TY 2021 Form 990EZ

(a) Name and title	(b) Average hours per week devoted to position	(c) Reportable compensation (Forms W-2/1099-MISC) (if not paid, enter -0-)
FRANCISCO ESPINEL MD IMMED PAST PRES	0.50	0
JENNY HONG MD President	0.50	0
DONALD SAROFF MD Director	0.50	0
MICHELLE SAROFF Executive Dir.	24.00	70,500
KEVIN DONOHUE DO PRESIDENT-ELECT	0.50	0
RUDY PIGALARGA MD Vice President	0.50	0
SHASHI RANGANATH MD Secretary	0.50	0
OMAR JAVERY MD Treasurer	0.50	0
ANDREA GIACOMETTI MD Director	0.50	0
JAY SALAMEH MD Director	0.50	0
PAULA BERGAMINI MD Director	0.50	0
WILLIAM FURLONG MD Director	0.50	0
TOM KINGSTON MD Director	0.50	0
JOHN SAMUEL MD Director	0.50	0

(a) Name and title

(b) Average
hours per week
devoted to position

(c) Reportable compensation
(Forms W-2/1099-MISC) (if not paid, enter -0-)

(d) Health benefits, contributions to employee benefit plans, and
deferred compensation

(e) Estimated amount
of other compensation

FRANCISCO ESPINEL MD

IMMED PAST PRES

0.50

JENNY HONG MD

President

0.50

DONALD SAROFF MD

Director

0.50

MICHELLE SAROFF

Executive Dir.

24.00

70,500

KEVIN DONOHUE DO

PRESIDENT-ELECT

0.50

RUDY PIGALARGA MD

Vice President

0.50

SHASHI RANGANATH MD

Secretary

0.50

OMAR JAVERY MD

Treasurer

0.50

ANDREA GIACOMETTI MD

Director

0.50

JAY SALAMEH MD

Director

0.50

PAULA BERGAMINI MD

Director

0.50

WILLIAM FURLONG MD

Director

0.50

TOM KINGSTON MD

Director

0.50

JOHN SAMUEL MD

Director

0.50

(a) Name and title of each employee

(b) Average
hours per week
devoted to position

(c) Reportable compensation
(Forms W-2/1099-MISC)

(d) Health benefits, contributions to employee benefit plans, and deferred compensation

(e) Estimated amount of other compensation

NONE

(a) Name and business address of each independent contractor

(b) Type of service

(c) Compensation

NONE

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
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Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

ARLINGTON COUNTY MEDICAL SOCIETY

Employer identification number

54-0544710

Return Reference	Explanation
Other Expenses.1001	Advertising and Promotion $800
Other Expenses.1002	Office Expenses $2696
Other Expenses.1003	Information Technology $1326
Other Expenses.1009	Depreciation $107
Other Expenses.1012	Insurance $1144
Other Expenses.1	TELEPHONE $1514
Other Expenses.2	BANK & CREDIT CARD FEES $697
Other Expenses.3	ADMINISTRATIVE TAXES $586
Other Expenses.4	MISCELLANEOUS & OTHER EXPENSE $536
Other Assets.1003	Machinery and Equipment - Beginning $28 Machinery and Equipment - Ending $28
Other Assets.1005	Accounts Receivable - Beginning $7500 Accounts Receivable - Ending $8325
Other Assets.1	PAYROLL REFUNDS - Beginning $0 PAYROLL REFUNDS - Ending $42
Total Liabilities.1001	Accounts Payable and Accrued Expenses - Beginning $859 Accounts Payable and Accrued Expenses - Ending $84
Total Liabilities.1003	Deferred Revenue - Beginning $6750 Deferred Revenue - Ending $10700
Total Liabilities.1	CREDIT CARD PAYABLE - Beginning $53 CREDIT CARD PAYABLE - Ending $69
Total Liabilities.2	PAYROLL TAXES PAYABLE - Beginning $4059 PAYROLL TAXES PAYABLE - Ending $6004

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.0

1	Contributions, gifts, grants, and similar amounts received ....................	1
2	Program service revenue including government fees and contracts ................	2	24,221
3	Membership dues and assessments .............................	3	103,205
4	Investment income ....................................	4
5a	Gross amount from sale of assets other than inventory .......	5a
b	Less: cost or other basis and sales expenses ............	5b	0
c	Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ......	5c
6	Gaming and fundraising events
a	Gross income from gaming (attach Schedule G if greater than $15,000)	6a
b	Gross income from fundraising events (not including $ of contributions from fundraising events reported on line 1) (attach Schedule G if the			sum of such gross income and contributions exceeds $15,000) ..	6b	11,785
c	Less: direct expenses from gaming and fundraising events ...	6c	9,782
d	Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c)	6d	2,003
7a	Gross sales of inventory, less returns and allowances ......	7a
b	Less: cost of goods sold .............	7b	0
c	Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) .........	7c
8	Other revenue (describe in Schedule O) ....................	8
9	Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 ..............	9	129,429

10	Grants and similar amounts paid (list in Schedule O) ................	10
11	Benefits paid to or for members ......................	11	13,713
12	Salaries, other compensation, and employee benefits ................	12	75,962
13	Professional fees and other payments to independent contractors ............	13	7,395
14	Occupancy, rent, utilities, and maintenance ...................	14	3,600
15	Printing, publications, postage, and shipping ...................	15	125
16	Other expenses (describe in Schedule O) ...................	16	9,406
17	Total expenses. Add lines 10 through 16 .................	17	110,201

18	Excess or (deficit) for the year (Subtract line 17 from line 9) ............	18	19,228
19	Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
	end-of-year figure reported on prior year’s return) .................	19	146,715
20	Other changes in net assets or fund balances (explain in Schedule O) ...........	20
21	Net assets or fund balances at end of year. Combine lines 18 through 20 ..........	21	165,943

Part ⅢStatement of Program Service Accomplishments (see the instructions for Part III) Check if the organization used Schedule O to respond to any question in this Part III . .	Expenses (Required for section 501(c)(3) and 501(c)(4) organizations; optional for others.)
What is the organization's primary exempt purpose? TO ADVOCATE FOR THE MEDICAL PROFESSION
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 MEMBERSHIP MEETINGS AND EXECUTIVE LEADERSHIP MEETINGS TO FACILITATE THE ORGANIZATION'S ACTIVITIES (Grants $ ) If this amount includes foreign grants, check here ...			28a	13,713
29 SPONSORSHIP OF GOLF AND TENNIS TOURNAMENTS TO RAISE MONEY FOR MEDICAL SCHOLORSHIP AND PROVIDE NETWORKING OPPORTUNITIES (Grants $ ) If this amount includes foreign grants, check here ...			29a	9,782
30 PROFESSIONAL OUTREACH BY PUBLISHING QUARTERLY NEWSLETTER TO PROMOTE EVENTS, MEETINGS AND VOLUNTEER OPPORTUNITIES FOR THE MEMBERS. (Grants $ ) If this amount includes foreign grants, check here ...			30a	800
TO ASSIST THE ARLINGTON COUNTY MEDICAL SOCIETY FOUNDATION WITH THEIR OUTREACH PROGRAMS (Grants $ ) If this amount includes foreign grants, check here ...
31 Other program services (describe in Schedule O) ................ (Grants $ ) If this amount includes foreign grants, check here...	31a
32 Total program service expenses (add lines 28a through 31a)..........	32	24,295

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