Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and 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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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 VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 1,630,917 | 1,593,254 | 1,562,669 | 1,408,734 | 1,338,218 | 7,533,792 |
| 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 | 2,409,547 | 2,535,165 | 2,339,357 | 2,807,767 | 2,972,316 | 13,064,152 |
| 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 | 4,040,464 | 4,128,419 | 3,902,026 | 4,216,501 | 4,310,534 | 20,597,944 |
| 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. | 155,000 | 155,000 | ||||
| c | Add lines 7a and 7b.. | 155,000 | 155,000 | ||||
| 8 | Public support. (Subtract line 7c from line 6.) | 20,442,944 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 4,040,464 | 4,128,419 | 3,902,026 | 4,216,501 | 4,310,534 | 20,597,944 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 707,305 | 356,630 | 417,329 | 99,262 | 80,986 | 1,661,512 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 707,305 | 356,630 | 417,329 | 99,262 | 80,986 | 1,661,512 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 24,325 | 24,325 | ||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 64,657 | 75,045 | 63,791 | 130,114 | 78,896 | 412,503 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 4,812,426 | 4,560,094 | 4,383,146 | 4,445,877 | 4,494,741 | 22,696,284 |
| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, 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 2019. 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 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
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| 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 6 | PHYSICIANS (MDS OR DOS) WHO HAVE AN INTEREST IN OCCUPATIONAL AND/OR ENVIRONMENTAL MEDICINE. NON-PHYSICIANS WHO HAVE ATTAINED THE DOCTORATE LEVEL DEGREE OF PHD, SCD, DRPH, OR EDD IN AN OCCUPATIONAL AND ENVIRONMENTAL HEALTH DISCIPLINE, A MASTER'S LEVEL DEGREE OR OTHER ADVANCED TRAINING IN A RELATED FIELD, OR ARE A CERTIFIED PHYSICIAN ASSISTANT, LICENSED NURSE PRACTITIONER, OR A CERTIFIED OCCUPATIONAL HEALTH NURSE (COHN). FULL-TIME RESIDENTS, WHO HAVE AN MD OR DO DEGREE, WITH AN INTEREST IN OCCUPATIONAL AND ENVIRONMENTAL MEDICINE. FULL-TIME MEDICAL STUDENTS OR INTERNS, EARNING AN MD OR DO DEGREE, WITH AN INTEREST IN OCCUPATIONAL AND ENVIRONMENTAL MEDICINE. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE GOVERNING BODY IS ELECTED ANNUALLY BY ITS MEMBERS. THE HOUSE OF DELEGATES SHALL NOMINATE TWO (2) CANDIDATES FOR EACH DIRECTORSHIP AND A FIRST AND SECOND ALTERNATE CANDIDATE, IN CASE A NOMINATED CANDIDATE CANNOT STAND FOR ELECTION, TO BE FILLED IN THE NEXT ELECTION OF DIRECTORS. THE HOUSE SHALL CONSIDER AS POTENTIAL CANDIDATES INCUMBENT DIRECTORS WHOSE TERMS OF OFFICE ARE EXPIRING, WHO ARE ELIGIBLE TO BE REELECTED, AND WHO HAVE BEEN RECOMMENDED FOR CONTINUED DIRECTORSHIP BY CURRENT MEMBERS OF THE BOARD OF DIRECTORS. EACH VOTING COLLEGE MEMBER SHALL BE ENTITLED TO ONE (1) VOTE FOR EACH DIRECTORSHIP TO BE FILLED, PROVIDED, HOWEVER, THAT A MEMBER MAY CAST NO MORE THAN ONE (1) VOTE FOR ANY NOMINEE FOR DIRECTOR. THOSE NOMINEES RECEIVING THE MOST VOTES (UP TO THE NUMBER OF DIRECTORS TO BE ELECTED) SHALL BE ELECTED. VOTING FOR THE ELECTION OF DIRECTORS AND OFFICERS SHALL BE CONDUCTED BY SECRET BALLOT. ELECTION BALLOTS SHALL BE DISTRIBUTED BY METHOD(S) DETERMINED BY THE BOARD OF DIRECTORS NO LATER THAN NOVEMBER 1. NAMES NOT ON THE BALLOT MAY BE WRITTEN IN. ONLY THOSE BALLOTS THAT HAVE BEEN RECEIVED AT THE PLACE DESIGNATED FOR RETURN BY DECEMBER 15 MAY BE COUNTED. THE RESULTS SHALL BE ANNOUNCED NO LATER THAN THE ANNUAL