Form990EZ
Department of the Treasury
Internal Revenue Service
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
bullet Do not enter social security numbers on this form as it may be made public.


bullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
A
For the 2022 calendar year, or tax year beginning 01-01-2022, and ending 12-31-2022
B
Check if applicable:
C Name of organization
KEYSTONE CHAPTER AMERICAN COLLEGE
OF SURGEONS
Number and street (or P. O. box, if mail is not delivered to street address)265 OBERLIN ROAD
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code MIDDLETOWN, PA170573014
D Employer identification number

23-2083532
E Telephone number

(717) 220-5255
F Group Exemption
Numberbullet  
G Accounting Method: Other (specify) bullet   H Check bulletI Website:bulletWWW.KC-ACS.ORGJ Tax-exempt status (check only one) - ( 6) bullet (insert no.) or
K Form of organization:  
L Add lines 5b, 6c, and 7b to line 9 to determine gross receipts. If gross receipts are $200,000 or more, or if total assets (Part II, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ ...........................bullet $ 30,940
Part Ⅰ
Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I) Check if the organization used Schedule O to respond to any question in this Part I.....................
VerticalRevenue 1 Contributions, gifts, grants, and similar amounts received .................... 1 100
2 Program service revenue including government fees and contracts ................ 2 690
3 Membership dues and assessments ............................. 3 30,150
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  
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  
c Less: direct expenses from gaming and fundraising events ... 6c  
d Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c) 6d  
7a Gross sales of inventory, less returns and allowances ...... 7a  
b Less: cost of goods sold ............. 7b  
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 .............. Bullet 9 30,940
.
VerticalExpenses 10 Grants and similar amounts paid (list in Schedule O) ................ 10  
11 Benefits paid to or for members ...................... 11  
12 Salaries, other compensation, and employee benefits ................ 12  
13 Professional fees and other payments to independent contractors ............ 13 30,433
14 Occupancy, rent, utilities, and maintenance ................... 14  
15 Printing, publications, postage, and shipping ................... 15  
16 Other expenses (describe in Schedule O) ................... 16 6,646
17 Total expenses. Add lines 10 through 16 ................. Bullet 17 37,079
VerticalNetAssets 18 Excess or (deficit) for the year (Subtract line 17 from line 9) ............ 18 -6,139
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 20,735
20 Other changes in net assets or fund balances (explain in Schedule O) ........... 20 -2,149
21 Net assets or fund balances at end of year. Combine lines 18 through 20 .......... 21 12,447
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10642I Form 990-EZ (2022)
Form 990-EZ (2022)
Page 2
Part ⅡBalance Sheets (see the instructions for Part II)Check if the organization used Schedule O to respond to any question in this Part II.................

(A) Beginning of year(B) End of year
22Cash, savings, and investments................
36,710
22
19,297
23Land and buildings....................
 
