Attach to Form 990 or Form 990-EZ.
See separate instructions.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization in col. (i) listed in your governing document? | (v) Did you notify the organization in col. (i) of your support? | (vi) Is the organization in col. (i) organized in the U.S.? | (vii) Amount of monetary support | |||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.).. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 32,650 | 100 | 32,750 | |||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 167,277 | 184,872 | 185,155 | 223,138 | 607,694 | 1,368,136 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | 199,927 | 184,972 | 185,155 | 223,138 | 607,694 | 1,400,886 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 61,922 | 29,351 | 48,624 | 42,058 | 181,955 | |
| c | Add lines 7a and 7b.. | 61,922 | 29,351 | 48,624 | 42,058 | 181,955 | |
| 8 | Public support (Subtract line 7c from line 6.) | 1,218,931 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 199,927 | 184,972 | 185,155 | 223,138 | 607,694 | 1,400,886 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 842 | 177 | 961 | 2,626 | 1,813 | 6,419 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 842 | 177 | 961 | 2,626 | 1,813 | 6,419 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 994 | 665 | 951 | 2,610 | ||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 200,769 | 185,149 | 187,110 | 226,429 | 610,458 | 1,409,915 |




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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
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| FORM 990, PART VI, SECTION A, LINE 2 | MARVIN BIRNBAUM AND ELAINE DAILY HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ASSOCIATION HAS TWO CLASSES OF MEMBERSHIP: REGULAR MEMBERSHIP AND HONORARY MEMBERSHIP. ANY PERSON EIGHTEEN YEARS OF AGE OR OLDER, OF GOOD CHARACTER, WHO HAS SHOWN A CONSISTENT AND CONTINUING INTEREST IN THE PURPOSES OF THE ASSOCIATION, AND WHOSE APPLICATION FOR MEMBERSHIP IS SUPPORTED BY AT LEAST ONE REGULAR MEMBER, IS ELIGIBLE FOR REGULAR MEMBERSHIP UPON ACCEPTANCE OF HIS OR HER APPLICATION BY THE ASSOCIATION'S SECRETARY AND PAYMENT OF DUES AND INITIATION FEES. ANY OTHER PERSON WHO HAS CONTRIBUTED IN AN OUTSTANDING MANNER TO THE ASSOCIATION OR TO EMERGENCY AND DISASTER MEDICINE IN GENERAL IS ELIGIBLE FOR HONORARY MEMBERSHIP UPON NOMINATION BY THE GOVERNING BODY, APPROVAL OF TWO-THIRDS OF THE REGULAR MEMBERSHIP, AND PAYMENT OF DUES AND INITIATION FEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | CHANGES TO THE ASSOCIATION'S BYLAWS REQUIRE APPROVAL OF A MAJORITY OF THE ASSOCIATION'S REGULAR MEMBERSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11 | NO REVIEW WAS OR WILL BE CONDUCTED. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE ASSOCIATION'S ANNUAL BUDGET, WHICH INCLUDES PROPOSED COMPENSATION LEVELS, IS DEVELOPED BY THE ADMINISTRATIVE COORDINATOR AND THE CHIEF FINANCIAL OFFICER. THE MEMBERS OF THE GOVERNING BODY HAVE THE OPPORTUNITY TO DISCUSS THE ANNUAL BUDGET AND PROPOSE CHANGES. THE MEMBERS OF THE GOVERNING BODY THEN APPROVE THE ANNUAL BUDGET, INCLUDING COMPENSATION LEVELS, AND DECISIONS ABOUT THE BUDGET ARE DOCUMENTED IN THE MINUTES OF THE MEETINGS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ASSOCIATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
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