MEMBERSHIP MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DIRECTOR OF FINANCE AND THE EXECUTIVE DIRECTOR REVIEW THE 990 RETURN BY COMPARING IT TO THE FINANCIAL STATEMENTS, NOTING ANY CHANGES IN DIRECTORS AND BY VERIFYING THAT THE INFORMATION ON THE RETURN REFLECTS THE POSITION AND ACTIVITIES OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY BY REQUIRING EACH DIRECTOR, WHO ARE CONSIDERED KEY EMPLOYEES, TO SUBMIT A CONFLICT OF INTEREST QUESTIONNAIRE TO ITS BOARD OF DIRECTORS ANNUALLY. THESE QUESTIONNAIRES ARE REVIEWED BY A SUBSET OF THE BOARD. THE SUBSET OF THE BOARD REVIEWS THE CONFLICTS DISCLOSED AND DECIDES WHAT, IF ANY, ACTION SHOULD BE TAKEN. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE DIRECTOR IS THE CEO OF THE ORGANIZATION. HIS/HER COMPENSATION IS BASED ON HIS/HER EVALUATION, WHICH IS DRAWN FROM THE ESSENTIAL DIMENSIONS OF ASSOCIATION MANAGEMENT. COMPENSATION IS COMPARED TO DATA OBTAINED FROM THE AMERICAN SOCIETY OF ASSOCIATION EXECUTIVES. THE CEO'S PERFORMANCE WILL BE REVIEWED SEMIANNUALLY BY THE PRESIDENT AND THE EXECUTIVE COMMITTEE IN A PROCESS AND FORMAT OF THE PRESIDENT'S CHOOSING WHICH ASSESSES THE CURRENCY AND CONTINUED RELEVANCE OF THE OBJECTIVES ESTABLISHED BY THE BOARD. THE CEO'S PERFORMANCE IS ALSO ANNUALLY REVIEWED BY THE BOARD. THESE PERFORMANCE REVIEWS WILL THEN DETERMINE WHETHER THE CEO FITS BETWEEN MANAGEMENT STYLE AND THE STYLE OF THE ORGANIZATION, AND IMPLEMENTATION OF THE WILL OF THE LEADERSHIP AND THE COLLECTIVE WILL OF THE MEMBERS. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST TO AMERICAN COLLEGE OF OCCUPATIONAL AND ENVIORNMENTAL MEDICINE HEADQUARTERS |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 516,220. MANAGEMENT AND GENERAL EXPENSES 251,641. FUNDRAISING EXPENSES 27,844. TOTAL EXPENSES 795,705. PROFESSIONAL FEES-DISABILITY ONLINE: PROGRAM SERVICE EXPENSES 7,031. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,031. SERVICE FEES: PROGRAM SERVICE EXPENSES 100,899. MANAGEMENT AND GENERAL EXPENSES 88,819. FUNDRAISING EXPENSES 2,538. TOTAL EXPENSES 192,256. |
| FORM 990, PART IX, LINE 24E | MISCELLANEOUS: PROGRAM SERVICE EXPENSES 30,330. MANAGEMENT AND GENERAL EXPENSES 65,973. FUNDRAISING EXPENSES 1,800. TOTAL EXPENSES 98,103. HONORARIA: PROGRAM SERVICE EXPENSES 96,450. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,450. BANK CHARGES: PROGRAM SERVICE EXPENSES 21,669. MANAGEMENT AND GENERAL EXPENSES 10,132. FUNDRAISING EXPENSES 32,657. TOTAL EXPENSES 64,458. PRINTING AND DESIGN: PROGRAM SERVICE EXPENSES 40,242. MANAGEMENT AND GENERAL EXPENSES 8,084. FUNDRAISING EXPENSES 1,478. TOTAL EXPENSES 49,804. COUNCIL AND COMMITTEES: PROGRAM SERVICE EXPENSES 49,045. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,045. DUES AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 9,682. MANAGEMENT AND GENERAL EXPENSES 38,012. FUNDRAISING EXPENSES 357. TOTAL EXPENSES 48,051. OFFICE EQUIPMENT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 40,814. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,814. TELEPHONE: PROGRAM SERVICE EXPENSES 1,268. MANAGEMENT AND GENERAL EXPENSES 28,251. FUNDRAISING EXPENSES 176. TOTAL EXPENSES 29,695. POSTAGE AND SHIPPING: PROGRAM SERVICE EXPENSES 23,803. MANAGEMENT AND GENERAL EXPENSES 1,269. FUNDRAISING EXPENSES 3,817. TOTAL EXPENSES 28,889. PROFESSIONAL DEVELOPMENT: PROGRAM SERVICE EXPENSES 8,957. MANAGEMENT AND GENERAL EXPENSES 13,939. FUNDRAISING EXPENSES 2,806. TOTAL EXPENSES 25,702. |
| FORM 990, PART XI, LINE 8 | THE ORGANIZATION MADE A PRIOR PERIOD ADJUSTMENT DURING 2019 DUE TO: RECOGNITION OF AN EXPENSE THAT WAS NOT RECORDED IN THE PRIOR YEAR AND THE SHIFTING OF A NET ASSETS CATEGORY FROM BOARD-DESIGNATED TO WITH RESTRICTIONS. |
| Software ID: | |
| Software Version: |