FORM
LM-20 - AGREEMENT
& ACTIVITIES REPORT
OMB No. 1245-0003 . Expires 01-31-2028 .
IMPORTANT: 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. Required of persons, including Labor Relations Consultants and Other Individuals and Organizations, under Section 203(b) of the Labor-Management Reporting and Disclosure Act of 1959, as amended (LMRDA).
Office of Labor-Management Standards
U.S. Department of Labor
For Official Use Only
E
OLMS
Read the instructions carefully before completing this report.
1.a. File Number: C-68694
Amended:
2.
Name and mailing address (including Zip Code):
Name:Rian Wathen
Title:President
Organization:Independent Center for Worker Education
EIN:27-5400106
P.O. Box., Bldg., Room No., if any:RM #201
Street:8206 Rockville Road
City:IndianapolisState:IN
ZIP code:46214
3.
Other address where records necessary to verify this report are kept:
Name:
Title:
Organization:
P.O. Box., Bldg., Room No., if any:
Street:
City:State:
ZIP code:
4.
Date fiscal year ends:Dec /25
5.
Type of person
a. X Individual       b. Partnership
c. Corporation C d. Other
Specify:
  Nature of Agreement or Arrangement
6.
Full name and address of employer with whom made (include ZIP Code):
Name:Sarah Brown
Organization:UnityPoint Health
EIN:42-0680452
Trade Name, if any:
P.O. Box., Bldg., Room No., if any:
Street:1776 West Lake Pkwy
City:Des MoinesState:IA
ZIP code:50266
7.
Date entered into12/21/2024

8.
Name of person(s) through whom made:
(a) Employer Representative (to be completed by the Primary Consultant):
Name and Title:
OR
(b) Primary Consultant (to be completed by the Sub-consultant):
Name and Title:Rian Wathen, President
Organization:ICwE
EIN:27-5400106
Signature and Verification
Each of the undersigned 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: Rian Wathen
Title: PRESIDENT
Date: Jan 30, 2025
Telephone Number: 317-850-0990
14.
SIGNED:
Title: TREASURER
Date:
Telephone Number:
Form LM-20 (2025)
9.
Check the appropriate box(es) to indicate whether an object of the activities undertaken is directly or indirectly:
a.
X
To persuade employees to exercise or not to exercise, or persuade employees as to the manner of exercising, the right to organize and bargain collectively through representatives of their own choosing.
b.
To supply an employer with information concerning the activities of employees or a labor organization in connection with a labor dispute involving such employer, except information for use solely in conjunction with an administrative or arbitral proceeding or a criminal or civil judicial proceeding.
10.
Terms and conditions. (Explain in detail; see instructions. Written agreements must be attached.):
XWritten Agreement/Arrangement
per attached agreement
Specific Activities to be performed
Activity1
11. For each activity, separately list in detail the information required. (See instructions.)
a. Nature of activity:Giving speeches, preparing written materials for distribution, and holding /conducting meetings with management and employees to answer questions on rights afforded by the National Labor Relations Act (NLRA).
11.b.Period during which activities performed:
12/21/25-ongoing
11.c. Extent of performance:
ongoing
11.d.
Name and address of person(s) through whom activities were performed or will be performed:
  Name:Rian Wathen         Organization:         Title:PresidentEIN:
  P.O. Box, Bldg., Room No., If any:Street:City:State:Zip:
12.a. Identify subject groups of employees:
Registered Nurses
12.b. Identify subject labor organizations:
Teamsters Local 90
Form LM-20 (2025)