23
 
24Other assets (describe in Schedule O) ..........
2,600
24
2,600
25Total assets......................
39,310
25
21,897
26
Total liabilities (describe in Schedule O) .............
18,575
26
9,450
27Net assets or fund balances (line 27 of column (B) must agree with line 21)
20,735
27
12,447
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? THE EASTERN PENNSYLVANIA CHAPTER OF THE AMERICAN COLLEGE OF SURGEONS WAS INCORPORATED IN APRIL 1993, UNDER THE PENNSYLVANIA NONPROFIT CORPORATION LAW OF 1988. EFFECTIVE JANUARY 1, 2003, THE CHAPTER MERGED WITH THE CENTRAL PENNSYLVANIA CHAPTER OF THE AMERICAN COLLEGE OF SURGEONS, INC. AND CHANGED ITS NAME TO THE KEYSTONE CHAPTER, AMERICAN COLLEGE OF SURGEONS, INC. THE PURPOSE OF THE CHAPTER IS TO ELEVATE THE STANDARDS OF SURGERY AND TO EDUCATE THE PROFESSION AND THE PUBLIC REGARDING THE SPECIAL TRAINING INVOLVED IN THE PRACTICE OF SURGERY. IN ADDITION, THE CHAPTER UNITES MEMBERS IN THEIR EFFORTS TO IMPROVE THE QUALITY OF SURGICAL PATIENT CARE AND PROVIDES A MEDIUM THROUGH WHICH SURGICAL EXPERIENCES MAY BE PRESENTED.
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 THE KEYSTONE CHAPTER, WHICH REPRESENTS 42 COUNTIES IN EASTERN AND CENTRAL PENNSYLVANIA, OFFERS EXCLUSIVE MEMBER BENEFITS, DEVELOPS EXCELLENT CONTINUING EDUCATION PROGRAMS, PROVIDES MORE FREQUENT AND USEFUL COMMUNICATIONS ON ISSUES OF CONCERN AND INTEREST TO THE SURGICAL PROFESSION, AND OVERALL, SERVES AS AN EFFECTIVE VOICE FOR SURGEONS.
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet		 28a  
29 THE CHAPTER HOLDS AN ANNUAL MEETING WHERE MEMBERS AND NON-MEMBER ATTENDEES QUALIFY FOR EDUCATION CREDITS. APPROXIMATELY 125 MEMBER AND NON-MEMBER PHYSICIANS ATTENDED THE ANNUAL SCIENTIFIC MEETING HELD ON NOVEMBER 18TH AT TOWER HEALTH READING HOSPITAL IN READING, PA. THIRTY POSTERS WERE SUBMITTED FOR THE ABSTRACT JUDGING COMPETITION; 12 POSTERS WERE SELECTED FOR ORAL PRESENTATIONS DURING THE SESSIONS. NINE EXHIBITORS WERE ON HAND TO DISPLAY AND DISCUSS THEIR PRODUCTS WITH THE ATTENDEES. A FULL-DAY PROGRAM OF EDUCATIONAL SESSIONS ON VARIOUS SURGICAL-RELATED TOPICS WAS PRESENTED PROVIDING ATTENDEES WITH CME. THE RESIDENT SURGICAL JEOPARDY TOURNAMENT WAS HELD IN CONJUNCTION WITH THE ANNUAL MEETING. NINE RESIDENT TEAMS COMPETED FOR THE COVETED HONOR OF RECEIVING THE JEOPARDY TROPHY.
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet		 29a  
30 THE CHAPTER IS AN EXCELLENT AND APPROPRIATE VEHICLE TO MAKE THE CONCERNS OF SURGEONS FROM EASTERN AND CENTRAL PENNSYLVANIA HEARD NOT ONLY AT ACS HEADQUARTERS IN CHICAGO, BUT ALSO IN HARRISBURG AND WASHINGTON, D.C. THROUGH ITS STRONG TIES WITH THE AMERICAN COLLEGE OF SURGEONS, THE THREE OTHER REGIONAL PENNSYLVANIA CHAPTERS AND THE PENNSYLVANIA MEDICAL SOCIETY, THE CHAPTER MONITORS AND SUPPORTS ACTION ON THE LEGISLATIVE AND REGULATORY ISSUES THAT AFFECT THEIR PATIENTS AND PROFESSION.
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet		 30a  
31 Other program services (describe in Schedule O) ................
(Grants $   ) If this amount includes foreign grants, check here...MediumBullet		 31a
32 Total program service expenses (add lines 28a through 31a).......... bullet 32  
Part Ⅳ
List of Officers, Directors, Trustees, and Key Employees (list each one even if not compensated ; see the instructions for Part IV)Check if the organization used Schedule O to respond to any question in this Part IV............
(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
STANISLAW P STAWICKI MD FACS  
 
PRESIDENT 		5.00 0    
P KURT BAMBERGER MD FACS  
 
PRESIDENT-EL 		5.00 0    
CHAND ROHATGI MD BS FACS  
 
SECRETARY/TR 		5.00 0    
SHANNON M FOSTER MD FACS  
 
IMMED. PAST 		5.00 0    
JOSEPH A BLANSFIELD MD FACS  
 
GOVERNOR 		5.00 0    
ANNE G RIZZO MD FACS  
 
REGENT 		5.00 0    
JOSEPH P BANNON MD FACS  
 
COUNCILOR 		5.00 0    
CHRISTOPHER BUTTS DO FACS  
 
COUNCILOR 		5.00 0    
CHRISTOPHER BUZAS DO FACS  
 
COUNCILOR 		5.00 0    
ROBERTO CASTILLO MD  
 
COUNCILOR 		5.00 0    
CHRISTOPHER P COPPOLA MD FACS  
 
COUNCILOR 		5.00 0    
DANIELLE HASHMI DO  
 
COUNCILOR 		5.00 0    
REBECCA HOFFMAN MD FACS  
 
COUNCILOR 		5.00 0    
MELISSA LINSKEY-DOUGHERTY MD  
 
COUNCILOR 		5.00 0    
DONALD MACKAY MD FACS  
 
COUNCILOR 		5.00 0    
COLLIN MYERS MD FACS  
 
COUNCILOR 		5.00 0    
ASANTHI RATNASEKERA MD FACS  
 
COUNCILOR 		5.00 0    
JOHN F TURNER III MD FACS  
 
COUNCILOR 		5.00 0    
LAURYN ULLRICH DO  
 
COUNCILOR 		5.00 0    
MATTHEW C INDECK MD FACS  
 
SENIOR ADVIS 		5.00 0    
RICHARD VAN DE GRAAF MD  
 
RAS REPRESEN 		5.00 0    
ROBBI-ANN M COOK CAE  
 
EXECUTIVE DI 		5.00 0    
Form 990-EZ (2022)
Form 990-EZ (2022)
Page 3
Part Ⅴ
Other Information
(Note the Schedule A and personal benefit contract statement requirements in the
instructions for Part V.) Check if the organization used Schedule O to respond to any question in this Part V.......
Yes
No
33
Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ...................
33
 
