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ObjectId: 201500459349300810 - Submission: 2015-02-14
TIN: 36-2406080
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
Attach to Form 990.
See separate instructions.
Information about Schedule J (Form 990) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
13
Open to Public Inspection
Name of the organization
AMERICAN SOCIETY FOR CLINICAL PATHOLOGY
Employer identification number
36-2406080
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel
Housing allowance or residence for personal use
Travel for companions
Payments for business use of personal residence
Tax idemnification and gross-up payments
Health or social club dues or initiation fees
Discretionary spending account
Personal services (e.g., maid, chauffeur, chef)
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain
1b
No
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a?
..
2
Yes
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
Compensation committee
Written employment contract
Independent compensation consultant
Compensation survey or study
Form 990 of other organizations
Approval by the board or compensation committee
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment?
................
4a
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan?
.........
4b
No
c
Participate in, or receive payment from, an equity-based compensation arrangement?
.........
4c
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization?
...........................
5a
No
b
Any related organization?
5b
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization?
6a
No
b
Any related organization?
6b
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III
............
7
Yes
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III
.............................
8
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)?
.........................
9
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013
Page 2
Schedule J (Form 990) 2013
Page
2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees.
Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note.
The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A)
Name and Title
(B)
Breakdown of W-2 and/or 1099-MISC compensation
(C)
Retirement and other deferred compensation
(D)
Nontaxable
benefits
(E)
Total of columns
(B)(i)-(D)
(F)
Compensation
reported as deferred
in prior Form 990
(i)
Base compensation
(ii)
Bonus & incentive compensation
(iii)
Other reportable compensation
1
E BLAIR HOLLADAY
EXECUTIVE VICE PRESIDENT
(i)
(ii)
435,212
0
52,885
0
43,495
0
20,000
0
10,944
0
562,536
0
0
0
2
STEVEN CIACCIO
CHIEF OPERATING OFFICER
(i)
(ii)
278,292
0
14,300
0
0
0
20,000
0
2,340
0
314,932
0
0
0
3
SUZANNE ZIEMNIK
VP - CONTINUING PROFESSIONAL DEVELOP
(i)
(ii)
206,922
0
15,706
0
0
0
17,979
0
2,240
0
242,847
0
0
0
4
JEFF JACOBS
VP - PUBLIC POLICY
(i)
(ii)
206,690
0
10,140
0
0
0
16,735
0
2,472
0
236,037
0
0
0
5
SHIWEN SONG
SR. SCIENTIFIC DIRECTOR
(i)
(ii)
173,789
0
9,000
0
1,500
0
7,559
0
1,328
0
193,176
0
0
0
6
PATRICIA TANABE
EXECUTIVE DIRECTOR-VP-BOC
(i)
(ii)
153,582
0
8,275
0
0
0
13,647
0
8,868
0
184,372
0
0
0
7
JEAN MARIE DILLON
VP-HUMAN RESOURCES AND DEVELOPMENT
(i)
(ii)
150,651
0
13,950
0
0
0
13,516
0
4,485
0
182,602
0
0
0
8
RON SWAN
CHIEF INFORMATION OFFICER
(i)
(ii)
151,201
0
8,050
0
0
0
13,284
0
6,931
0
179,466
0
0
0
9
JOHN ZHU
INFORMATION TECH MANAGER
(i)
(ii)
128,723
0
0
0
0
0
0
0
37,743
0
166,466
0
0
0
Schedule J (Form 990) 2013
Page 3
Schedule J (Form 990) 2013
Page
3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference
Explanation
PART I, LINE 1A
E. BLAIR HOLLADAY WAS THE ONLY ELGIBLE PERSON TO RECEIVE THE HOUSING BENEFIT. THE AMOUNT OF $30,000 WAS INCLUDED IN TAXABLE EARNINGS AND TREATED AS TAXABLE COMPENSATION.
PART I, LINE 1B
THIS BENEFIT WAS DECIDED UPON BY THE BOARD OF DIRECTORS, THEY HAVE JOINT REVIEW IN REGARDS TO THE FRINGE BENEFITS THAT THE EVP WILL BE ELIGIBLE FOR WHEN REVIEWING HIS COMPENSATION ON AN ANNUAL BASIS.
PART I, LINE 7
SOME INDIVIDUALS RECEIVED PERFORMANCE BONUSES, AND THE EXECUTIVE V.P. (HOLLADAY) RECEIVED A BONUS PAYMENT, AS APPROVED BY THE BOARD OF DIRECTORS. ADDITIONALLY, ON AN ANNUAL BASIS, THE SOCIETY REVIEWS THEIR BUDGET TO DETERMINE WHETHER IT IS IN A DEFICIT FOR THE UPCOMING FISCAL YEAR. IF IT IS NOT IN A DEFICIT, SENIOR MANAGEMENT REQUESTS APPROVAL FROM A BOARD COMMITTEE FOR ALL STAFF (EXCEPT THE EXEC. VICE PRESIDENT) TO RECEIVE A 1 OR 2% BONUS CALCULATED AGAINST THEIR EARNINGS. THE BONUS IS DISCRETIONARY, AS WELL. EMPLOYEES THAT MEET THE INCOME CRITERIA FOR BEING HIGHLY COMPENSATED ARE ENTERED IN A SEPARATE, DISCRETIONARY BONUS PROGRAM THAT ENABLES THEM TO BE CONSIDERED FOR A HIGHER BONUS THAT IS DETERMINED BASED ON WHETHER THE SOCIETY ENDS THE FISCAL YEAR IN A DEFICIT OR NOT. SOME INDIVIDUALS IN THIS HCE GROUP MAY BE INELIGIBLE BASED ON WORK PERFORMANCE, BASED ON DETERMINATION BY EVP AND VP OF HR & DEVELOPMENT.
Schedule J (Form 990) 2013
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