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: 07-31-2019
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
069-941
2. PERIOD COVERED
From10/01/2015
Through09/30/2016
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
UNION OF AMERICAN PHYSICIANS
5. DESIGNATION (Local, Lodge, etc.)
STATE FEDERATION
 6. DESIGNATION NBR

7. UNIT NAME (if any)
CALIFORNIA FEDERATION OF THE UNION OF AMERICAN
8. MAILING ADDRESS (Type or print in capital letters)
First Name
STUART
 Last Name
BUSSEY
P.O Box - Building and Room Number
SUITE 1380
Number and Street
180 GRAND AVE
City
OAKLAND
State
CA		 ZIP Code + 4
94612


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:stuart A BusseyPRESIDENT71. SIGNED:Peter A StattiTREASURER
Date:Dec 29, 2016Telephone Number:510-839-0193Date:Jan 04, 2017Telephone Number:805-922-8311
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21 FILE NUMBER: 069-941
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?Yes
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?Yes
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.)Yes
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?$500,000
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?09/2018
20. How many members did the labor organization have at the end of the reporting period?2,614
21. What are the labor organization's rates of dues and fees?
Rates of Dues and Fees
Dues/FeesAmount UnitMinimumMaximum
(a) Regular Dues/Fees$440perYear$72.00$3385.00
(b) Working Dues/Feesper
(c) Initiation Feesper
(d) Transfer Feesper
(e) Work Permitsper

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS AND LIABILITIES FILE NUMBER: 069-941

ASSETS
ASSETS Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
22. Cash $5,361,049$6,365,411
23. Accounts Receivable1$0
24. Loans Receivable2
25. U.S. Treasury Securities $0$0
26. Investments5$1,000,000
27. Fixed Assets6
28. Other Assets7
29. TOTAL ASSETS $6,361,049$6,365,411

LIABILITIES
LIABILITIES Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
30. Accounts Payable8
31. Loans Payable9
32. Mortgages Payable $0$0
33. Other Liabilities10
34. TOTAL LIABILITIES $0$0
35. NET ASSETS$6,361,049$6,365,411
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B - RECEIPTS AND DISBURSEMENTS FILE NUMBER: 069-941

CASH RECEIPTSSCHAMOUNT
36. Dues and Agency Fees $5,765,387
37. Per Capita Tax $0
38. Fees, Fines, Assessments, Work Permits $0
39. Sale of Supplies $0
40. Interest $35,606
41. Dividends $0
42. Rents $0
43. Sale of Investments and Fixed Assets3
44. Loans Obtained9
45. Repayments of Loans Made2
46. On Behalf of Affiliates for Transmittal to Them $0
47. From Members for Disbursement on Their Behalf $0
48. Other Receipts14$0
49. TOTAL RECEIPTS $5,800,993
CASH DISBURSEMENTSSCHAMOUNT
50. Representational Activities15$2,186,359
51. Political Activities and Lobbying16$415,319
52. Contributions, Gifts, and Grants17$0
53. General Overhead18$1,173,871
54. Union Administration19$186,747
55. Benefits20$404,014
56. Per Capita Tax $430,321
57. Strike Benefits $0
58. Fees, Fines, Assessments, etc. $0
59. Supplies for Resale $0
60. Purchase of Investments and Fixed Assets4$0
61. Loans Made2
62. Repayment of Loans Obtained9
63. To Affiliates of Funds Collected on Their Behalf $0
64. On Behalf of Individual Members $0
65. Direct Taxes $0
  
66. Subtotal $4,796,631
67. Withholding Taxes and Payroll Deductions  
  67a. Total Withheld$615,766  
  67b. Less Total Disbursed$615,766  
  67c. Total Withheld But Not Disbursed 
68. TOTAL DISBURSEMENTS $4,796,631
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE FILE NUMBER: 069-941

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: 069-941

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$0$0$0$0$0
Totals will be automatically entered in... Item 24
Column (A) 		Item 61Item 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: 069-941

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: 069-941

Description (if land or buildings, give location)
(A) 		Cost
(B) 		Book Value
(C) 		Cash Paid
(D)
Total of all lines above$0$0$0
 Less Reinvestments$0
(The total from Net Purchases Line will be automatically entered in Item 60.)Net Purchases$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 - INVESTMENTS FILE NUMBER: 069-941

