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-69218
Amended:
2.
Name and mailing address (including Zip Code):
Name:Amed D Santana
Title:President & CEO
Organization:Santana International, Inc
EIN:27-2005389
P.O. Box., Bldg., Room No., if any:
Street:7049 Westwind Dr Suite 6001
City:El PasoState:TX
ZIP code:79912
3.
Other address where records necessary to
verify this report are kept:
Name:Phillip Wilson
Title:President
Organization:LRI CONSULTING SERVICES, INC.
P.O. Box., Bldg., Room No., if any:PO Box 1529
Street:
City:Broken ArrowState:OK
ZIP code:74011
4.
Date fiscal year ends:Dec /31
5.
Type of person
a.
Individual b.
Partnership
c.
X
Corporation C d.
Other
Specify:
Nature of Agreement or Arrangement
6.
Full name and address of employer with whom made (include ZIP Code):
Name:Michael Holser
Organization:Dominos Pizza, Inc
EIN:
Trade Name, if any:
P.O. Box., Bldg., Room No., if any:30
Street:Frank Lloyd Wright Drive
City:Ann ArborState:MI
ZIP code:48105
7.
Date entered into07/15/2025
8.
Name of person(s) through whom made:
(a) Employer Representative (to be completed by the Primary Consultant):
Name and Title:Michael Holser
OR
(b) Primary Consultant (to be completed by the Sub-consultant):
Name and Title:
Organization:
EIN:
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:
Amed D Santana
Title:
PRESIDENT
Date:
Jul 30, 2025
Telephone Number:
915-215-3725
14.
SIGNED:
Amed D Santana
Title:
TREASURER
Date:
Jul 30, 2025
Telephone Number:
915-215-3725
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.):
Written Agreement/Arrangement
Verbal agreement to represent Dominos Pizza, Inc at their facility in Denver, CO to educate their painters regarding exercising their rights to organize and bargain collectively.
This agreement is for no specific time and may be terminated by either party at any time. Hourly rate of $212.50 per hour, plus reasonable travel expenses.
Specific Activities to be performed
Activity1
11. For each activity, separately list in detail the information required.
(See instructions.)
a. Nature of activity:Prepared for and held voluntary employee meetings to educate employees regarding their rights under the NLRA. Answered questions regarding the same.
11.b.Period during which activities
performed:
various days beginning July 15, 2025
11.c. Extent of performance:
ongoing
11.d.
Name and address of person(s) through
whom
activities were performed or will be performed: