544-573 (LM2) 12/31/2013

U.S. Department of Labor
Office of Labor-Management Standards
Washington, DC 20210

FORM LM-2 LABOR ORGANIZATION ANNUAL REPORT

Form Approved
Office of Management and Budget
No. 1245-0003
Expires: 08-31-2016

MUST BE USED BY LABOR ORGANIZATIONS WITH $250,000 OR MORE IN TOTAL ANNUAL RECEIPTS AND LABOR ORGANIZATIONS IN TRUSTEESHIP

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.

READ THE INSTRUCTIONS CAREFULLY BEFORE PREPARING THIS REPORT.

For Official Use Only

1. FILE NUMBER
544-573

2. PERIOD COVERED
From	01/01/2013
Through	12/31/2013

3.	(a) AMENDED - Is this an amended report:	No
	(b) HARDSHIP - Filed under the hardship procedures:	No
	(c) TERMINAL - This is a terminal report:	No

4. AFFILIATION OR ORGANIZATION NAME STATE COUNTY & MUNI EMPLS AFL-CIO
5. DESIGNATION (Local, Lodge, etc.) LOCAL UNION	6. DESIGNATION NBR 4911
7. UNIT NAME (if any) UNITED EMS WORKERS

8. MAILING ADDRESS (Type or print in capital letters)
First Name JIMMY P	Last Name GAMBONE
P.O Box - Building and Room Number 203
Number and Street
City OAKLEY
State CA	ZIP Code + 4 94561

9. Are your organization's records kept at its mailing address?

Each of the undersigned, duly authorized officers of the above labor organization, declares, under penalty of perjury and other applicable penalties of law, that all of the information submitted in this report (including information contained in any accompanying documents) has been examined by the signatory and is, to the best of the undersigned individual's knowledge and belief, true, correct and complete (See Section V on penalties in the instructions.)

70. SIGNED:

Jimmy P Gambone

PRESIDENT

71. SIGNED:

John Hosmon

TREASURER

Date:

Apr 02, 2014

Telephone Number:

925-808-1338

Date:

Apr 02, 2014

Telephone Number:

408-375-1104

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

ITEMS 10 THROUGH 21

FILE NUMBER: 544-573

10. During the reporting period did the labor organization create or participate in the administration of a trust or a fund or organization, as defined in the instructions, which provides benefits for members or beneficiaries?	No
11(a). During the reporting period did the labor organization have a political action committee (PAC) fund?	No
11(b). During the reporting period did the labor organization have a subsidiary organization as defined in Section X of these Instructions?	No
12. During the reporting period did the labor organization have an audit or review of its books and records by an outside accountant or by a parent body auditor/representative?	No
13. During the reporting period did the labor organization discover any loss or shortage of funds or other assets? (Answer "Yes" even if there has been repayment or recovery.)	No
14. What is the maximum amount recoverable under the labor organization's fidelity bond for a loss caused by any officer, employee or agent of the labor organization who handled union funds?	$100,000
15. During the reporting period did the labor organization acquire or dispose of any assets in a manner other than purchase or sale?	No
16. Were any of the labor organization's assets pledged as security or encumbered in any way at the end of the reporting period?	No
17. Did the labor organization have any contingent liabilities at the end of the reporting period?	No
18. During the reporting period did the labor organization have any changes in its constitution or bylaws, other than rates of dues and fees, or in practices/procedures listed in the instructions?	No
19. What is the date of the labor organization's next regular election of officers?

20. How many members did the labor organization have at the end of the reporting period?

3,000

21. What are the labor organization's rates of dues and fees?

Rates of Dues and Fees
Dues/Fees	Amount		Unit	Minimum	Maximum
(a) Regular Dues/Fees	18.81	per	Pay Period	16.15	21.47
(b) Working Dues/Fees		per
(c) Initiation Fees		per
(d) Transfer Fees		per
(e) Work Permits		per

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

STATEMENT A - ASSETS AND LIABILITIES

FILE NUMBER: 544-573

ASSETS

ASSETS	Schedule Number	Start of Reporting Period (A)	End of Reporting Period (B)
22. Cash		$0	$132,484
23. Accounts Receivable	1	$0	$0
24. Loans Receivable	2	$0
25. U.S. Treasury Securities		$0	$0
26. Investments	5	$0
27. Fixed Assets	6	$0	$2,097
28. Other Assets	7	$0
29. TOTAL ASSETS		$0	$134,581

LIABILITIES

LIABILITIES	Schedule Number	Start of Reporting Period (A)	End of Reporting Period (B)
30. Accounts Payable	8	$0
31. Loans Payable	9	$0
32. Mortgages Payable		$0	$0
33. Other Liabilities	10	$0
34. TOTAL LIABILITIES		$0	$0