No
34
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the changeon Schedule O. See instructions. ..........................
34
 
No
35a
Did the organization have unrelated business gross income of $1,000 or more during the year from business activities (such as those reported on lines 2, 6a, and 7a, among others)? ............
35a
 
No
b
If "Yes," to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule O
35b
 
 
c
Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
35c
Yes
 
36
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes," complete applicable parts of Schedule N ................
36
 
No
37a
Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet
37a
 
b
Did the organization file Form 1120-POL for this year?...................
37b
 
No
38a
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?..
38a
 
No
b
If “Yes," complete Schedule L, Part II and enter the total amount involved .
38b
 
39
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on line 9.......
39a
 
b
Gross receipts, included on line 9, for public use of club facilities.....
39b
 
40a
Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 bullet   ; section 4912 bullet   ; section 4955 bullet  
b
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes," complete Schedule L, Part I
40b
 
 
c
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958bullet  
d
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Enter amount of tax on line 40c reimbursed by the organizationbullet  
e
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T ................
40e
 
No
41List the states with which a copy of this return is filed. bullet
42a The organization's books are in care of bulletROBBI-ANN M COOK
 Telephone no.bullet (717) 220-5255


Located at bullet265 OBERLIN ROADMIDDLETOWN, PA ZIP + 4 bullet170573014
Yes
No
b
At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)? . .
42b
 
No
If “Yes," enter the name of the foreign country: bullet
See the instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
c
At any time during the calendar year, did the organization maintain an office outside the U.S.? . . .
42c
 
No
If “Yes," enter the name of the foreign country: bullet
43 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of Form 1041 - Check here ...... bullet
and enter the amount of tax-exempt interest received or accrued during the tax year ....bullet43
 
Yes
No
44a
Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed insteadof Form 990-EZ.............................
44a
 
No
b
Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must be completedinstead of Form 990-EZ.............................
44b
 
No
c
Did the organization receive any payments for indoor tanning services during the year? .........
44c
 
No
d
If "Yes," to line 44c, has the organization filed a Form 720 to report these payments? If "No," provide an
explanation in Schedule O ............................
44d
 
 
45a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?.........
45a
 
No
45b
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form 990-EZ (see instructions)......................
45b
 
No
Form 990-EZ (2022)
Form 990-EZ (2022)
Page 4
Yes
No
46
Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition to candidates for public office? If “Yes," complete Schedule C, Part I. Click to see attachment
List of Attached Documents:
// Content
...........
46
 
No
Part Ⅵ
Section 501(c)(3) Organizations Only All section 501(c)(3) organizations must answer questions 47- 49b and 52, and complete the tables for lines 50 and 51. Check if the organization used Schedule O to respond to any question in this Part VI ..................
Yes
No
47
Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II .......................
47
 
 
48
Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ..
48
 
 
49a
Did the organization make any transfers to an exempt non-charitable related organization?......
49a
 
 
b
If "Yes," was the related organization a section 527 organization?................
49b
 
 
50
Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(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
 
f
Total number of other employees paid over $100,000 .............bullet  

51
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and business address of each independent contractor (b) Type of service (c) Compensation
 
d
Total number of other independent contractors each receiving over $100,000..........bullet  


52
Did the organization complete Schedule A? NOTE. All section 501(c)(3) organizations must attach a
completed Schedule A ........................................bullet
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name bullet

Firm's EIN bullet
Firm's address bullet



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
Form 990-EZ (2022)

Additional Data


Software ID:  
Software Version:  

Form 990-EZ, Special Condition Description:
Special Condition Description

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
KEYSTONE CHAPTER AMERICAN COLLEGE
OF SURGEONS
Employer identification number

23-2083532
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990) 2021


Schedule C (Form 990) 2021
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
 
c
Media advertisements? ...................................................................................................
 
 
 
d
Mailings to members, legislators, or the public? .............................................................................
 
 
 
e
Publications, or published or broadcast statements? ...........................................................
 
 
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
 
 
i
Other activities? ...................................................................................................................
 
