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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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          </BusinessName>
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          <USAddress>
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        </ContractorAddress>
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      <ContractorCompensationGrp>
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        </ContractorAddress>
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      <FootnoteTextInd>X</FootnoteTextInd>
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        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization is a tax-exempt Organization under IRS Code Section 501(c)(3) and consequently records no provision for income taxes. The Organization files information returns in the U.S. federal jurisdiction and the State of California. With few exceptions, the Organization is no longer subject to U.S. federal, state and local examinations by tax authorities for years prior to 2016. The Organization has analyzed its filing positions with the Internal Revenue Service and the State of California. The Organization does not anticipate any of its filing positions would result in a material adverse effect on the Organization's financial condition, results of operations or cash flow as the Organization believes its filing positions would be sustained on audit. No liability has been recorded for uncertain tax positions. The Organization recognizes interest accrued related to unrecognized tax benefits, if any, in interest expense and penalties in operating expenses. During the year ended December 31, 2019,the Organization did not recognize any interest or penalties.</ExplanationTxt>
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        <TypeOfActivitiesConductedTxt>World Meeting and Live Surgical Course</TypeOfActivitiesConductedTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Accounting Method:</FormAndLineReferenceDesc>
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    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Management and operational duties are delegated to Status Plus, a Netherlands based management company.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>ISSM has the following types of members: full members, associate members and honorary members.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>A nominating committee shall be formed for each election. The nominating committee shall be chaired by the immediate past-president of the Society. The nominating committee shall consist of all past-presidents plus one member from each Regional Society. Each Regional Society shall determine whether its representative to the nominating committee shall be elected by members of the Regional Society or shall by appointed by its Board of Directors. The term of office of each Regional Society representation shall be two years. The nominating committee shall nominate one candidate for each open position. In addition to the candidates nominated by the nominating cmmittee, any member of the Society who is not delinquent of dues or ineligible by law to serve as a company director in the State of California may be nominated for election by presenting to the Secretary General a petition for nomination signed by any 20 full members of the Society. There will not be nominations from the floor during the biennial meetings of members. In an election at the biennial meeting of the members, the candidate for each office receiving the most votes shall be elected.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>Any action that may be taken at any regular or special meeting of members may be taken without a meeting. If an action is taken without a meeting, the Society must distribute a written ballot to every member entitled to vote on the matter. The ballot must state the proposed action, provide an opportunity to specify approval or disapproval of any proposal, and provide a reasonable time within which to return the ballot to the Society. Such ballot may be taken by electronic transmission but only for a matter referred by the Board of Directors. Approval by written ballot is valid only when the number of votes cast by ballot within the time period specified equals or exceeds the quorum required to be present at a meeting authorizing the action, and the number of approvals equals or exceeds the number of votes that would be required to approve at a meeting at which the total number of votes cast was the same as the number of votes cast by ballot.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is reviewed by the Executive Committee for erros and omissions before it is filed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>All officers, directors and key staff are required to sign a statement annually disclosing any possible conflicts of interest. The Organization monitors compliance to the best of its ability.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>ISSM is under a Board reviewed/approved management agreement.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is available on GuideStar website, www.guidestar.org. Registration on the site is required in order to view the return, but there is no charge. Other documents are available upon request.</ExplanationTxt>
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      <SupplementalInformationDetail>
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</Return>