U.S Department of Labor
Office of Labor-Management Standards
Washington, DC 20210
LM-10
EMPLOYER REPORT
This report is mandatory under P.L. 86-257, as amended. Failure to comply may result in criminal prosecution, fines, or civil penalties as provided by 29 U.S.C. 439 or 440.
Form Approved
Office of Management and Budget
OMB No. 1245-0003 .
Expires 09-30-2021 .
 For Official Use Only


 E
READ THE INSTRUCTIONS CAREFULLY BEFORE COMPLETING THIS REPORT.
PART A
 1. File Number: E-69369
 2. Fiscal Year CoveredFrom:01/01/2020Through:12/31/2020
                                                    Month/Day/Year               Month/Day/Year
3. Name and address of Reporting Employer (inc. trade name, if any).
Employer:MH Mission Hospital, LLP
Trade Name:Mission Hospital
Attention To:Laurie  L  Haynes
Title:Chief Financial Officer
Mailing Address
P.O. Box., Bldg., Room No., if any:
Street:509 Biltmore Avenue
City:AshevilleState:NC
ZIP Code + 4:28801
4. Name and address of President or corresponding principal officer, if different from address in Item 3.
Name:Chad Patrick
P.O. Box., Bldg., Room No., if any:
Street:509 Biltmore Avenue
City:AshevilleState:NC
ZIP Code + 4:28801
5.
Any other address where records necessary to verify this report will be available for examination.
Name:
Title:
Organization:
P.O. Box., Bldg., Room No., if any:
Street:
City:State:
ZIP Code + 4:
6.
Indicate by checking the appropriate box or boxes where records necessary to verify this report will be available for examination.

X Address in Item 3
 Address in Item 4
 Address in Item 5
  7. Type of organization.
   Corporation       Partnership       Individual       X Other (specify)Limited Liability Limited Partnership
Signatures
Each of the undersigned, duly authorized officers of the above employer declares, under penalty of perjury and other applicable penalties of law, that all of the information submitted in this report (including the information contained in any accompanying documents) has been examined by the signatory and is, to the best of the undersigned's knowledge and belief, true, correct, and complete. (See Section VIII on penalties in the instructions.)
13.
SIGNED: James C Patrick
Title: PRESIDENT
On Date: Mar 30, 2021
Telephone Number: 904-772-5800
14.
SIGNED: Laurie L Haynes
Title: CHIEF FINANCIAL OFFICER
On Date: Mar 30, 2021
Telephone Number: 828-213-0184
Form LM-10 (2003)
8.
Type of Reportable Activity Engaged In By Employer

Read the following questions and the accompanying instructions carefully, taking into consideration the exclusions listed in the instructions for these items, and check either ''Yes" or ''No'' for each item. For each item that is answered ''Yes'', you must attach a Part B which appears on Page 3. Complete a separate Part B for each ''Yes'' answer to any of Items 8.a. through 8.f. Also, if the answer is ''Yes'' for more than one person or organization, complete a separate Part B for each person or organization. If you answer ''Yes'', enter the number of Part Bs that are submitted for that item in the line indicated.
DURING THE FISCAL YEAR COVERED BY THIS REPORT:
    If "Yes",     number of     Part Bs     attached

8.a
Did you make or promise or agree to make, directly or indirectly, any payment or loan of money or other thing of value (including reimbursed expenses) to any labor organization or to any officer, agent, shop steward, or other representative or employee of any labor organization?
 YES   NOX
0

8.b
Did you make, directly or indirectly, any payment (including reimbursed expenses) to any of your employees, or to any group or committee of your employees, for the purpose of causing them to persuade other employees to exercise or not to exercise, or as to the manner of exercising, the right to organize and bargain collectively through representatives of their own choosing without previously or at the same time disclosing such payment to all such other employees?
  YES   NOX
0

8.c
Did you make any expenditure where an object thereof, directly or indirectly, was to interfere with, restrain, or coerce employees in the right to organize and bargain collectively through representatives of their own choosing?
  YES  NOX
0

