Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 1,793,684 | 1,374,102 | 1,576,842 | 1,307,952 | 1,592,033 | 7,644,613 |
| 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 | 1,793,684 | 1,374,102 | 1,576,842 | 1,307,952 | 1,592,033 | 7,644,613 |
| 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).. | 6,421,477 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 1,223,136 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 1,793,684 | 1,374,102 | 1,576,842 | 1,307,952 | 1,592,033 | 7,644,613 |
| 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 VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | 7,644,613 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 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 | ||||||
| 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 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2018 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
|---|
| I. BACKGROUNDIVC FILTER STUDY GROUP FOUNDATION ("IVCF") IS A NONPROFIT ORGANIZATION INCORPORATED IN WASHINGTON, D.C. IN 2012. IVC FILTER STUDY GROUP FOUNDATION (IVCF) ADVANCES, ENCOURAGES, & SUPPORTS MEDICAL RESEARCH, SCIENTIFIC STUDIES, & EDUCATION WITH THE GOAL OF IMPROVING PATIENT SAFETY, SURGICAL OUTCOMES, METHODS & PRACTICE WITH A FOCUS ON VASCULAR SURGERY & INTERVENTIONAL RADIOLOGY. IVCF CURRENTLY HAS ONE PROGRAM: PRESERVEDSTUDY.II. ANALYSISIVCF QUALIFIES AS A "PUBLICLY SUPPORTED ORGANIZATION DESCRIBED UNDER SECTION 170(B)(1)(A)(VI) AND THEREFORE AS AN ORGANIZATION DESCRIBED IN SECTION 509(A)(1) BECAUSE IT SATISFIES THE "FACTS AND CIRCUMSTANCES TEST" SET FORTH IN SECTION 1.170A-9(E)(3) OF THE TREASURY REGULATIONS.A. THRESHOLD REQUIREMENTSIVCF IS ELIGIBLE FOR A DETERMINATION OF PUBLIC SUPPORT UNDER THE FACTS AND CIRCUMSTANCES TEST BECAUSE IT MEETS THE TWO THRESHOLD REQUIREMENTS FOR CONSIDERATION. FIRST, THE PORTION OF IVCF'S SUPPORT THAT QUALIFIES AS ELIGIBLE PUBLIC SUPPORT IS APPROXIMATELY 16.00%, WHICH EXCEEDS THE 10% THRESHOLD REQUIRED UNDER TREASURY REGULATION SECTION 1.170A-9(E)(3)(I). SECOND, IVCF'S OPERATIONS ENSURE THAT IT WILL CONTINUE TO ATTRACT NEW AND ADDITIONAL PUBLIC SUPPORT, AS REQUIRED BY TREASURY REGULATION SECTION 1.170A-9(E)(3)(II). IVCF SOLICITS THE FUNDS FROM A SELECT GROUP OF MANUFACTURERS AS MANDATED BY THE UNITED STATES FOOD AND DRUG ADMINISTRATION.B. OTHER RELEVANT FACTORSIN DETERMINING WHETHER IVCF MEETS THE "FACTS AND CIRCUMSTANCES TEST," THE TREASURY REGULATIONS ALSO PROVIDE A LIST OF FACTORS THAT SERVE AS INDICIA OF WHETHER AN ORGANIZATION QUALIFIES AS "PUBLICLY SUPPORTED." THE HIGHER THE PERCENTAGE OF SUPPORT ABOVE THE 10% REQUIREMENT, THE LOWER THE ORGANIZATION'S BURDEN IN ESTABLISHING ITS PUBLICLY SUPPORTED NATURE WITH OTHER FACTORS.THESE ADDITIONAL FACTORS, DISCUSSED BELOW, PROVIDE FURTHER EVIDENCE THAT IVCF SATISFIES THE FACTS AND CIRCUMSTANCES TEST. BECAUSE IVCF'S PERCENTAGE OF SUPPORT IS 16.00%, IVCF HAS A HIGHER BURDEN IN PROVING ITS PUBLICLY SUPPORTED NATURE THROUGH THESE FACTORS.1. SOURCES OF SUPPORTIVCF RECEIVES ITS PUBLIC SUPPORT FROM A WIDE VARIETY OF CONTRIBUTORS AND DOES NOT DEPEND ON A SINGLE FAMILY FOR CONTRIBUTIONS, TWO FACTS THAT PROVIDE FURTHER SUPPORT FOR IVCF'S QUALIFICATION AS A "PUBLICLY SUPPORTED" ENTITY. THESE DONORS INCLUDE 6 FOR-PROFIT CORPORATIONS WHO MANUFACTURE THE FILTERS ENROLLED IN THE STUDY. BECAUSE THERE ARE A LIMITED AMOUNT OF COMPANIES THAT MANUFACTURE THE DEVICES ENROLLED IN THE STUDY, AND THE STUDY HAS BEEN REQUESTED BY THE FDA, THE MANUFACTURES FUND THE STUDY AS A GROUP INSTEAD OF ORGANIZING THEIR OWN INDIVIDUAL STUDIES.2. REPRESENTATIVE GOVERNING BODYTHE REPRESENTATIVE NATURE OF AN ORGANIZATION'S GOVERNING BODY IS ALSO A FACTOR IN DETERMINING WHETHER IT QUALIFIES UNDER THE "FACTS AND CIRCUMSTANCES TEST." IN CONSIDERING WHETHER A BOARD IS REPRESENTATIVE, SUCH FACTORS AS THE MEMBERS' EXPERTISE IN THE RELEVANT FIELD, THEIR HISTORY OF LEADERSHIP IN