2024-08-15T15:10:42-05:00 2023-09-30 912011386 JACOBSON JARVIS & CO PLLC 200 1ST AVE W SUITE 200 SEATTLE WA 98119 990 2022-10-01 910750294 WASHINGTON STATE DENTAL ASSOCIATION WASH 2064481914 126 NW CANAL STREET 300 SEATTLE WA 98107 BRACKEN KILLPACK EXECUTIVE DIRECTOR 2064481914 2024-08-15 1 0 JACOB J DEHNE CPA P02534988 2066288990 2024-08-15 2022 2024-08-08 14:25:15Z BRACKEN KILLPACK 126 NW CANAL STREET 300 SEATTLE WA 98107 5295351 0 X WWW.WSDA.ORG X 1949 WA TO UNITE MEMBERS OF THE DENTAL PROFESSION TO PROMOTE ORAL HEALTH OF THE HIGHEST QUALITY. 15 12 11 27 373504 125052 186336 0 3039473 4513337 533713 8448 534863 343114 4294385 4864899 0 0 0 0 1061498 1080799 0 0 0 2941554 4244608 4003052 5325407 291333 -460508 12510051 11096875 2550576 1320596 9959475 9776279 TO UNITE THE MEMBERS OF THE DENTAL PROFESSION WITHIN THE STATE AND WITH SIMILAR ASSOCIATIONS IN OTHER STATES AS CONSTITUENT PARTS OF THE AMERICAN DENTAL ASSOCIATION, WITH A VIEW TO THE EXTENSION OF DENTAL KNOWLEDGE AND TO THE ADVANCEMENT OF DENTAL SCIENCE. 0 0 WASHINGTON STATE DENTAL ASSOCIATION (WSDA) PROMOTES ORAL HEALTH OF THE HIGHEST QUALITY WITH 4,100+ MEMBERS REPRESENTING OVER 69 PERCENT OF THE PRACTICING DENTAL PROFESSIONALS IN WASHINGTON STATE. WSDA HAS AN ACTIVE PRESENCE WITH THE LEGISLATURE, CONTINUALLY ESTABLISHING ETHICAL STANDARDS FOR THE PROFESSION AND DEVELOPING SERVICES FOR THOSE LACKING ORAL HEALTH CARE. THE PACIFIC NORTHWEST DENTAL CONFERENCE (PNDC) OFFERS THREE DAYS OF CONTINUING DENTAL EDUCATION WITH OVER 50 NATIONALLY-RENOWNED SPEAKERS AND A DENTAL TRADE SHOW OF MORE THAN 150 EXHIBITS. WITH NEARLY 6,000 ATTENDEES, THE PNDC IS THE LARGEST GATHERING OF DENTAL PROFESSIONALS IN WASHINGTON. THE WASHINGTON STATE DENTAL ASSOCIATION FORMED WSDA GROUP RETRO, A RETROSPECTIVE RATING PROGRAM SANCTIONED BY THE WASHINGTON STATE DEPARTMENT OF LABOR AND INDUSTRIES IN ORDER TO IMPROVE SAFETY AND TO HELP PREVENT INJURIES IN THE DENTAL OFFICE THROUGH TRAINING AND EDUCATION. 0 0 1 1 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 53 0 1 11 1 1 1 0 0 0 1 1 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 WA X BRACKEN KILLPACK 2064481914 126 NW CANAL STREET 300 SEATTLE WA 98107 JOHN GIBBONS PAST PRESIDENT 5.00 0.00 X X 25000 0 0 NATHAN RUSSELL CURRENT PRESIDENT 5.00 0.00 X X 10000 0 0 CHRIS DOROW PRESIDENT-ELECT 5.00 1.00 X X 20000 0 0 BLAKE MCKINLEY SECRETARY - TREASURER 5.00 0.00 X X 0 0 0 LISA BUTTARO DIRECTOR 5.00 0.00 X 0 0 0 BRITTANY DEAN DIRECTOR 5.00 0.00 X 0 0 0 JOSEPH DE JESUS DIRECTOR 5.00 0.00 X 0 0 0 LISA EGBERT DIRECTOR 5.00 0.00 X 0 0 0 EMILY HOBART DIRECTOR 5.00 0.00 X 0 0 0 CHRISTINE KIRCHNER DIRECTOR 5.00 1.00 X 0 0 0 MARK KODAY DIRECTOR 5.00 0.00 X 0 0 0 MELANIE LANG DIRECTOR 5.00 0.00 X 0 0 0 KIN NORDBERG DIRECTOR 5.00 0.00 X 0 0 0 DANIEL TREMBLAY DIRECTOR 5.00 0.00 X 0 0 0 DANIEL WILSON DIRECTOR 5.00 0.00 X 0 0 0 BRACKEN KILLPACK EXECUTIVE DIRECTOR 30.00 1.00 X 172329 86294 0 KAINOA TROTTER ASSISTANT EXECUTIVE DIRECTOR 38.00 0.00 X 147500 0 0 EMILY LOVELL DIRECTOR OF GOVT AFFAIRS 38.00 0.00 X 112135 0 0 486964 86294 0 3 0 1 0 EMPLOYER RESOURCES NORTHWEST 1119 PACIFIC AVENUE STE 900 TACOMA WA 98402 GROUP RETRO SERVICES 209489 FM PUBLIC AFFIARS LLC 3806 SUNSET BEACH DR OLYMPIA WA 98502 PUBLIC AFFAIRS 140407 SYSTEM SIX BOOKKEEPING 7356 15TH AVE NW STE A SEATTLE WA 98117 ACCOUNTING 137209 3 PNW DENTAL CONFERENCE 813920 2522364 2522364 MEMBERSHIP DUES 813920 1325501 1325501 SPONSORSHIPS 813920 604472 604472 GRANTS 813920 61000 61000 4513337 8448 8448 375732 430452 -54720 -54720 -54720 ADVERTISING 541800 191143 191143 