8.d
Did you make any expenditure where an object thereof, directly or indirectly, was to obtain information concerning the activities of employees or of a labor organization in connection with a labor dispute in which you were involved?
  YES  NOX
0

8.e
Did you make any agreement or arrangement with a labor relations consultant or other independent contractor or organization pursuant to which such person undertook activities where an object thereof, directly or indirectly, was to persuade employees to exercise or not to exercise, or as to the manner of exercising, the right to organize and bargain collectively through representatives of their own choosing; or did you make any payment (including reimbursed expenses) pursuant to such an agreement or arrangement?
 YESX  NO
12

8.f
Did you make any agreement or arrangement with a labor relations consultant or other independent contractor or organization pursuant to which such person undertook activities where an object thereof, directly or indirectly, was to furnish you with information concerning activities of employees or of a labor organization in connection with a labor dispute in which you were involved; or did you make any payment pursuant to such agreement or arrangement?
  YES  NOX
0


TOTAL NUMBER OF PART Bs FOR THIS REPORT IS:12

Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a.X Agreement       Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).Independent Labor Consultant
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:Andria Danine Simckes
P.O. Box., Bldg., Room No., if any:
Street:1011 Sonata Lane
City:Apollo BeachState:FL
ZIP Code + 4:33572
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: ADS Consulting, LLC
P.O. Box., Bldg., Room No., if any:
Street:1011 Sonata Lane
City:Apollo BeachState:FL
ZIP Code + 4:33572
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
04/28/2020
10.b.
    The promise, agreement, or arrangement was:

Oral       X Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
05/21/2020
  $2,400
  Check
05/30/2020
  $7,200
  Check
06/11/2020
  $12,600
  Check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made to ADS Consulting, LLC under the terms of a written agreement, a copy of which has been filed contemporaneously herewith.
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a.X Agreement       Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).President
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:Carina Hunt
P.O. Box., Bldg., Room No., if any:
Street:606 Champions Court
City:RoanokeState:TX
ZIP Code + 4:76262
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: C. Hunt Management Consulting, Inc.
P.O. Box., Bldg., Room No., if any:
Street:606 Champions Court
City:RoanokeState:TX
ZIP Code + 4:76262
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
03/09/2020
10.b.
    The promise, agreement, or arrangement was:

Oral       X Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
03/26/2020
  $8,660
  Check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made to C. Hunt Consulting, Inc. under the terms of a written agreement, a copy of which has been filed contemporaneously herewith.
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a.X Agreement       Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).Partner
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:Michael D Penn
P.O. Box., Bldg., Room No., if any:Suite 505
Street:63 Via Pico Plaza
City:San ClementeState:CA
ZIP Code + 4:92672
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: The Crossroads Group Labor Relations Consultants
P.O. Box., Bldg., Room No., if any:Suite 505
Street:63 Via Pico Plaza
City:San ClementeState:CA
ZIP Code + 4:92672
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
03/08/2020
10.b.
    The promise, agreement, or arrangement was:

Oral       X Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
03/26/2020
  $34,972
  Check
05/14/2020
  $45,566
  Check
04/01/2020
  $25,832
  Check
04/21/2020
  $22,653
  Check
04/18/2020
  $18,713
  Check
04/22/2020
  $17,909
  Check
04/30/2020
  $31,249
  Check
05/09/2020
  $17,296
  Check
05/14/2020
  $45,566
  Check
05/21/2020
  $21,690
  Check
05/28/2020
  $22,453
  Check
06/03/2020
  $22,083
  Check
06/11/2020
  $19,317
  Check
06/18/2020
  $22,475
  Check
06/24/2020
  $22,004
  Check
07/22/2020
  $23,562
  Check
07/08/2020
  $20,875
  Check
07/15/2020
  $20,844
  Check
07/28/2020
  $22,155
  Check
07/30/2020
  $24,575
  Check
08/05/2020
  $19,158
  Check
08/15/2020
  $28,450
  Check
09/08/2020
  $35,195
  Check
08/25/2020
  $27,677
  Check
09/01/2020
  $29,203
  Check
09/14/2020
  $22,087
  Check
01/05/2021
  $3,652
  Check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made to The Crossroads Group under the terms of a written agreement, a copy of which has been filed contemporaneously herewith.
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a.X Agreement       Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).President
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:JASON GREER
P.O. Box., Bldg., Room No., if any:
Street:4301 HAWKINS RIDGE DRIVE
City:ST LOUISState:MO
ZIP Code + 4:63129
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: GREER CONSULTING INC.
P.O. Box., Bldg., Room No., if any:
Street:4301 HAWKINS RIDGE DRIVE
City:ST LOUISState:MO
ZIP Code + 4:63129
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
03/13/2020
10.b.
    The promise, agreement, or arrangement was:

Oral       X Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
04/14/2020
  $107,245
  check
04/07/2020
  $12,111
  check
04/18/2020
  $15,923
  check
04/29/2020
  $12,939
  check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made to Greer Consulting, Inc. under the terms of a written agreement, a copy of which has been filed contemporaneously herewith.
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a.X Agreement       Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).Independent Labor Consultant
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:Kirsten Johnson Moore
P.O. Box., Bldg., Room No., if any:
Street:139 Drexel Road
City:ArdmoreState:PA
ZIP Code + 4:19003
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: Kirsten Johnson Moore, DNP, RN
P.O. Box., Bldg., Room No., if any:
Street:139 Drexel Road
City:ArdmoreState:PA
ZIP Code + 4:19003
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
04/14/2020
10.b.
    The promise, agreement, or arrangement was:

Oral       X Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
05/21/2020
  $4,400
  check
07/02/2020
  $13,800
  check
09/03/2020
  $49,325
  check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made to Kirsten Johnson Moore under the terms of a written agreement, a copy of which has been filed contemporaneously herewith.
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a.X Agreement       Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).Independent Labor Consultant
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:James Misercola
P.O. Box., Bldg., Room No., if any:
Street:325 Walnut Street #1
City:BridewaterState:MA
ZIP Code + 4:02324
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: Labor Educators, LLC
P.O. Box., Bldg., Room No., if any:
Street:325 Walnut Street #1
City:BridewaterState:MA
ZIP Code + 4:02324
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
04/27/2020
10.b.
    The promise, agreement, or arrangement was:

Oral       X Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
07/02/2020
  $14,400
  check
10/06/2020
  $47,825
  check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made to Labor Educators, LLC under the terms of a written agreement, a copy of which has been filed contemporaneously herewith.
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a. Agreement       X Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).Independent Labor Consultant
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:Katie Lev
P.O. Box., Bldg., Room No., if any:
Street:21 Pleasant Street
City:HudsonState:MA
ZIP Code + 4:01749
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: Lev Labor, LLC
P.O. Box., Bldg., Room No., if any:
Street:21 Pleasant Street
City:HudsonState:MA
ZIP Code + 4:01749
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
08/04/2020
10.b.
    The promise, agreement, or arrangement was:

X Oral       Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
08/20/2020
  $8,800
  check
08/25/2020
  $7,003
  check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made under an oral agreement to provide employees with information concerning their rights under the National Labor Relations Act.
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a.X Agreement       Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).President
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:BENJAMIN JOHNSON
P.O. Box., Bldg., Room No., if any:
Street:55 BIGGS STREET
City:BARREState:VT
ZIP Code + 4:05641
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: PROGRESSIVE LABOR SOLUTIONS
P.O. Box., Bldg., Room No., if any:
Street:55 BIGGS STREET
City:BARREState:VT
ZIP Code + 4:05641
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
04/27/2020
10.b.
    The promise, agreement, or arrangement was:

Oral       X Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
08/17/2020
  $20,400
  check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made to Progressive Labor Solutions, LLC under the terms of a written agreement, a copy of which has been filed contemporaneously herewith.
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a.X Agreement       Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).Independent Labor Consultant
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:Evelyn D Fragoso
P.O. Box., Bldg., Room No., if any:
Street:4859 W SLAUSON AVENUE SUITE 191
City:LOS ANGELESState:CA
ZIP Code + 4:90056
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: Quality Labor Solutions
P.O. Box., Bldg., Room No., if any:
Street:4859 W SLAUSON AVENUE SUITE 191
City:LOS ANGELESState:CA
ZIP Code + 4:90056
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
05/09/2020
10.b.
    The promise, agreement, or arrangement was:

Oral       X Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
06/06/2020
  $14,400
  check
07/06/2020
  $1,600
  check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made to Quality Labor Solutions, LLC under the terms of a written agreement, a copy of which has been filed contemporaneously herewith.
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a.X Agreement       Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).Independent Labor Consultants
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:BYRON J CLAY
P.O. Box., Bldg., Room No., if any:
Street:1011 Sonata Lane
City:Apollo BeachState:FL
ZIP Code + 4:33572
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: RELIANT LABOR CONSULTANTS
P.O. Box., Bldg., Room No., if any:
Street:1011 Sonata Lane
City:Apollo BeachState:FL
ZIP Code + 4:33572
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
04/01/2020
10.b.
    The promise, agreement, or arrangement was:

Oral       X Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
05/30/2020
  $31,800
  check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made to Reliant Labor Consultants under the terms of a written agreement, a copy of which has been filed contemporaneously herewith.
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a.X Agreement       Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).President
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:Rita Tripp
P.O. Box., Bldg., Room No., if any:
Street:10320 Howe Lane
City:LeewoodState:KS
ZIP Code + 4:66206
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: Healthcare Management Group
P.O. Box., Bldg., Room No., if any:
Street:10320 Howe Lane
City:LeewoodState:KS
ZIP Code + 4:66206
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
03/09/2020
10.b.
    The promise, agreement, or arrangement was:

Oral       X Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
03/26/2020
  $31,427
  check
05/21/2020
  $16,100
  check
05/30/2020
  $7,000
  check
06/06/2020
  $800
  check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made to Healthcare Management Group under the terms of a written agreement, a copy of which has been filed contemporaneously herewith.
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e. X
ITEM 8.f.

 9.a.X Agreement       Payment       Both
 9.c. Position In labor organization or with employer (if an independent labor consultant, so state).CEO
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:Russell Brown
P.O. Box., Bldg., Room No., if any:P.O. Box 372636
Street:
City:Satellite BeachState:FL
ZIP Code + 4:39237 - 2636
9.d. Name and address of firm or labor organization with whom employed or affiliated.
Organization: Road Warrior Production LLC
P.O. Box., Bldg., Room No., if any:P.O. Box 372636
Street:
City:Satellite BeachState:FL
ZIP Code + 4:39237 - 2636
10.a.
    Date of the promise, agreement, or arrangement pursuant to which payments or expenditures were agreed to or made.
03/09/2020
10.b.
    The promise, agreement, or arrangement was:

Oral       X Written*       Both

(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy). 11.b. Amount of each payment or expenditure 11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
03/26/2020
  $38,658
  check
03/30/2020
  $26,647
  check
04/07/2020
  $19,152
  check
04/18/2020
  $33,705
  check
04/22/2020
  $16,152
  check
05/02/2020
  $21,854
  check
05/09/2020
  $16,152
  check
05/14/2020
  $20,104
  check
05/21/2020
  $19,482
  check
05/28/2020
  $19,178
  check
06/03/2020
  $22,152
  check
06/11/2020
  $20,274
  check
06/16/2020
  $16,152
  check
07/01/2020
  $36,620
  check
07/15/2020
  $16,293
  check
07/28/2020
  $36,023
  check
08/05/2020
  $19,332
  check
08/15/2020
  $23,753
  check
08/20/2020
  $22,909
  check
08/27/2020
  $22,189
  check
09/01/2020
  $22,089
  check
09/14/2020
  $18,365
  check
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Payment was made to Road Warrior Production LLC under the terms of a written agreement, a copy of which has been filed contemporaneously herewith.
Form LM-10 (2003)