501c | X | Organization501c |
| Gross Receipts | 138073 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 110276 | ContributionsGiftsGrantsEtc |
| Investment Income | 623 | InvestmentIncome |
| Other Revenue Total | 27174 | OtherRevenueTotal |
| Total Revenue | 138073 | TotalRevenue |
| Salaries Other Comp Empl Benefits | 53118 | SalariesOtherCompEmplBenefits |
| Fees And Oth Pymt To Ind Contractors | 2038 | FeesAndOthPymtToIndContractors |
| Occupancy Rent Utilities And Maint | 16627 | OccupancyRentUtilitiesAndMaint |
| Printing Publications Postage | 5176 | PrintingPublicationsPostage |
| Other Expenses Total | 23546 | OtherExpensesTotal |
| Total Expenses | 100505 | TotalExpenses |
| Excess Or Deficit For Year | 37568 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 56586 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 94154 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81396 | BOY |
| EOY | 146879 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10155 | BOY |
| EOY | 5221 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91551 | BOY |
| EOY | 152100 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34965 | BOY |
| EOY | 57946 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56586 | BOY |
| EOY | 94154 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| 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. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service 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. | DescriptionProgramServiceAccom |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation |
|---|---|---|---|---|---|---|
| JACKIE COURTNEY | ||||||
| 5110 S FLORIDA AVE BLDG A STE 111 | LAKELAND | FL | 33813 | EXECUTIVE DI | 40.00 | 48594 |
| DEAN SHULL MD | ||||||
| 5110 S FLORIDA AVE BLDG A STE 111 | LAKELAND | FL | 33813 | PRESIDENT | 1.00 | 0 |
| DANIEL HAIGHT MD | ||||||
| 5110 S FLORIDA AVE BLDG A STE 111 | LAKELAND | FL | 33813 | DIRECTOR | 1.00 | 0 |
| KEVIN DORSETT MD | ||||||
| 1247 LAKELAND HILLS BLVD | LAKELAND | FL | 33805 | CHAIRMAN | 1.00 | 0 |
| RICHARD HAMILTON MD | ||||||
| 5110 S FLORIDA AVE BLDG A STE 111 | LAKELAND | FL | 33813 | VICE PRESIDE | 1.00 | 0 |
| RALPH NOBO MD | ||||||
| 5110 S FLORIDA AVE BLDG 1 STE 111 | LAKELAND | FL | 33813 | DIRECTOR | 1.00 | 0 |
| SERGIO SEOANE MD | ||||||
| 5110 S FLORIDA AVE BLDG A STE 111 | LAKELAND | FL | 33813 | DIRECTOR | 1.00 | 0 |
| ARVIND SONI MD | ||||||
| 5110 S FLORIDA AVE BLDG A STE 111 | LAKELAND | FL | 33813 | VICE PRESIDE | 1.00 | 0 |
| JAMES SANDERS MD | ||||||
| 5110 S FLORIDA AVE BLDG A STE 111 | LAKELAND | FL | 33813 | SECRETARY/TR | 1.00 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | false | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | true | OrganizationHadUBI |
| Organization Filed990 T | true | OrganizationFiled990T |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Organization Dissolved Etc | false | OrganizationDissolvedEtc |
| Did Org File Form1120 POL This Year | false | DidOrgFileForm1120POLThisYear |
| Made Loans To From Officers | false | MadeLoansToFromOfficers |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JACKIE COURTNEY | NamePerson |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5110 S FLORIDA AVE STE 111 | AddressLine1 |
| City | LAKELAND | City |
| State | FL | State |
| ZIP Code | 33813 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8636444051 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccount |
| Foreign Office | false | ForeignOffice |
| Maintain Any Donor Advised Funds | false | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | false | DoesOrgHaveHospital |
| Tanning Services Provided | false | TanningServicesProvided |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Engage Political Cmpgn Activities | false | EngagePoliticalCmpgnActivities |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER REVENUE | FORM 990-EZ, PART I, LINE 8 | ENDORSEMENT INCOME 27,174 TOTAL 27,174 |
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | EXPENSES OFFICE 1,300 TRAVEL 1,427 CONFERENCES/MEETINGS 16,521 INSURANCE 3,731 NON-INVESTMENT DEPRECIATION 567 TOTAL 23,546 |
| OTHER CHANGES IN NET ASSETS OR FUND BALANCES | FORM 990-EZ, PART I, LINE 20 | 2009 FEDERAL INCOME TAX 0 |
| OTHER ASSETS | FORM 990-EZ, PART II, LINE 24 | 19,363 19,613 LESS ACCUMULATED DEPRECIATION 18,367 18,936 DUE FROM P.C. MEDICAL BULLETIN 4,354 4,354 DUE FROM P.C. MEDICAL FOUNDATION 4,615 0 UTILITY DEPOSIT 190 190 TOTAL 10,155 5,221 |
| OTHER LIABILITIES | FORM 990-EZ, PART II, LINE 26 | DEFERRED REVENUE 32,942 50,292 PAYROLL LIABILITIES 1,923 2,699 DUE TO FOUNDATION 100 4,955 |
| PRIMARY EXEMPT PURPOSE | 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. |
| FIRST ACCOMPLISHMENT | 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. |
Compensation Explanation CompensationExplanation
Compensation Compensation (9 entries)
| JACKIE COURTNEY |
| DEAN SHULL MD |
| DANIEL HAIGHT MD |
| KEVIN DORSETT MD |
| RICHARD HAMILTON MD |
| RALPH NOBO MD |
| SERGIO SEOANE MD |
| ARVIND SONI MD |
| JAMES SANDERS MD |