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
034-229
2.
PERIOD COVERED
From
01/01/2016
Through
12/31/2016
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
AUTO WORKERS AFL-CIO
5. DESIGNATION (Local, Lodge, etc.)
LOCAL UNION
6. DESIGNATION NBR
1250
7. UNIT NAME (if any)
8. MAILING ADDRESS (Type or print in capital
letters)
First Name
JACK
Last Name
FEDERAN
P.O Box - Building and Room Number
Number and Street
17250 HUMMEL RD.
City
BROOK PARK
State
OH
ZIP Code + 4
441422134
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:
MARK E PAYNE
PRESIDENT
71. SIGNED:
JACK FEDERAN
TREASURER
Date:
Feb 17, 2017
Telephone
Number:
216-367-3128
Date:
Feb 17, 2017
Telephone
Number:
216-267-9900
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21
FILE NUMBER:
034-229
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?
Yes
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?
Yes
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?
$250,000
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?
1,623
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 hours straight time
per
month
0
0
(b) Working Dues/Fees
0
per
0
0
0
(c) Initiation Fees
$50
per
one time
0
0
(d) Transfer Fees
0
per
0
0
0
(e) Work Permits
0
per
0
0
0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS
AND LIABILITIES
FILE NUMBER:
034-229
ASSETS
ASSETS
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
22. Cash
$607,933
$577,316
23. Accounts Receivable
1
$0
$0
24. Loans Receivable
2
$0
$0
25. U.S. Treasury
Securities
$0
$0
26. Investments
5
$0
$0
27. Fixed Assets
6
$765,247
$768,946
28. Other Assets
7
$961
$1,290
29.
TOTAL ASSETS
$1,374,141
$1,347,552
LIABILITIES
LIABILITIES
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
30. Accounts Payable
8
$223,874
$97,475
31. Loans Payable
9
$0
$0
32. Mortgages Payable
$0
$0
33. Other Liabilities
10
$7,782
$11,129
34. TOTAL
LIABILITIES
$231,656
$108,604
35. NET
ASSETS
$1,142,485
$1,238,948
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B -
RECEIPTS AND DISBURSEMENTS
FILE NUMBER:
034-229
CASH
RECEIPTS
SCH
AMOUNT
36. Dues and Agency Fees
$1,543,124
37. Per Capita Tax
$0
38. Fees, Fines,
Assessments, Work Permits
$0
39. Sale of Supplies
$370
40. Interest
$307
41. Dividends
$0
42. Rents
$72,940
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
$0
48. Other Receipts
14
$279,416
49. TOTAL RECEIPTS
$1,896,157
CASH DISBURSEMENTS
SCH
AMOUNT
50.
Representational Activities
15
$211,566
51.
Political Activities and Lobbying
16
$1,701
52.
Contributions, Gifts, and Grants
17
$3,619
53. General
Overhead
18
$49,158
54. Union
Administration
19
$331,355
55. Benefits
20
$34,123
56. Per
Capita Tax
$1,239,285
57. Strike
Benefits
$0
58. Fees,
Fines, Assessments, etc.
$0
59. Supplies
for Resale
$0
60. Purchase
of Investments and Fixed Assets
4
$3,699
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
$0
65. Direct
Taxes
$50,357
66. Subtotal
$1,924,863
67.
Withholding Taxes and Payroll Deductions
67a. Total
Withheld
$114,740
67b. Less Total
Disbursed
$116,651
67c.
Total Withheld But Not Disbursed
-$1,911
68.
TOTAL DISBURSEMENTS
$1,926,774
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS
RECEIVABLE AGING SCHEDULE
FILE NUMBER:
034-229
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:
034-229
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 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:
034-229
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:
034-229
Description (if land or buildings, give location)
(A)
Cost
(B)
Book Value
(C)
Cash Paid
(D)
Total
of all lines above
$3,699
$3,699
$3,699
Telephone System
$3,699
$3,699
$3,699
Less Reinvestments
$0
(The
total from Net Purchases Line will be automatically
entered in Item 60.)