THE COMMUNITY AND THEIR TRADITION OF PUBLIC SERVICE ARE RELEVANT. IVCF'S BOARD OF DIRECTORS INCLUDES A VARIETY OF INDIVIDUALS WITH EXCEPTIONAL BACKGROUNDS IN THE ENVIRONMENTAL FIELD. THE BOARD INCLUDES REPRESENTATION FROM PHYSICIAN MEMBERS OF THE SOCIETY OF VASCULAR SURGERY AND THE SOCIETY OF INTERVENTIONAL RADIOLOGY, WHOSE MEMBERS IMPLANT THE FILTERS AS PART OF THEIR DAILY PRACTICES. THE EXECUTIVE DIRECTORS OF BOTH THE SOCIETY OF VASCULAR SURGERY AND THE SOCIETY OF INTERVENTIONAL RADIOLOGY ALSO SIT ON THE BOARD. THE FOLLOWING INDIVIDUALS CURRENTLY SERVE ON IVCF'S BOARD OF DIRECTORS:JEANNE LABERGE, MD (SIR) - PRESIDENTPETER F. LAWRENCE, MD (SVS) - VICE-PRESIDENTSUSAN E. SEDORY, MA, CAE - TREASURERKENNETH M. SLAW, PHD - SECRETARYPETER GLOVICZKI, MD (SVS)MARSHALL E. HICKS, MD (SIR)3. PUBLIC PARTICIPATION IN PROGRAMSUNDER SECTION 1.170A-9(E)(3)(VI)(C)(1) OF THE TREASURY REGULATIONS, ONE FACTOR INDICATING THAT AN ORGANIZATION QUALIFIES AS "PUBLICLY SUPPORTED" UNDER THE FACTS AND CIRCUMSTANCES TEST IS THAT "MEMBERS OF THE PUBLIC HAVING SPECIALIZED KNOWLEDGE OR EXPERTISE, PUBLIC OFFICIALS, OR CIVIC OR COMMUNITY LEADERS" PARTICIPATE IN, OR SPONSOR, THE ORGANIZATION'S PROGRAMS. AS DISCUSSED ABOVE, ALL OF IVCF'S DIRECTORS ARE EXPERTS AND LEADERS IN THE PRACTICE OF IVC FILTER PLACEMENT AND USE TECHNIQUES. ALL OF THE PUBLIC SUPPORT RECEIVED FOR THE STUDY COMES FROM FOR-PROFIT CORPORATIONS THAT HAVE AN INTIMATE KNOWLEDGE OF THE IVC FILTERS THAT ARE BEING STUDIED AS THEY MANUFACTURE THE PRODUCTS THAT ARE BEING IMPLANTED IN THE PATIENTS. |
| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | IVCF ENTERED INTO A MANAGEMENT AGREEMENT WITH THE SOCIETY OF INTERVENTIONAL RADIOLOGY (SIR) AND THE SOCIETY OF VASCULAR SURGERY (SVS), BOTH OF WHICH PROVIDE MANAGEMENT AND OTHER ADMINISTRATIVE SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 6 | IVCF HAS TWO MEMBERS: THE SOCIETY OF INTERVENTIONAL RADIOLOGY (SIR) AND THE SOCIETY OF VASCULAR SURGERY (SVS). EACH MEMBER WILL EXERCISE ITS MEMBERSHIP RIGHTS, INCLUDING THE RIGHT TO VOTE, THROUGH ACTION OF THEIR RESPECTIVE EXECUTIVE COUNCILS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOCIETY OF INTERVENTIONAL RADIOLOGY (SIR) AND THE SOCIETY OF VASCULAR SURGERY (SVS) ENTERED INTO A JOINT VENTURE AGREEMENT TO FORM IVCF. SIR AND SVS EACH APPOINT 50% OF THE BOARD OF DIRECTORS OF IVCF. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BYLAWS MAY BE ALTERED, AMENDED OR REPEALED AND NEW BYLAWS MAY BE ADOPTED UPON APPROVAL OF IVCF'S MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | IVCF HIRES AN INDEPENDENT ACCOUNTING FIRM TO PREPARE THE FEDERAL FORM 990. UPON RECEIPT OF THE DRAFT FORM 990, IT IS REVIEWED BY THE PRESIDENT. A COPY OF THE DRAFT FORM 990 IS THEN SENT TO THE BOARD OF DIRECTORS VIA E-MAIL. A PERIOD OF A FEW DAYS IS GIVEN TO THE BOARD MEMBERS TO ADDRESS ANY CONCERNS THAT THEY MAY HAVE BEFORE THE FEDERAL FORM 990 IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | AT THE ANNUAL BOARD OF DIRECTORS MEETING, A CONFLICT OF INTEREST DOCUMENT IS DISTRIBUTED TO ALL OF THE MEMBERS FOR UPDATE AND THEIR SIGNATURE VERIFYING IF THERE ARE ANY CONFLICTS OF INTEREST. AT ANY MEETING OR OCCASION, IF A MEMBER DISCLOSES THAT THEY HAVE A MATERIAL FINANCIAL INTEREST IN A PROPOSED TRANSACTION, IT IS RECORDED IN THE MINUTES. THE PERSON WHO HAS A CONFLICT OF INTEREST IS NOT ALLOWED TO VOTE ON A QUESTION THAT RELATES TO ANY PROPOSED TRANSACTION IN WHICH THEY HAVE A MATERIAL FINANCIAL INTEREST. |
| FORM 990, PART VI, SECTION C, LINE 19 | IVCF MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONSULTANTS (NERI-FILTER STUDY GROUP): PROGRAM SERVICE EXPENSES 1,607,988. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,607,988. OTHER CONSULTANTS: PROGRAM SERVICE EXPENSES 387,392. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 387,392. |
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| Software Version: |