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)) $0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 6 - FIXED ASSETS FILE NUMBER: 069-941

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
E. Other Fixed Assets
F. Totals of Lines A through E (Column(D) Total will be automatically entered in Item 27, Column(B)) $0$0$0$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER ASSETS FILE NUMBER: 069-941

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: 069-941

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: 069-941

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 44Item 62 Item 69
with Explanation 		Item 31
Column (D)
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 10 - OTHER LIABILITIES FILE NUMBER: 069-941

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: 069-941

(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 		Bussey ,  Stuart   A
President
C		$182,666$13,729$196,395
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Statti ,  Peter   A
Treasurer
C		$4,199$4,199
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Pendukar ,  Shakalpi  
Secretary
C		$2,545$2,545
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Lewis ,  Ronald   H
Vice President
C		$12,658$12,658
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Mubashir ,  Farooqi   A
Vice President
C		$3,521$3,521
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Behrman ,  Victoria   A
Board Member
C		$0$0
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Cheng ,  Rex   L
Board Member
C		$0$0
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Dilibero ,  Ralph  
Board Member
C		$372$372
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Flocks ,  Jay   S
Board Member
C		$175$175
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Jetton ,  James   K
Board Member
P		$249$249
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Keulen ,  David   J
Board Member
C		$131$131
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Landers ,  Michael   J
Board Member
C		$1,176$1,176
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Lorig ,  Milton   L
Board Member
C		$475$475
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Quint ,  Keith   M
Board Member
C		$2,744$2,744
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Shepperson ,  Ronald  
Board Member
C		$1,225$1,225
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Yee ,  Brian   Y
Board Member
C		$86$86
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
Total Officer Disbursements$182,666$0$43,285$0$225,951
Less Deductions     
Net Disbursements    $225,951
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES FILE NUMBER: 069-941

(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
A
B
C 		Adams ,  Indya   M
Administrative Specialist
N/A		$40,250$521$0$40,771
I
Schedule 15
Representational Activities 		59 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		41 %
A
B
C 		Alexander ,  Cheryl   R
Finance Manager
N/A		$96,601$1,900$0$98,501
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		100 % Schedule 19
Administration
A
B
C 		Baldovinos ,  Nancy  
Office Manager
N/A		$65,858$86$0$65,944
I
Schedule 15
Representational Activities 		59 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		41 %
A
B
C 		Baxter ,  Andrew   J
Senior Rep/Organizer
N/A		$109,137$4,798$324$114,259
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Bussey ,  Stuart   A
President
N/A		$16,583$3,607$0$20,190
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Chiappetta ,  R Douglas  
Director, Legislative
N/A		$151,676$417$9,474$161,567
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		100 % Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Cordova ,  Christine   A
Administrative Specialist
N/A		$55,036$378$0$55,414
I
Schedule 15
Representational Activities 		76 % Schedule 16
Political Activities and Lobbying 		3 % Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		21 %
A
B
C 		Duarte ,  Gloria   A
Office Manager
N/A		$105,302$335$0$105,637
I
Schedule 15
Representational Activities 		76 % Schedule 16
Political Activities and Lobbying 		3 % Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		21 %
A
B
C 		Dunn ,  Laurel   A
Administrative Specialist
N/A		$35,992$352$0$36,344
I
Schedule 15
Representational Activities 		76 % Schedule 16
Political Activities and Lobbying 		3 % Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		21 %
A
B
C 		Duritz ,  Jeffrey   C
Senior Representative
N/A		$109,044$8,437$0$117,481
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Ford ,  Lisa  
Representative
N/A		$57,616$6,499$313$64,428
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Gashaw ,  Theodros   K
Lead Organizer
N/A		$78,303$14,602$3,878$96,783
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Golden-Ortiz ,  Glynnis  
Senior Represntative
N/A		$87,507$8,589$1,679$97,775
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Groh ,  Albert   W
Consultant
N/A		$98,761$2,237$236$101,234
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Hernandez ,  Patricia  
Senior Representative
N/A		$129,738$7,590$576$137,904
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Ige ,  Christopher   J
Sr. Rep/Political Liason
N/A		$97,203$5,920$371$103,494
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Irvin ,  Lux   R
Senior Representative
N/A		$108,546$7,307$504$116,357
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Lester ,  Charles  
Director of Organizing
N/A		$21,508$7,747$0$29,255
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Modrall ,  Claudia   C
Private Practice Assistan
N/A		$59,463$665$0$60,128
I
Schedule 15
Representational Activities 		76 % Schedule 16
Political Activities and Lobbying 		3 % Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		21 %
A
B
C 		Mohammed ,  Adrian   A
Administrative Specialist
N/A		$25,509$427$0$25,936
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Munoz ,  Albert   A
Senior Representative
N/A		$24,923$6,246$0$31,169
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Murillo ,  John   M
Regional Administrator
N/A		$137,187$1,590$764$139,541
I
Schedule 15
Representational Activities 		59 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		41 %
A
B
C 		Park ,  Chung   Y
Representiave
N/A		$11,528$1,578$0$13,106
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Perriera ,  Bryon   A
Organizer
N/A		$19,187$362$7,343$26,892
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Rivera ,  Nereyda   M
Senior Representative
N/A		$100,722$29,564$0$130,286
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Robinson ,  Gary   R
Consultant
N/A		$41,887$3,715$0$45,602
I
Schedule 15
Representational Activities 		92 % Schedule 16
Political Activities and Lobbying 		8 % Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Snipes ,  Carolyn  
Office Manager
N/A		$60,957$206$0$61,163
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Torres ,  Juan  
Administrative Specialist
N/A		$5,509$0$0$5,509
I
Schedule 15
Representational Activities 		59 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		41 %
A
B
C 		Williams ,  Zegory   A
Executive Director
N/A		$166,253$9,757$3,919$179,929
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Wilson ,  Suzanne   L
Business & Comm. Director
N/A		$135,694$3,685$825$140,204
I
Schedule 15
Representational Activities 		76 % Schedule 16
Political Activities and Lobbying 		3 % Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		21 %
TOTALS RECEIVED BY EMPLOYEES MAKING $10,000 OR LESS$0
I Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
Total Employee Disbursements$2,253,480$0$139,117$30,206$2,422,803
Less Deductions    $615,766
Net Disbursements    $1,807,037
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 - MEMBERSHIP STATUS FILE NUMBER: 069-941