COMMISSIONS 900099 167361 167361 REBATES 900099 24330 24330 15000 15000 397834 4864899 4513337 373504 -21942 X 371319 526100 96175 87205 66397 117354 99329 582469 73998 511098 328890 1082682 18269 CONSULTANT AND CONTRACT 624972 HONORARIUM STIPENDS AND 409429 GROUP RETRO 209999 119722 5325407 1479432 864841 1103830 1139495 574066 144763 591605 87843 5752716 2419662 3252752 3333054 1816639 2066829 3659408 3424408 32319 35642 12510051 11096875 378344 472607 2031858 674849 140374 173140 2550576 1320596 X 9959475 9776279 9959475 9776279 12510051 11096875 -460508 277312 0 X 1 X 0 1 0 WASHINGTON STATE DENTAL POLITICAL ACTION COMMITTEE 126 NW CANAL STREET SUITE 300 SEATTLE WA 98107 910980907 245858 0 0 0 1325501 217606 217606 217606 445400 445400 2842509 971191 1871318 1324580 322792 1001788 1140227 1125679 14548 3333054 WDIA INVESTMENT 5000 C INVESTMENT IN SUBSIDIARIES 3419408 C 3424408 FEDERAL INCOME TAXES SEVERANCE BENEFIT 71518 DEFERRED COMPENSATION PAYABLE 35642 DEPOSITS 20980 INCOME TAX PAYABLE 45000 173140 X 1 1 X X X X X 0 0 0 BRACKEN KILLPACK EXECUTIVE DIRECTOR 172329 86294 0 0 0 0 0 0 0 0 172329 86294 0 0 PART I, LINE 1A INFREQUENTLY, REQUIRED TRAVEL FOR AN OFFICER OR DIRECTOR MAY BE TO AN EVENT THAT INCLUDES SPOUSE ACTIVITIES. IN THIS CASE, A SPOUSE MAY ACCOMPANY THE OFFICER OR DIRECTOR AND HAVE THEIR TRAVEL-RELATED EXPENSES REIMBURSED BY THE ASSOCIATION. FORM 990, PART VI, SECTION A, LINE 6 THE WASHINGTON STATE DENTAL ASSOCIATION IS A DENTAL MEMBERSHIP ORGANIZATION WITH OVER 4,100 MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE WASHINGTON STATE DENTAL ASSOCIATION IS A DENTAL MEMBERSHIP ORGANIZATION WITH MEMBERS THAT ELECT DELEGATES FROM THE MEMBERSHIP POOL. THESE DELEGATES ARE THE GOVERNING BODY THAT IN TURN ELECT THE ASSOCIATION'S BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE ANNUAL OPERATING BUDGET, GOVERNANCE RESOLUTIONS, AND CHANGES TO THE BYLAWS OF THE ORGANIZATION MUST BE APPROVED BY THE ELECTED DELEGATES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS SHARED WITH THE WSDA BOARD OF DIRECTORS PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C EVERY YEAR THE BOARD MEMBERS MUST DISCLOSE CONFLICTS AND THEY ARE ASKED TO DISCLOSE CONFLICTS THROUGHOUT THE GOVERNING YEAR SHOULD A CONFLICT ARISE. FORM 990, PART VI, SECTION B, LINE 15A THERE IS AN EXECUTIVE DIRECTOR COMPENSATION COMMITTEE THAT IS COMPRISED OF THE BOARD SECRETARY-TREASURER, THE IMMEDIATE PAST PRESIDENT, AND FOUR AT-LARGE MEMBERS OF THE BOARD OF DIRECTORS. THIS COMMITTEE OF INDEPENDENT MEMBERS WILL MAKE COMPENSATION RECOMMENDATIONS FOR THE EXECUTIVE DIRECTOR TO THE BOARD OF DIRECTORS FOR ITS CONSIDERATION. FORM 990, PART VI, SECTION C, LINE 19 THIS INFORMATION MAY BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G TEMP STAFFING 94,056. HUMAN RESOURCES 19,458. PHOTOGRAPHER 15,038. AUDIO/VISUAL 279,482. OTHER PROFESSIONAL FEES 174,435. 126 CANAL CENTRE LLC 126 NW CANAL STREET STE 300 SEATTLE WA 98107 271641420 REAL ESTATE WA 375732 3584089 WASHINGTON STATE DENTAL ASSOCIATION WASHINGTON STATE DENTAL POLITICAL ACTION COMMITTEE 126 NW CANAL STREET STE 300 SEATTLE WA 98107 910980907 POLITICAL CAMPAIGN FUNDING WA 527 WASHINGTON STATE DENTAL ASSOCIATION 0 WASHINGTON DENTISTS' INSURANCE AGENCY 126 NW CANAL STREET STE 300 SEATTLE WA 98107 911499261 INSURANCE SALES WA WASHINGTON STATE DENTAL ASSOCIATION C 2257089 976835 1.00000 1 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 1 1 0 WASHINGTON DENTISTS' INSURANCE AGENCY F 235000 FAIR MARKET VALUE WASHINGTON STATE DENTAL POLITICAL ACTION COMMITTEE R 245858 BOOK