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
008-701
2.
PERIOD COVERED
From
01/01/2015
Through
12/31/2015
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
AUTO WORKERS AFL-CIO
5. DESIGNATION (Local, Lodge, etc.)
LOCAL UNION
6. DESIGNATION NBR
3999
7. UNIT NAME (if any)
8. MAILING ADDRESS (Type or print in capital
letters)
First Name
KIRK
Last Name
DOUGLASS
P.O Box - Building and Room Number
PO BOX 213
Number and Street
259 Front St.
City
BATH
State
ME
ZIP Code + 4
045300213
9. Are your organization's records kept at its
mailing address?
Yes
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:
Kirk R Douglass
PRESIDENT
71. SIGNED:
Samantha S Malsch
TREASURER
Date:
Mar 15, 2016
Telephone
Number:
207-442-3692
Date:
Mar 15, 2016
Telephone
Number:
207-443-2922
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21
FILE NUMBER:
008-701
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?
$140,000
15. During the reporting period did the labor
organization acquire or dispose of any assets in a manner
other than purchase or sale?
Yes
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?
05/2017
20. How many members did the labor organization
have at the end of the reporting period?
722
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
2 1/2 HRS STR TIME
per
MONTH
0
0
(b) Working Dues/Fees
N/A
per
0
0
(c) Initiation Fees
250
per
ONE TIME
0
0
(d) Transfer Fees
125
per
ONE TIME
0
0
(e) Work Permits
N/A
per
0
0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS
AND LIABILITIES
FILE NUMBER:
008-701
ASSETS
ASSETS
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
22. Cash
$957,122
$957,413
23. Accounts Receivable
1
$0
24. Loans Receivable
2
$0
25. U.S. Treasury
Securities
$0
$0
26. Investments
5
$0
27. Fixed Assets
6
$22,341
$20,262
28. Other Assets
7
$396
$396
29.
TOTAL ASSETS
$979,859
$978,071
LIABILITIES
LIABILITIES
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
30. Accounts Payable
8
$34,812
$50,665
31. Loans Payable
9
$0
32. Mortgages Payable
$0
$0
33. Other Liabilities
10
$0
34. TOTAL
LIABILITIES
$34,812
$50,665
35. NET
ASSETS
$945,047
$927,406
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B -
RECEIPTS AND DISBURSEMENTS
FILE NUMBER:
008-701
CASH
RECEIPTS
SCH
AMOUNT
36. Dues and Agency Fees
$562,500
37. Per Capita Tax
$0
38. Fees, Fines,
Assessments, Work Permits
$26,125
39. Sale of Supplies
$0
40. Interest
$2,036
41. Dividends
$0
42. Rents
$0
43. Sale of Investments
and Fixed Assets
3
$0
44. Loans Obtained
9
$0
45. Repayments of Loans
Made
2
$0
46. On Behalf of
Affiliates for Transmittal to Them
$0
47. From Members for
Disbursement on Their Behalf
$6,854
48. Other Receipts
14
$9,018
49. TOTAL RECEIPTS
$606,533
CASH DISBURSEMENTS
SCH
AMOUNT
50.
Representational Activities
15
$92,227
51.
Political Activities and Lobbying
16
$3,321
52.
Contributions, Gifts, and Grants
17
$1,691
53. General
Overhead
18
$103,572
54. Union
Administration
19
$38,365
55. Benefits
20
$1,838
56. Per
Capita Tax
$348,187
57. Strike
Benefits
$672
58. Fees,
Fines, Assessments, etc.
$0
59. Supplies
for Resale
$0
60. Purchase
of Investments and Fixed Assets
4
$415
61. Loans
Made
2
$0
62.
Repayment of Loans Obtained
9
$0
63. To
Affiliates of Funds Collected on Their Behalf
$0
64. On
Behalf of Individual Members
$7,854
65. Direct
Taxes
$68
66. Subtotal
$598,210
67.
Withholding Taxes and Payroll Deductions
67a. Total
Withheld
$0
67b. Less Total
Disbursed
$8,032
67c.
Total Withheld But Not Disbursed
-$8,032
68.
TOTAL DISBURSEMENTS
$606,242
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS
RECEIVABLE AGING SCHEDULE
FILE NUMBER:
008-701
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
$0
$0
$0
$0
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:
008-701
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
$0
$0
$0
$0
$0
Total of all lines
above
$0
$0
$0
$0
$0
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:
008-701
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
$0
(The
total from Net Sales Line will be automatically entered
in Item 43)
Net Sales
$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 4 - PURCHASE
OF INVESTMENTS AND FIXED ASSETS
FILE NUMBER:
008-701
Description (if land or buildings, give location)
(A)
Cost
(B)
Book Value
(C)
Cash Paid
(D)
Total
of all lines above
$415
$415
$415
FURNITURE & EQUIPEMENT (COMPUTERS)
$415
$415
$415
Less Reinvestments
$0
(The
total from Net Purchases Line will be automatically
entered in Item 60.)