Net Purchases
$3,699
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 -
INVESTMENTS
FILE NUMBER:
034-229
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:
034-229
Description
(A)
Cost or Other Basis
(B)
Total Depreciation or
Amount Expensed
(C)
Book Value
(D)
Value
(E)
A.
Land (give location)
Land
1
:
17250 Hummel Road Brookpark, OH 44142
$65,280
$65,280
$65,280
B.
Buildings (give location)
Building
1
:
17250 Hummel Road, Brookpark, OH 44142
$305,889
$0
$305,889
$305,889
C. Automobiles
and
Other Vehicles
$0
$0
$0
$0
D. Office
Furniture
and Equipment
$332,946
$0
$332,946
$332,946
E.
Other Fixed Assets
$64,831
$0
$64,831
$64,831
F. Totals of Lines A through E
(Column(D) Total will be automatically entered in Item
27, Column(B))
$768,946
$0
$768,946
$768,946
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER
ASSETS
FILE NUMBER:
034-229
Description
(A)
Book Value
(B)
Total
(Total will be automatically entered in Item 28, Column(B))
$1,290
80 Womens Committee T-Shirts @ $10 each
$800
10 Veterans T-Shirts @ $12 each
$120
Veterans Trinkets
$370
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS
PAYABLE AGING SCHEDULE
FILE NUMBER:
034-229
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
$86,705
$0
$0
$0
Total from all other accounts payable
$10,770
$0
$0
$0
Totals
(Total for Column(B) will be automatically entered in Item
30, Column(D))
$97,475
$0
$0
$0
Per Capita Taxes
$76,797
$0
$0
$0
Real Estate Taxes
$9,908
$0
$0
$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 9 - LOANS
PAYABLE
FILE NUMBER:
034-229
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:
034-229
Description
(A)
Amount at End of Period
(B)
Total Other Liabilities
(Total will be automatically entered in Item 33, Column(D))
$11,129
Federal Taxes Forwarded
$3,875
FICA Employee Forwarded
$1,973
FICA Employer Forwarded
$1,973
State Taxes Forwarded
$1,240
City Taxes Forwarded
$38
Local Taxes Forwarded
$665
Wage Withholding Forwarded
$457
Group Life Insurance Forwarded
$487
Union Dues Forwarded
$191
Federal Unemployment Taxes
$143
State Unemployment Taxes
$87
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL
OFFICERS AND DISBURSEMENTS TO OFFICERS
FILE NUMBER:
034-229
(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
Bretz
,
Stephen
J Guide C
$0
$16
$0
$0
$16
I
Schedule 15
Representational Activities
100
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
0
%
A
B
C
Cullen
,
Mark
P Trustee C
$8,288
$823
$3,311
$0
$12,422
I
Schedule 15
Representational Activities
10
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
90
%
A
B
C
Davis
,
Nadine
E Recording Secretary C
$14,420
$1,997
$365
$0
$16,782
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
100
%
A
B
C
Federan
,
Jack
S Financial Secretary C
$84,959
$18,614
$0
$0
$103,573
I
Schedule 15
Representational Activities
11
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
1
%
Schedule 19
Administration
88
%
A
B
C
Fields-Jr
,
Robert
E Exec Board Mem C
$271
$275
$0
$0
$546
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
100
%
A
B
C
Kiser
,
Donald
F Retiree Chairman P
$0
$372
$0
$0
$372
I
Schedule 15
Representational Activities
100
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
0
%
A
B
C
Lawson
,
Dale
A Sergeant At Arms C
$0
$0
$0
$0
$0
I
Schedule 15
Representational Activities
100
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
0
%
A
B
C
Moore
,
Tommie
L Exec Board Mem C
$0
$0
$0
$0
$0
I
Schedule 15
Representational Activities
100
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
0
%
A
B
C
Moore
,
William
R Trustee C
$8,106
$597
$2,882
$0
$11,585
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
100
%
A
B
C
Payne
,
Mark
E President C
$6,752
$7,605
$6,626
$0
$20,983
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
100
%
A
B
C
Ropelewski
,
John