Category of Membership
(A) 		Number
(B) 		Voting Eligibility
(C)
Members (Total of all lines above) 2,614 
Agency Fee Payers*965
Total Members/Fee Payers3,579 
*Agency Fee Payers are not considered members of the labor organization.
Direct Bill Members128Yes
State Employed Members1,139Yes
County Employed Members1,347Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19 FILE NUMBER: 069-941

SCHEDULE 14   OTHER RECEIPTS
1. Named Payer Itemized Receipts$0
2. Named Payer Non-itemized Receipts$0
3. All Other Receipts
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
6. Total Disbursements$0
SCHEDULE 15   REPRESENTATIONAL ACTIVITIES
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$225,951
4. To Employees$1,960,408
5. All Other Disbursements
6. Total Disbursements$2,186,359
SCHEDULE 18   GENERAL OVERHEAD
1. Named Payee Itemized Disbursements$598,077
2. Named Payee Non-itemized Disbursements$477,293
3. To Officers$0
4. To Employees$98,501
5. All Other Disbursements
6. Total Disbursements$1,173,871
SCHEDULE 16   POLITICAL ACTIVITIES AND LOBBYING
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$238,173
3. To Officers$0
4. To Employees$177,146
5. All Other Disbursements
6. Total Disbursements$415,319
SCHEDULE 19   UNION ADMINISTRATION
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$0
4. To Employees$186,747
5. All Other Disbursements
6. Total Disbursements$186,747
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER RECEIPTS FILE NUMBER: 069-941

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: 069-941

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 16 - POLITICAL ACTIVITIES AND LOBBYING FILE NUMBER 069-941

Name and Address
(A)
AFSCME PEOPLE Qualified Committee

1625 L Street, N.W.
Washington
DC
20036
Type or Classification
(B)
Political Action Fund Group
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$8,491
Total of All Transactions with this Payee/Payer for This Schedule$8,491
Name and Address
(A)
UAPD Medical Action Committee