Net Purchases
$415
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 -
INVESTMENTS
FILE NUMBER:
008-701
Description
(A)
Amount
(B)
Marketable Securities
A. Total Cost
$0
B. Total Book Value
$0
C. List each
marketable security which has a book value over $5,000
and exceeds 5% of Line B.
Other Investments
D. Total Cost
$0
E. Total Book Value
$0
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))
$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 6 - FIXED
ASSETS
FILE NUMBER:
008-701
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)
$0
$0
$0
$0
C. Automobiles
and
Other Vehicles
D. Office
Furniture
and Equipment
$20,262
$0
$20,262
$20,262
E.
Other Fixed Assets
F. Totals of Lines A through E
(Column(D) Total will be automatically entered in Item
27, Column(B))
$20,262
$0
$20,262
$20,262
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER
ASSETS
FILE NUMBER:
008-701
Description
(A)
Book Value
(B)
Total
(Total will be automatically entered in Item 28, Column(B))
$396
BIBLE INVENTORY (12 BIBLES @ 33.00 EACH)
$396
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS
PAYABLE AGING SCHEDULE
FILE NUMBER:
008-701
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
$50,665
$0
$0
$0
Totals
(Total for Column(B) will be automatically entered in Item
30, Column(D))
$50,665
$0
$0
$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 9 - LOANS
PAYABLE
FILE NUMBER:
008-701
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:
008-701
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:
008-701
(A) Name
(B) Title
(C) Status
(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
ANDREWS
,
MARK
B GUIDE C
$0
$10,909
$0
$10,909
I
Schedule 15
Representational Activities
60
%
Schedule 16
Political Activities and Lobbying
3
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
37
%
A
B
C
DOUGLASS
,
KIRK
R PRESIDENT C
$0
$0
$3,941
$0
$3,941
I
Schedule 15
Representational Activities
92
%
Schedule 16
Political Activities and Lobbying
3
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
5
%
A
B
C
GATES
,
WILLIAM
T REP-AT-LARGE C
$0
$0
$15,237
$0
$15,237
I
Schedule 15
Representational Activities
82
%
Schedule 16
Political Activities and Lobbying
2
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
16
%
A
B
C
MALSCH
,
SAMANTH
S TREASURER C
$0
$0
$13,542
$0
$13,542
I
Schedule 15
Representational Activities
29
%
Schedule 16
Political Activities and Lobbying
2
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
69
%
A
B
C
MOULTON
,
GREGORY
REP AT LARGE C
$0
$0
$11,131
$0
$11,131
I
Schedule 15
Representational Activities
61
%
Schedule 16
Political Activities and Lobbying
9
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
30
%
A
B
C
NORTON
,
TERRI
SECRETARY C
$0
$0
$18,172
$0
$18,172
I
Schedule 15
Representational Activities
51
%
Schedule 16
Political Activities and Lobbying
1
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
48
%
A
B
C
RICE
,
GEORGE
REP AT LARGE C
$0
$0
$8,692
$0
$8,692
I
Schedule 15
Representational Activities
80
%
Schedule 16
Political Activities and Lobbying
3
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
17
%
A
B
C
VELLELLA
,
TRENT
VICE PRESIDENT C
$0
$0
$31,234
$0
$31,234
I
Schedule 15
Representational Activities
91
%
Schedule 16
Political Activities and Lobbying
2
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
7
%
A
B
C
WELCH
,
CHUCK
SGT-AT-ARMS C
$0
$0
$4,565
$0
$4,565
I
Schedule 15
Representational Activities
63
%
Schedule 16
Political Activities and Lobbying
5
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
32
%
Total Officer
Disbursements
$0
$0
$117,423
$0
$117,423
Less Deductions
Net
Disbursements
$117,423
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 -
DISBURSEMENTS TO EMPLOYEES
FILE NUMBER:
008-701
(A) Name
(B) Title
(C) Other Payer
(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
TOTALS RECEIVED
BY EMPLOYEES MAKING $10,000 OR LESS
$0
$0
$5,631
$0
$5,631
I
Schedule 15
Representational Activities
12
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
88
%
Total
Employee Disbursements
$0
$0
$5,631
$0
$5,631
Less
Deductions
Net Disbursements
$5,631
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 -
MEMBERSHIP STATUS
FILE NUMBER:
008-701
Category of Membership
(A)
Number
(B)
Voting Eligibility
(C)
Members
(Total of all lines above)
722
Agency Fee Payers*
0
Total Members/Fee Payers
722
*Agency Fee Payers are
not considered members of the labor organization.