T Trustee C
$3,154
$447
$0
$0
$3,601
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
100
%
A
B
C
Taylor
,
Charles
E Retiree Chairman N
$0
$2,200
$0
$0
$2,200
I
Schedule 15
Representational Activities
100
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
0
%
A
B
C
Virden-Jr
,
Henry
Exec Board Mem C
$655
$26
$744
$0
$1,425
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
100
%
A
B
C
Wallace
,
Patrick
L Vice President C
$469
$459
$2,012
$0
$2,940
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
100
%
Total Officer
Disbursements
$127,074
$33,431
$15,940
$0
$176,445
Less Deductions
$56,325
Net
Disbursements
$120,120
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 -
DISBURSEMENTS TO EMPLOYEES
FILE NUMBER:
034-229
(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
Hora
,
William
M Custodian NA
$11,750
$0
$0
$0
$11,750
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
100
%
Schedule 19
Administration
0
%
A
B
C
Medina
,
Theresa
Office Manager NA
$72,533
$0
$0
$0
$72,533
I
Schedule 15
Representational Activities
31
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
69
%
A
B
C
Price
,
Cynthia
K Spec Assign'd B NA
$57,297
$0
$0
$0
$57,297
I
Schedule 15
Representational Activities
100
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
0
%
A
B
C
Szucs
,
Leslie
Custodian NA
$12,600
$0
$0
$0
$12,600
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
2
%
Schedule 18
General Overhead
98
%
Schedule 19
Administration
0
%
TOTALS RECEIVED
BY EMPLOYEES MAKING $10,000 OR LESS
$53,119
$6,022
$8,455
$0
$67,596
I
Schedule 15
Representational Activities
34
%
Schedule 16
Political Activities and Lobbying
1
%
Schedule 17
Contributions
1
%
Schedule 18
General Overhead
24
%
Schedule 19
Administration
40
%
Total
Employee Disbursements
$207,299
$6,022
$8,455
$0
$221,776
Less
Deductions
$58,033
Net Disbursements
$163,743
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 -
MEMBERSHIP STATUS
FILE NUMBER:
034-229
Category of Membership
(A)
Number
(B)
Voting Eligibility
(C)
Members
(Total of all lines above)
1,623
Agency Fee Payers*
Total Members/Fee Payers
1,623
*Agency Fee Payers are
not considered members of the labor organization.
Regular Members
1,623
Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE
- SCHEDULES 14 THROUGH 19
FILE NUMBER:
034-229
SCHEDULE 14 OTHER RECEIPTS
1. Named Payer
Itemized Receipts
$214,215
2. Named Payer
Non-itemized Receipts
$51,542
3. All Other Receipts
$13,659
4. Total
Receipts
$279,416
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
$928
5. All Other
Disbursements
$2,691
6. Total
Disbursements
$3,619
SCHEDULE 15 REPRESENTATIONAL
ACTIVITIES
1. Named Payee
Itemized Disbursements
$6,785
2. Named Payee
Non-itemized Disbursements
$24,457
3. To Officers
$15,223
4. To Employees
$102,765
5. All Other
Disbursements
$62,336
6. Total
Disbursements
$211,566
SCHEDULE 18 GENERAL OVERHEAD
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$1,036
4. To Employees
$40,321
5. All Other
Disbursements
$7,801
6. Total
Disbursements
$49,158
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
$676
5. All Other
Disbursements
$1,025
6. Total
Disbursements
$1,701
SCHEDULE 19 UNION
ADMINISTRATION
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$31,816
3. To Officers
$160,186
4. To Employees
$77,086
5. All Other
Disbursements
$62,267
6. Total
Disbursements
$331,355
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER
RECEIPTS
FILE NUMBER:
034-229
Name and Address
(A)
Ford Motor Company PO Box 1758
Dearborn MI 48121
Type or Classification
(B)
Automotive
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$16,712
Total
Non-Itemized Transactions with this Payee/Payer
$2,870
Total of All Transactions with this
Payee/Payer for This Schedule
$19,582
REIMB FROM FORD (NICKEL F
02/22/2016
$16,712