35. NET ASSETS

$134,581

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

STATEMENT B - RECEIPTS AND DISBURSEMENTS

FILE NUMBER: 544-573

CASH RECEIPTS	SCH	AMOUNT
36. Dues and Agency Fees		$474,900
37. Per Capita Tax		$0
38. Fees, Fines, Assessments, Work Permits		$0
39. Sale of Supplies		$0
40. Interest		$59
41. Dividends		$0
42. Rents		$0
43. Sale of Investments and Fixed Assets	3
44. Loans Obtained	9
45. Repayments of Loans Made	2
46. On Behalf of Affiliates for Transmittal to Them		$0
47. From Members for Disbursement on Their Behalf		$0
48. Other Receipts	14	$0
49. TOTAL RECEIPTS		$474,959

CASH DISBURSEMENTS		SCH	AMOUNT
50. Representational Activities		15	$163,801
51. Political Activities and Lobbying		16	$20,857
52. Contributions, Gifts, and Grants		17	$1,010
53. General Overhead		18	$16,271
54. Union Administration		19	$19,454
55. Benefits		20	$487
56. Per Capita Tax			$106,000
57. Strike Benefits			$0
58. Fees, Fines, Assessments, etc.			$0
59. Supplies for Resale			$0
60. Purchase of Investments and Fixed Assets		4	$2,097
61. Loans Made		2
62. Repayment of Loans Obtained		9
63. To Affiliates of Funds Collected on Their Behalf			$0
64. On Behalf of Individual Members			$0
65. Direct Taxes			$12,313

66. Subtotal			$342,290
67. Withholding Taxes and Payroll Deductions
67a. Total Withheld	$0
67b. Less Total Disbursed	$0
67c. Total Withheld But Not Disbursed
68. TOTAL DISBURSEMENTS			$342,290

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE

FILE NUMBER: 544-573

Entity or Individual Name (A)	Total Account Receivable (B)	90-180 Days Past Due (C)	180+ Days Past Due (D)	Liquidated Account Receivable (E)
Total of all itemized accounts receivable	$0	$0	$0	$0
Totals from all other accounts receivable
Totals (Total of Column (B) will be automatically entered in Item 23, Column(B))	$0	$0	$0	$0

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 2 - LOANS RECEIVABLE

FILE NUMBER: 544-573

List below loans to officers, employees, or members which at any time during the reporting period exceeded $250 and list all loans to business enterprises regardless of amount.
(A)

Loans
Outstanding at
Start of Period
(B)

Loans Made
During Period
(C)

Repayments Received During Period
Cash (D)(1)	Other Than Cash (D)(2)

Loans
Outstanding at
End of Period
(E)

Total of loans not listed above

Total of all lines above

Totals will be automatically entered in...

Item 24
Column (A)

Item 61

Item 45

Item 69
with Explanation

Item 24
Column (B)

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 3 - SALE OF INVESTMENTS AND FIXED ASSETS

FILE NUMBER: 544-573

Description (if land or buildings, give location) (A)	Cost (B)	Book Value (C)	Gross Sales Price (D)	Amount Received (E)
Total of all lines above	$0	$0	$0	$0

				Less Reinvestments
(The total from Net Sales Line will be automatically entered in Item 43)				Net Sales

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 4 - PURCHASE OF INVESTMENTS AND FIXED ASSETS

FILE NUMBER: 544-573

Description (if land or buildings, give location) (A)	Cost (B)	Book Value (C)	Cash Paid (D)
Total of all lines above	$2,097	$2,097	$2,097
Laptop for Treasurer	$926	$926	$926
External Hard Drive	$87	$87	$87
Laptop for Secretary	$1,084	$1,084	$1,084

		Less Reinvestments	$0
(The total from Net Purchases Line will be automatically entered in Item 60.)		Net Purchases	$2,097

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 5 - INVESTMENTS

FILE NUMBER: 544-573

Description (A)	Amount (B)
Marketable Securities
A. Total Cost
B. Total Book Value
C. List each marketable security which has a book value over $5,000 and exceeds 5% of Line B.

Other Investments
D. Total Cost
E. Total Book Value
F. List each other investment which has a book value over $5,000 and exceeds 5% of Line E. Also, list each subsidiary for which separate reports are attached.