 
 
j
Total. Add lines 1c through 1i ....................................................................................................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
No
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
Yes
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
No
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C (Form 990) 2021


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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.
MediumBullet 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
KEYSTONE CHAPTER AMERICAN COLLEGE
OF SURGEONS
Employer identification number

23-2083532
Return Reference Explanation
FORM 990-EZ, PART I, LINE 16 EXPENSES SUPPLIES 14 WEBSITE 4,221 INSURANCE 1,802 BANK FEES 609 TOTAL 6,646
FORM 990-EZ, PART I, LINE 20 UNREALIZED LOSS ON INVESTMENTS -2,149
FORM 990-EZ, PART II, LINE 24 PREPAID EXPENSES AND DEFERRED CHARGES 2,600 2,600 TOTAL 2,600 2,600
FORM 990-EZ, PART II, LINE 26 DEFERRED REVENUE 18,575 9,450
FORM 990-EZ, PART III THE EASTERN PENNSYLVANIA CHAPTER OF THE AMERICAN COLLEGE OF SURGEONS WAS INCORPORATED IN APRIL 1993, UNDER THE PENNSYLVANIA NONPROFIT CORPORATION LAW OF 1988. EFFECTIVE JANUARY 1, 2003, THE CHAPTER MERGED WITH THE CENTRAL PENNSYLVANIA CHAPTER OF THE AMERICAN COLLEGE OF SURGEONS, INC. AND CHANGED ITS NAME TO THE KEYSTONE CHAPTER, AMERICAN COLLEGE OF SURGEONS, INC. THE PURPOSE OF THE CHAPTER IS TO ELEVATE THE STANDARDS OF SURGERY AND TO EDUCATE THE PROFESSION AND THE PUBLIC REGARDING THE SPECIAL TRAINING INVOLVED IN THE PRACTICE OF SURGERY. IN ADDITION, THE CHAPTER UNITES MEMBERS IN THEIR EFFORTS TO IMPROVE THE QUALITY OF SURGICAL PATIENT CARE AND PROVIDES A MEDIUM THROUGH WHICH SURGICAL EXPERIENCES MAY BE PRESENTED.
FORM 990-EZ, PART III, LINE 28 THE KEYSTONE CHAPTER, WHICH REPRESENTS 42 COUNTIES IN EASTERN AND CENTRAL PENNSYLVANIA, OFFERS EXCLUSIVE MEMBER BENEFITS, DEVELOPS EXCELLENT CONTINUING EDUCATION PROGRAMS, PROVIDES MORE FREQUENT AND USEFUL COMMUNICATIONS ON ISSUES OF CONCERN AND INTEREST TO THE SURGICAL PROFESSION, AND OVERALL, SERVES AS AN EFFECTIVE VOICE FOR SURGEONS.
FORM 990-EZ, PART III, LINE 29 THE CHAPTER HOLDS AN ANNUAL MEETING WHERE MEMBERS AND NON-MEMBER ATTENDEES QUALIFY FOR EDUCATION CREDITS. APPROXIMATELY 125 MEMBER AND NON-MEMBER PHYSICIANS ATTENDED THE ANNUAL SCIENTIFIC MEETING HELD ON NOVEMBER 18TH AT TOWER HEALTH READING HOSPITAL IN READING, PA. THIRTY POSTERS WERE SUBMITTED FOR THE ABSTRACT JUDGING COMPETITION; 12 POSTERS WERE SELECTED FOR ORAL PRESENTATIONS DURING THE SESSIONS. NINE EXHIBITORS WERE ON HAND TO DISPLAY AND DISCUSS THEIR PRODUCTS WITH THE ATTENDEES. A FULL-DAY PROGRAM OF EDUCATIONAL SESSIONS ON VARIOUS SURGICAL-RELATED TOPICS WAS PRESENTED PROVIDING ATTENDEES WITH CME. THE RESIDENT SURGICAL JEOPARDY TOURNAMENT WAS HELD IN CONJUNCTION WITH THE ANNUAL MEETING. NINE RESIDENT TEAMS COMPETED FOR THE COVETED HONOR OF RECEIVING THE JEOPARDY TROPHY.
FORM 990-EZ, PART III, LINE 30 THE CHAPTER IS AN EXCELLENT AND APPROPRIATE VEHICLE TO MAKE THE CONCERNS OF SURGEONS FROM EASTERN AND CENTRAL PENNSYLVANIA HEARD NOT ONLY AT ACS HEADQUARTERS IN CHICAGO, BUT ALSO IN HARRISBURG AND WASHINGTON, D.C. THROUGH ITS STRONG TIES WITH THE AMERICAN COLLEGE OF SURGEONS, THE THREE OTHER REGIONAL PENNSYLVANIA CHAPTERS AND THE PENNSYLVANIA MEDICAL SOCIETY, THE CHAPTER MONITORS AND SUPPORTS ACTION ON THE LEGISLATIVE AND REGULATORY ISSUES THAT AFFECT THEIR PATIENTS AND PROFESSION.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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