1121 L Street, Ste. 904
Sacramento
CA
95814
Type or Classification
(B)
Legislative Advocacy Group
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$7,000
Total of All Transactions with this Payee/Payer for This Schedule$7,000
Name and Address
(A)
UAPD Medical Action Committee
c/o Olson Hagel Fishburn
555 Capital Mall, Ste. 1425
Sacramento
CA
95814
Type or Classification
(B)
PAC Reporting Attorneys
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$222,682
Total of All Transactions with this Payee/Payer for This Schedule$222,682
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 17 - CONTRIBUTIONS, GIFTS & GRANTS FILE NUMBER: 069-941

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: 069-941

Name and Address
(A)
520 Capital Mall Inc

2870 Gateway Oaks
Sacramento
CA
95833
Type or Classification
(B)
Office Space Leasing Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$69,232
Total Non-Itemized Transactions with this Payee/Payer$16,149
Total of All Transactions with this Payee/Payer for This Schedule$85,381
Sacramento Rent10/01/2015$6,766
Sacramento Rent11/01/2015$6,921
Sacramento Rent12/01/2015$6,997
Sacramento Retn01/01/2016$6,921
Sacramento Rent02/01/2016$7,289
Sacramento Rent03/01/2016$7,092
Sacramento Rent04/01/2016$7,437
Sacramento Rent05/01/2016$6,317
Sacramento Rent06/01/2016$6,317
Sacramento Rent07/01/2016$7,175
Name and Address
(A)
ABM Parking Services

1960 E. Grand Avenue
El Segundo
CA
90245
Type or Classification
(B)
Employee Parking for LA Office
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$10,710
Total of All Transactions with this Payee/Payer for This Schedule$10,710
Name and Address
(A)
AmTrust North America
P.O. Box 6939

Cleveland
OH
44101
Type or Classification
(B)
Wokerrs Comp Insurance (New)
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$24,432
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$24,432
Annual Premium02/01/2016$24,432
Name and Address
(A)
Coalition of County Unions

2 Cupania Circle
Monterey Park
CA
91750
Type or Classification
(B)
Consulting Services
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$11,033
Total of All Transactions with this Payee/Payer for This Schedule$11,033
Name and Address
(A)
Comcast
P.O. Box 34744

Seattle
WA
98124
Type or Classification
(B)
Satellite Connections for Sacramento and Oakland
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$8,764
Total of All Transactions with this Payee/Payer for This Schedule$8,764
Name and Address
(A)
Davis Cowell & Bowe

595 Market Street, Ste. 1
San Francisco
CA
94105
Type or Classification
(B)
Legal Office for Oakland Office
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$44,720
Total Non-Itemized Transactions with this Payee/Payer$13,517
Total of All Transactions with this Payee/Payer for This Schedule$58,237
Legal08/05/2016$17,743
Legal08/26/2016$26,977
Name and Address
(A)
Easy Permit
P.O. Box 374874

Pittsburg
PA
15250
Type or Classification
(B)
Postage Machine Leases for 3 offices
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$10,508
Total of All Transactions with this Payee/Payer for This Schedule$10,508
Name and Address
(A)
Embassy Suites


Burlingame
CA
Type or Classification
(B)
Hotel Conference
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$9,943
Total of All Transactions with this Payee/Payer for This Schedule$9,943
Name and Address
(A)
Golden Gate Print & Media Services

11144 Golf Links Road
Oakland
CA
94605
Type or Classification
(B)
Professional Printing Services
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$10,417
Total Non-Itemized Transactions with this Payee/Payer$24,708
Total of All Transactions with this Payee/Payer for This Schedule$35,125
Printed Materials04/08/2016$5,053
Printed Materials09/16/2016$5,364
Name and Address
(A)
Handled With Care

14358 Wicks Blvd.
San Leandro
CA
94577
Type or Classification
(B)
Printing and Delivery
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$6,475
Total of All Transactions with this Payee/Payer for This Schedule$6,475
Name and Address
(A)
Hub International

3000 Executive Parkway
San Ramon
CA
94583
Type or Classification
(B)
Officer & Directors Liability Insurance
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$14,790
Total Non-Itemized Transactions with this Payee/Payer$3,814
Total of All Transactions with this Payee/Payer for This Schedule$18,604
Premium - Renewal09/30/2016$14,790
Name and Address
(A)
James R. Mount

3967 Mead Street
Antioch
CA
94531
Type or Classification
(B)
Computer Technician for Oakland Office
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$13,200
Total of All Transactions with this Payee/Payer for This Schedule$13,200
Name and Address
(A)
Jaystar Group Inc.

