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)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 191,831 | 181,705 | 193,740 | 133,200 | 147,265 | 847,741 |
| 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 | 346,328 | 328,724 | 135,470 | 52,530 | 251,827 | 1,114,879 |
| 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 | 538,159 | 510,429 | 329,210 | 185,730 | 399,092 | 1,962,620 |
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 1,962,620 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 538,159 | 510,429 | 329,210 | 185,730 | 399,092 | 1,962,620 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 214 | 295 | 210 | 43 | 43 | 805 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 214 | 295 | 210 | 43 | 43 | 805 |
| 11 | Net income from unrelated business activities not included on 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.) .. | 2,148 | 1,493 | 3,815 | 7,456 | ||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 540,521 | 512,217 | 333,235 | 185,773 | 399,135 | 1,970,881 |
| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| 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 3 | ADAM HAD A MANAGEMENT AGREEMENT WITH SOLUTIONS FOR ASSOCIATION MANAGEMENT INC. (SAMI), THROUGH WHICH SHC PROVIDED ADAM WITH EXECUTIVE MANAGEMENT AND ADMINISTRATIVE SERVICES FOR THE ACTIVITIES AND PROGRAMS OF THE ASSOCIATION, INLCUDING COMPUTERIZED FILE MAINTENANCE AND OFFICE SPACE. THE MANAGEMENT AGREEMENT INCLUDED THE SERVICES OF AN EXECUTIVE DIRECTOR WHO WAS NOT COMPENSATED BY ADAM. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERSHIP IN THE ASSOCIATION SHALL BE OPEN TO PERSONS, DERMATOLOGY OFFICES AND PRACTICES AND COMPANIES WHO ARE INVOLVED IN, OR THAT HAVE A SPECIFIC INTEREST IN, THE FIELD OF DERMATOLOGY. THERE SHALL BE SIX (6) CLASSES OF MEMBERS (CHARTER, ACTIVE, AFFILIATE, HONORARY, CORPORATE AND PRACTICE) AS FOLLOWS: CHARTER MEMBERS - INDIVIDUALS ACCEPTED TO MEMBERSHIP ON OR BEFORE DECEMBER 31, 1994. CHARTER MEMBERS WILL NOT CHANGE MEMBERSHIP CATEGORY ONCE ACCEPTED IN THE ASSOCIATION. CHARTER MEMBERS MAY VOTE AND HOLD OFFICE AND ARE REQUIRED TO PAY DUES AS DETERMINED BY THE BOARD. ACTIVE MEMBERS - INDIVIDUALS WHO ARE ACTIVELY ENGAGED IN DERMATOLOGY AND WERE ACCEPTED TO MEMBERSHIP ON OR AFTER JANUARY 1, 1995. ACTIVE MEMBERS MAY VOTE AND HOLD OFFICE AND ARE REQUIRED TO PAY DUES AS DETERMINED BY THE BOARD. ACTIVE MEMBERS WHO CEASE BEING ACTIVELY ENGAGED IN DERMATOLOGY MAY CHOOSE TO REMAIN IN THE ASSOCIATION AS AFFILIATE MEMBERS. AFFILIATE MEMBERS - INDIVIDUALS WHO HAVE A SPECIFIC INTEREST IN THE FIELD OF DERMATOLOGY, BUT MAY NOT BE SERVING IN THE CAPACITY OF AN ADMINISTRATOR OR MANAGER OF A DERMATOLOGICAL PRACTICE. AFFILIATE MEMBERS MAY VOTE AND HOLD OFFICE AND ARE REQUIRED TO PAY DUES AS DETERMINED BY THE BOARD. IF AN AFFILIATE MEMBER BECOMES ACTIVELY ENGAGED IN DERMATOLOGY THEY MAY REQUEST ELEVATION TO ACTIVE MEMBER STATUS. HONORARY MEMBERS - INDIVIDUALS RECOGNIZED FOR THEIR OUTSTANDING CONTRIBUTIONS TO THE FIELD OF DERMATOLOGY ADMINISTRATION OR MANAGEMENT. A RECOMMENDATION FROM A MEMBER OF THE BOARD, ACCOMPANIED BY THE CANDIDATE'S QUALIFICATIONS, SHALL BE SENT TO THE ASSOCIATION SECRETARY NOT LESS THAN SIXTY (60) DAYS PRIOR TO AN ANNUAL MEETING. HONORARY MEMBER STATUS IS GRANTED WHEN APPROVED BY A MAJORITY VOTE OF THE BOARD. HONORARY MEMBERS ARE NOT REQUIRED TO PAY DUES AND MAY NOT VOTE OR HOLD OFFICE. CORPORATE MEMBERS - A CORPORATE MEMBER IS A COMPANY OR FIRM WITH A SPECIFIC INTEREST IN THE FIELD OF DERMATOLOGY. CORPORATE MEMBERS ARE REQUIRED TO PAY DUES BASED ON MEMBERSHIP CATEGORY AS DETERMINED BY THE BOARD. A CORPORATE MEMBER MAY NOT VOTE OR HOLD OFFICE. PRACTICE MEMBERS - A PRACTICE MEMBER IS A PRIVATE, GROUP OR ACADEMIC DERMATOLOGY RELATED OFFICE OR PRACTICE THAT DESIRES TO DESIGNATE THREE OR MORE EMPLOYEES AS REPRESENTATIVES OF THE PRACTICE FOR PARTICIPATION IN THE ASSOCIATION. PRACTICE MEMBERS ARE REQUIRED TO PAY DUES AS DETERMINED BY THE BOARD BASED ON THE NUMBER OF EMPLOYEE REPRESENTATIVES DESIGNATED BY THE PRACTICE FROM TIME TO TIME. DESIGNATED EMPLOYEE REPRESENTATIVES MAY VOTE AND HOLD OFFICE. PRIVILEGES - A MEMBER OF THE ASSOCIATION, WHOSE DUES ARE PAID IN FULL AND IS NOT UNDER SUSPENSION, SHALL BE CONSIDERED A MEMBER IN GOOD STANDING. |
| FORM 990, PART VI, SECTION A, LINE 7A | ONLY CHARTER, ACTIVE AND AFFILIATE MEMBERS AND DESIGNATED EMPLOYEE REPRESENTATIVES OF PRACTICE MEMBERS IN GOOD STANDING SHALL BE ENTITLED TO VOTE, HOLD OFFICE, ACT AS DELEGATES OR SERVE ON THE BOARD OR A COMMITTEE. MEMBERSHIP IS NOT TRANSFERABLE. |
| FORM 990, PART VI, SECTION A, LINE 7B | VOTING MEMBERS MAY VOTE ON ANY ISSUES THAT THE BOARD PLACES BEFORE THEM FOR VOTE. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO OTHER COMMITTEES AUTHORIZED TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS PREPARED BY A 3RD PARTY ACCOUNTING FIRM. A COPY OF THE 990 IS THEN GIVEN TO MANAGEMENT FOR REVIEW. A FINAL COPY IS THEN GIVEN TO EACH MEMBER OF THE BOARD FOR THEIR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS IN CONCERT WITH THE EXECUTIVE DIRECTOR MAINTAINS COMPLIANCE WITH THE WRITTEN CONFLICT OF INTEREST POLICY. UNDER THE WRITTEN CONFLICT OF INTEREST POLICY, DURING ANY PRESENTATION OR DISCUSSION AT AN EDUCATIONAL SESSION, THE DIRECTOR WILL ASK EACH SPEAKER/COMMERCIAL ENDORSER/CONSULTANT PARTICIPATING IN THE DISCUSSION OF A PARTICULAR ISSUE, TO INTRODUCE HIMSELF OR HERSELF BY NAME AND PROFESSIONAL POSITION AND TO IDENTIFY ANY ASPECT OF THE SPEAKER/COMMERCIAL ENDORSER/CONSULTANT'S PERSONAL OR PROFESSIONAL CIRCUMSTANCES WHICH MIGHT REASONABLY BE EXPECTED TO AFFECT THE SPEAKER/COMMERCIAL ENDORSER/CONSULTANT'S VIEWS ON THE SUBJECT UNDER DISCUSSION. ANY INDIVIDUAL WHO REFUSES TO PROVIDE SUCH INFORMATION WILL BE DENIED THE OPPORTUNITY TO SPEAK. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. |
| Software ID: | |
| Software Version: |