Regular MEMBERS
722
Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE
- SCHEDULES 14 THROUGH 19
FILE NUMBER:
008-701
SCHEDULE 14 OTHER RECEIPTS
1. Named Payer
Itemized Receipts
$8,319
2. Named Payer
Non-itemized Receipts
$0
3. All Other Receipts
$699
4. Total
Receipts
$9,018
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
$1,691
6. Total
Disbursements
$1,691
SCHEDULE 15 REPRESENTATIONAL
ACTIVITIES
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$9,990
3. To Officers
$80,903
4. To Employees
$676
5. All Other
Disbursements
$658
6. Total
Disbursements
$92,227
SCHEDULE 18 GENERAL OVERHEAD
1. Named Payee
Itemized Disbursements
$31,852
2. Named Payee
Non-itemized Disbursements
$34,508
3. To Officers
$0
4. To Employees
$0
5. All Other
Disbursements
$37,212
6. Total
Disbursements
$103,572
SCHEDULE 16 POLITICAL
ACTIVITIES AND LOBBYING
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$3,319
4. To Employees
$0
5. All Other
Disbursements
$2
6. Total
Disbursements
$3,321
SCHEDULE 19 UNION
ADMINISTRATION
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$33,202
4. To Employees
$4,955
5. All Other
Disbursements
$208
6. Total
Disbursements
$38,365
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER
RECEIPTS
FILE NUMBER:
008-701
Name and Address
(A)
International Union-Uaw P.O. Box 77000
Detroit MI 48277-1277
Type or Classification
(B)
LABOR ORGANIZATION
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$8,319
Total
Non-Itemized Transactions with this Payee/Payer
$0
Total of All Transactions with this
Payee/Payer for This Schedule
$8,319
13TH REBATE
05/20/2015
$8,319
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 -
REPRESENTATIONAL ACTIVITIES
FILE NUMBER:
008-701
Name and Address
(A)
KRAKOW SOURIS & LANDRY LLC 225 Friend St.
Boston MA 02114-0000
Type or Classification
(B)
LAWYERS
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$9,990
Total of All Transactions with this
Payee/Payer for This Schedule
$9,990
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 -
POLITICAL ACTIVITIES AND LOBBYING
FILE NUMBER
008-701
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 17 -
CONTRIBUTIONS, GIFTS & GRANTS
FILE NUMBER:
008-701
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 18 - GENERAL
OVERHEAD
FILE NUMBER:
008-701
Name and Address
(A)
ASTOR CROWNE PLAZA HOTEL 739 CANAL STREET
NEW ORLEANS LA 70130-0000
Type or Classification
(B)
HOTEL
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$0
Total
Non-Itemized Transactions with this Payee/Payer
$5,709
Total of All Transactions with this
Payee/Payer for This Schedule
$5,709
Name and Address
(A)
BURGESS COMPUTER 6 OAK GROVE AVE.
BATH ME 04530-0000
Type or Classification
(B)
COMPUTER SERVICES
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$9,799
Total of All Transactions with this
Payee/Payer for This Schedule
$9,799
Name and Address
(A)
ES I INC. 259 FRONT STREET
BATH ME 04530-0000
Type or Classification
(B)
PROPERTY OWNER
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$18,900
Total of All Transactions with this
Payee/Payer for This Schedule
$18,900
Name and Address
(A)
STROM ENGINEERING OF FLORIDA SUITE 101 26852 TANIC DRIVE WESLEY CHAPEL FL 33544-0000
Type or Classification
(B)
CONTRACT EMP AGENCY
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$5,380
Total
Non-Itemized Transactions with this Payee/Payer
$0
Total of All Transactions with this
Payee/Payer for This Schedule
$5,380
NLRB SETTLEMENT - RTRN OF
06/24/2015
$5,380
Name and Address
(A)
WINTER PEOPLE INC. 125 US ROUTE 1
FREEPORT ME 04032-0000
Type or Classification
(B)
MEMORABILIA SALES
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$26,472
Total
Non-Itemized Transactions with this Payee/Payer
$100
Total of All Transactions with this
Payee/Payer for This Schedule
$26,572
FINAL PYMNT TO WINTERPPL
12/02/2015
$13,047
TO RPLC CHK 18446 96 GIF
08/05/2015
$6,975
WINTERPPL 88 GCS 318968
09/23/2015
$6,450
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 19 - UNION
ADMINISTRATION
FILE NUMBER:
008-701
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 20 -
BENEFITS
FILE NUMBER:
008-701
Description
(A)
To Whom Paid
(B)
Amount
(C)
Total of all
lines above (Total will be automatically entered in Item
55.)
$1,838
Workers Compensation Insurance
MEMIC
$1,838
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL
INFORMATION SUMMARY
FILE NUMBER:
008-701
Question 15: Disposed of three computers and one computer monitor.
Statement A,
Cash Begin Total: LINE 22 A: TO ACCOUNT FOR CHECK VOIDED FOR PREVIOUS YEAR OF $25.00.
Schedule 13, Row1:ANYONE WHO HAS APPLIED AND BEEN ACCEPTED FOR MEMBERSHIP IS A REGULAR MEMBER. REGULAR MEMBERS PAY FULL DUES.