85 East Avenue
Norwalk
CT
06851
Type or Classification
(B)
Database System for Union
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$22,488
Total of All Transactions with this Payee/Payer for This Schedule$22,488
Name and Address
(A)
Juan Torres

1015 W 85th St., Apt 6
Los Angeles
CA
90044
Type or Classification
(B)
Temporary Employee
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$13,211
Total of All Transactions with this Payee/Payer for This Schedule$13,211
Name and Address
(A)
Labite


Los Angeles
CA
Type or Classification
(B)
Catering Company in Los Angeles
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$8,076
Total of All Transactions with this Payee/Payer for This Schedule$8,076
Name and Address
(A)
Law Office of Lawrence Rozenweig

2730 Wilshire Blvd., #425
Santa Monica
CA
90403
Type or Classification
(B)
Legal Office for LA Office
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$11,728
Total Non-Itemized Transactions with this Payee/Payer$19,772
Total of All Transactions with this Payee/Payer for This Schedule$31,500
Legal03/15/2016$11,728
Name and Address
(A)
Mach 11 180 LLC
P.O. Box 3982302

San Francisco
CA
94104
Type or Classification
(B)
Oakland Rent
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$121,018
Total Non-Itemized Transactions with this Payee/Payer$27,107
Total of All Transactions with this Payee/Payer for This Schedule$148,125
Oakland Rent10/01/2015$11,713
Oakland Rent11/01/2015$11,713
Oakland Rent12/01/2015$11,713
Oakland Rent01/04/2016$12,256
Oakland Rent02/01/2016$12,331
Oakland Rent03/01/2016$12,268
Oakland Rent04/01/2016$12,256
Oakland Rent05/01/2016$12,256
Oakland Rent06/01/2016$12,256
Oakland Rent07/01/2016$12,256
Name and Address
(A)
Marriott


Burlingame
CA
Type or Classification
(B)
Hotel Conference
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$25,674
Total Non-Itemized Transactions with this Payee/Payer$11,203
Total of All Transactions with this Payee/Payer for This Schedule$36,877
Various Meetings01/20/2016$11,203
Various Meetings04/28/2016$14,471
Name and Address
(A)
Menza Systems

1600 S. Sherbourne Drive
Los Angeles
CA
90035
Type or Classification
(B)
Computer Tech for LA Office
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$9,512
Total of All Transactions with this Payee/Payer for This Schedule$9,512
Name and Address
(A)
Mr. Copy

5657 Copley Drive
San Diego
CA
92111
Type or Classification
(B)
Supplies for Copiers
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$6,595
Total of All Transactions with this Payee/Payer for This Schedule$6,595
Name and Address
(A)
Office Depot
P.O. Box 689020

Des Moines
IA
50368
Type or Classification
(B)
Office Supplies
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$23,037
Total of All Transactions with this Payee/Payer for This Schedule$23,037
Name and Address
(A)
Olson Hagel & Fishburn LLP

555 Capital Mall, Ste. 1425
Sacramento
CA
95814
Type or Classification
(B)
Legal for Oakland Office - Lobbyist & PAC
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$14,060
Total of All Transactions with this Payee/Payer for This Schedule$14,060
Name and Address
(A)
Pitney Bowes Global Financial Services
P.O. Box 37187

Pittsburg
PA
15250
Type or Classification
(B)
Postage Machine Leases for 3 offices
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$10,223
Total of All Transactions with this Payee/Payer for This Schedule$10,223
Name and Address
(A)
Regus Management Group LLC
P.O. Box 842456

Dallas
TX
75284
Type or Classification
(B)
Office Rental for LA Location
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$27,550
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$27,550
LA Rent10/23/2015$10,248
LA Rent11/20/2015$10,549
LA Rent12/15/2015$5,784
LA Rent- Final Payment02/01/2016$969
Name and Address
(A)
Robert Half
P.O. Box 743295

Los Angeles
CA
90074
Type or Classification
(B)
Temporary Agency
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$12,908
Total of All Transactions with this Payee/Payer for This Schedule$12,908
Name and Address
(A)
Schwerin Campbell Barnard LLP