G. Total of Lines B and E (Total will be automatically entered in Item 26, Column(B))

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 6 - FIXED ASSETS

FILE NUMBER: 544-573

Description (A)	Cost or Other Basis (B)	Total Depreciation or Amount Expensed (C)	Book Value (D)	Value (E)
A. Land (give location)	$0		$0	$0

B. Buildings (give location)

C. Automobiles and Other Vehicles

D. Office Furniture and Equipment

$2,097

E. Other Fixed Assets

F. Totals of Lines A through E (Column(D) Total will be automatically entered in Item 27, Column(B))

$2,097

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 7 - OTHER ASSETS

FILE NUMBER: 544-573

Description (A)	Book Value (B)
Total (Total will be automatically entered in Item 28, Column(B))	$0

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 8 - ACCOUNTS PAYABLE AGING SCHEDULE

FILE NUMBER: 544-573

Entity or Individual Name (A)	Total Account Payable (B)	90-180 Days Past Due (C)	180+ Days Past Due (D)	Liquidated Account Payable (E)
Total for all itemized accounts payable	$0	$0	$0	$0
Total from all other accounts payable	$0	$0	$0	$0
Totals (Total for Column(B) will be automatically entered in Item 30, Column(D))	$0	$0	$0	$0

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 9 - LOANS PAYABLE

FILE NUMBER: 544-573

Source of Loans Payable at Any Time During the Reporting Period (A)	Loans Owed at Start of Period (B)	Loans Obtained During Period (C)	Repayment During Period Cash (D)(1)	Repayment During Period Other Than Cash (D)(2)	Loans Owed at End of Period (E)
Total Loans Payable	$0	$0	$0	$0	$0
Totals will be automatically entered in...	Item 31 Column (C)	Item 44	Item 62	Item 69 with Explanation	Item 31 Column (D)

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 10 - OTHER LIABILITIES

FILE NUMBER: 544-573

Description (A)	Amount at End of Period (B)
Total Other Liabilities (Total will be automatically entered in Item 33, Column(D))	$0

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS

FILE NUMBER: 544-573

(A)
Name

(B)
Title

(D)
Gross Salary
Disbursements
(before any
deductions)

(E)
Allowances
Disbursed

(F)
Disbursements for Official Business

(G)
Other
Disbursements not reported in
(D) through (F)

(H)
TOTAL

A
B
C

Gambone , Jimmy
President
C

Schedule 15
Representational Activities

65 %

Schedule 16
Political Activities and Lobbying

10 %

Schedule 17
Contributions

Schedule 18
General Overhead

5 %

Schedule 19
Administration

20 %

A
B
C

Bower , Bill
Vice President
C

Schedule 15
Representational Activities

90 %

Schedule 16
Political Activities and Lobbying

Schedule 17
Contributions

Schedule 18
General Overhead

Schedule 19
Administration

10 %

A
B
C

Canez , Sandra
Secretary
C

Schedule 15
Representational Activities

80 %

Schedule 16
Political Activities and Lobbying

Schedule 17
Contributions

Schedule 18
General Overhead

10 %

Schedule 19
Administration

10 %

A
B
C

Hosmon , John H
Treasurer
N

Schedule 15
Representational Activities

Schedule 16
Political Activities and Lobbying

Schedule 17
Contributions

Schedule 18
General Overhead

50 %

Schedule 19
Administration

50 %

Total Officer Disbursements	$0	$0	$0	$0	$0
Less Deductions
Net Disbursements					$0

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES

FILE NUMBER: 544-573

(A)
Name

(B)
Title

(D)
Gross Salary
Disbursements
(before any
deductions)

(E)
Allowances Disbursed

(F)
Disbursements for Official Business

(G)
Other Disbursements not reported in
(D) through (F)

(H)
TOTAL

A
B
C

Brollini , Jason
Political Director
None

$12,461

$5,672

$18,133

Schedule 15
Representational Activities

Schedule 16
Political Activities and Lobbying

100 %

Schedule 17
Contributions

Schedule 18
General Overhead

Schedule 19
Administration

A
B
C

Canez , Sandra
Labor Representative
None

$23,813

$325

$7,301

$31,439

Schedule 15
Representational Activities

75 %

Schedule 16
Political Activities and Lobbying

Schedule 17
Contributions

Schedule 18
General Overhead

10 %

Schedule 19
Administration

15 %

A
B
C

Gambone , Jimmy
Aministrative Chief
None

$30,143

$325

$24,013

$54,481

Schedule 15
Representational Activities

65 %

Schedule 16
Political Activities and Lobbying

5 %

Schedule 17
Contributions

Schedule 18
General Overhead

10 %

Schedule 19
Administration

20 %

A
B
C

Misner , Jeff
Labor Representative
None

$33,854

$260

$22,681

$56,795

Schedule 15
Representational Activities

95 %

Schedule 16
Political Activities and Lobbying

Schedule 17
Contributions

Schedule 18
General Overhead

5 %

Schedule 19
Administration

A
B
C

Szmyt , Daniel
Labor Representative
None

$15,850

$195

$2,597

$18,642

Schedule 15
Representational Activities

95 %

Schedule 16
Political Activities and Lobbying

Schedule 17
Contributions

Schedule 18
General Overhead

5 %

Schedule 19
Administration

TOTALS RECEIVED BY EMPLOYEES MAKING $10,000 OR LESS

$17,781

$6,893

$24,674

Schedule 15
Representational Activities

80 %

Schedule 16
Political Activities and Lobbying

Schedule 17
Contributions

Schedule 18
General Overhead

10 %

Schedule 19
Administration

10 %

Total Employee Disbursements	$133,902	$1,105	$69,157	$0	$204,164
Less Deductions
Net Disbursements					$204,164

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 13 - MEMBERSHIP STATUS

FILE NUMBER: 544-573

Category of Membership (A)	Number (B)	Voting Eligibility (C)
Members (Total of all lines above)	3,000
Agency Fee Payers*	0
Total Members/Fee Payers	3,000
*Agency Fee Payers are not considered members of the labor organization.
Regular Members	3,000	Yes

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19

FILE NUMBER: 544-573

SCHEDULE 14 OTHER RECEIPTS
1. Named Payer Itemized Receipts	$0
2. Named Payer Non-itemized Receipts	$0
3. All Other Receipts	$0
4. Total Receipts	$0

SCHEDULE 17 CONTRIBUTIONS, GIFTS & GRANTS
1. Named Payee Itemized Disbursements	$0
2. Named Payee Non-itemized Disbursements	$0
3. To Officers	$0
4. To Employees	$0
5. All Other Disbursements	$1,010
6. Total Disbursements	$1,010

SCHEDULE 15 REPRESENTATIONAL ACTIVITIES
1. Named Payee Itemized Disbursements	$6,133
2. Named Payee Non-itemized Disbursements	$5,054
3. To Officers	$0
4. To Employees	$150,396
5. All Other Disbursements	$2,218
6. Total Disbursements	$163,801

SCHEDULE 18 GENERAL OVERHEAD
1. Named Payee Itemized Disbursements	$0
2. Named Payee Non-itemized Disbursements	$0
3. To Officers	$0
4. To Employees	$14,831
5. All Other Disbursements	$1,440
6. Total Disbursements	$16,271

SCHEDULE 16 POLITICAL ACTIVITIES AND LOBBYING
1. Named Payee Itemized Disbursements	$0
2. Named Payee Non-itemized Disbursements	$0
3. To Officers	$0
4. To Employees	$20,857
5. All Other Disbursements	$0
6. Total Disbursements	$20,857

SCHEDULE 19 UNION ADMINISTRATION
1. Named Payee Itemized Disbursements	$0
2. Named Payee Non-itemized Disbursements	$0
3. To Officers	$0
4. To Employees	$18,079
5. All Other Disbursements	$1,375
6. Total Disbursements	$19,454

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 14 - OTHER RECEIPTS

FILE NUMBER: 544-573

Name and Address
(A)

-1

Type or Classification
(B)

Purpose (C)	Date (D)	Amount (E)
Total Itemized Transactions with this Payee/Payer
Total Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this Payee/Payer for This Schedule		$0

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 15 - REPRESENTATIONAL ACTIVITIES

FILE NUMBER: 544-573

Name and Address
(A)

Dennis R. Brown

869 Concord St
Framingham
MA
01701

Type or Classification
(B)

Legal

Purpose (C)	Date (D)	Amount (E)
Total Itemized Transactions with this Payee/Payer		$6,133
Total Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this Payee/Payer for This Schedule		$6,133
New England Arbitration Holiday Pay	10/26/2013	$6,133

Name and Address
(A)

Weinberg, Roger, and Rosenfeld

1001 Marina Village Pkwy200
Alameda
CA
94501

Type or Classification
(B)

Legal

Purpose (C)	Date (D)	Amount (E)
Total Itemized Transactions with this Payee/Payer
Total Non-Itemized Transactions with this Payee/Payer		$5,054
Total of All Transactions with this Payee/Payer for This Schedule		$5,054

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

SCHEDULE 16 - POLITICAL ACTIVITIES AND LOBBYING

FILE NUMBER 544-573

There was no data found for this schedule.

SCHEDULE 17 - CONTRIBUTIONS, GIFTS & GRANTS

FILE NUMBER: 544-573

There was no data found for this schedule.

SCHEDULE 18 - GENERAL OVERHEAD

FILE NUMBER: 544-573

There was no data found for this schedule.

SCHEDULE 19 - UNION ADMINISTRATION

FILE NUMBER: 544-573

There was no data found for this schedule.

SCHEDULE 20 - BENEFITS

FILE NUMBER: 544-573

Description (A)	To Whom Paid (B)	Amount (C)
Total of all lines above (Total will be automatically entered in Item 55.)		$487
Workers Comp	The Hartford	$487

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

69. ADDITIONAL INFORMATION SUMMARY

FILE NUMBER: 544-573

Address of Record: International recently closed office site - local in search of new office space and is using a PO box in conjunction with private residence.

Schedule 13, Row1:All members pay full dues



Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)