18 West Mercer St, Ste. 400
Seattle
WA
98119
Type or Classification
(B)
Legal Office for Washington State
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$55,980
Total Non-Itemized Transactions with this Payee/Payer$10,626
Total of All Transactions with this Payee/Payer for This Schedule$66,606
Legal08/05/2016$6,515
Legal08/26/2016$19,825
Legal09/30/2016$29,640
Name and Address
(A)
Southwest Airlines
P.O. Box 36647

Dallas
TX
75235
Type or Classification
(B)
Airline
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$74,875
Total of All Transactions with this Payee/Payer for This Schedule$74,875
Name and Address
(A)
Standard Parking

202 Kitredge Street
Berkeley
CA
94704
Type or Classification
(B)
Employee Parking for Oakland Office
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$18,975
Total of All Transactions with this Payee/Payer for This Schedule$18,975
Name and Address
(A)
State Farm Insurance

3645 Grand Avenue
Oakland
CA
94610
Type or Classification
(B)
Workers Comp Insurance
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$10,176
Total of All Transactions with this Payee/Payer for This Schedule$10,176
Name and Address
(A)
The Realty Associates
P.O. Box 848590

Los Angeles
CA
90084
Type or Classification
(B)
Rent for LA Office
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$73,682
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$73,682
Rent03/01/2016$10,526
Rent04/01/2016$10,526
Rent05/01/2016$10,526
Rent06/01/2016$10,526
Rent07/01/2016$10,526
Rent08/01/2016$10,526
Rent09/01/2016$10,526
Name and Address
(A)
United Airlines

233 South Wacker Drive
Chicago
IL
60606
Type or Classification
(B)
Airline
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$5,290
Total of All Transactions with this Payee/Payer for This Schedule$5,290
Name and Address
(A)
US Bancorop
P.O. Box 790448

St. Louis
MO
63179
Type or Classification
(B)
Leasing Company Telephone Equipment
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$15,155
Total of All Transactions with this Payee/Payer for This Schedule$15,155
Name and Address
(A)
Van Sloten & Laranang CPAs

39176-B State Street
Fremont
CA
94538
Type or Classification
(B)
CPAs for Annual Audit
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$6,100
Total of All Transactions with this Payee/Payer for This Schedule$6,100
Name and Address
(A)
Westin Hotels

335 Powell Street
San Francisco
CA
94105
Type or Classification
(B)
Triennial Events
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$118,854
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$118,854
Triennial Deposit10/01/2015$23,184
Triennial Deposit10/07/2015$69,553
Final Payment11/12/2015$26,117
Name and Address
(A)
Xerox Corporation
P.O. Box 7405

Pasadena
CA
91109
Type or Classification
(B)
Lease and supplies for Copier
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$18,023
Total of All Transactions with this Payee/Payer for This Schedule$18,023
Name and Address
(A)
Xobee Communications LLC

440 W. Fallbrook
Fresno
CA
93711
Type or Classification
(B)
Telephone System Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$11,060
Total of All Transactions with this Payee/Payer for This Schedule$11,060
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 19 - UNION ADMINISTRATION FILE NUMBER: 069-941

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: 069-941

Description
(A) 		To Whom Paid
(B) 		Amount
(C)
Total of all lines above (Total will be automatically entered in Item 55.)$404,014
Dental InsuranceDelta Dental$38,788
Health and Vision InsuranceWestern Alliance Trust Fund$125,629
Life InsuranceThe Standard Insurance$3,418
PensionAFSCME State Street Bank$236,179
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL INFORMATION SUMMARY FILE NUMBER: 069-941


Question 11(a):

Question 11(a): : : : UAPD Medical Issues Committee c/o Olson Hagel & Fishburn LLP 555 Capital Mall, Ste. 1425 Sacramento, CA 95814

Question 12: Van Sloten & Laranang,CPAs 608 Main Street, Suite A Pleasanton, CA 94566

Question 13: Non business related credit card expenses, fully repaid by the employee.

Statement A,

Cash Begin Total: Not sure what happened here... Same as previous LM2

Schedule 13, Row1:

Schedule 13, Row1:Private Practice Members

Schedule 13, Row2:

Schedule 13, Row2:State of California Employees

Schedule 13, Row2:

Schedule 13, Row2::

Schedule 13, Row3:

Schedule 13, Row3:Various Counties in California

Schedule 13, Row3:

Schedule 13, Row3::

Schedule 13, Row1:

Schedule 13, Row1::
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)