Name and Address
(A)
International Union Uaw P O Box 77000
Detroit MI 48277-1277
Type or Classification
(B)
Union
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$171,113
Total
Non-Itemized Transactions with this Payee/Payer
$600
Total of All Transactions with this
Payee/Payer for This Schedule
$171,713
PCT REBATE 11/2015
01/15/2016
$10,440
PCT REBATE 12/2015
03/07/2016
$29,026
PCT REBATE 01/2016
03/11/2016
$13,673
PCT REBATE 13TH CHECK; CH
04/18/2016
$19,150
PCT REBATE 02/2016
04/25/2016
$9,730
PCT REBATE 03/2016
05/13/2016
$25,663
PCT REBATE 04/2016
06/23/2016
$10,749
PCT REBATE 05/2016
07/18/2016
$10,543
PCT REBATE 06/2016
08/08/2016
$10,734
PCT REBATE 07/2016
09/14/2016
$13,268
PCT REBATE 08/2016
10/14/2016
$10,324
PCT REBATE 09/2016
11/21/2016
$7,813
Name and Address
(A)
Recreation Committee 17250 Hummel Rd
Brook Park OH 44142
Type or Classification
(B)
Union
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$6,255
Total
Non-Itemized Transactions with this Payee/Payer
$8,227
Total of All Transactions with this
Payee/Payer for This Schedule
$14,482
DONATION AND ENTRANCE FEE
05/10/2016
$6,255
Name and Address
(A)
Uaw-Ford National Programs P.O. Box 1758
Dearborn MI 48121
Type or Classification
(B)
Labor Organization
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$20,135
Total
Non-Itemized Transactions with this Payee/Payer
$39,845
Total of All Transactions with this
Payee/Payer for This Schedule
$59,980
REIMB FOR REG BENE REP C.
02/04/2016
$9,411
REIMB FOR REG BENE REP C.
06/06/2016
$5,228
REIMB FOR REG BENE REP C.
10/31/2016
$5,496
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 -
REPRESENTATIONAL ACTIVITIES
FILE NUMBER:
034-229
Name and Address
(A)
Blue Ribbon Catering 50 N Prospect St
Norwalk OH 44857
Type or Classification
(B)
Catering
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$8,633
Total of All Transactions with this
Payee/Payer for This Schedule
$8,633
Name and Address
(A)
Golf Incorporated 1316 Mudbrook Rd
Huron OH 44839
Type or Classification
(B)
Recreation
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$6,785
Total
Non-Itemized Transactions with this Payee/Payer
$0
Total of All Transactions with this
Payee/Payer for This Schedule
$6,785
JUNE 5 2016 UAW LOCAL 12
06/10/2016
$6,785
Name and Address
(A)
John Ropelewski 37236 Sugar Creek Lane
North Ridgeville OH 44039
Type or Classification
(B)
Recreation Events
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$0
Total
Non-Itemized Transactions with this Payee/Payer
$8,793
Total of All Transactions with this
Payee/Payer for This Schedule
$8,793
Name and Address
(A)
The Illuminating Company P O Box 3638
Akron OH 44309-3638
Type or Classification
(B)
Electric Distributor
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$0
Total
Non-Itemized Transactions with this Payee/Payer
$7,031
Total of All Transactions with this
Payee/Payer for This Schedule
$7,031
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 -
POLITICAL ACTIVITIES AND LOBBYING
FILE NUMBER
034-229
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:
034-229
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:
034-229
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 19 - UNION
ADMINISTRATION
FILE NUMBER:
034-229
Name and Address
(A)
Blue Ribbon Catering 50 N Prospect St
Norwalk OH 44857
Type or Classification
(B)
Catering
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$8,755
Total of All Transactions with this
Payee/Payer for This Schedule
$8,755
Name and Address
(A)
Jason Vessey 1204 Sprowl Rd
Huron OH 44839
Type or Classification
(B)
Contractor
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$0
Total
Non-Itemized Transactions with this Payee/Payer
$5,704
Total of All Transactions with this
Payee/Payer for This Schedule
$5,704
Name and Address
(A)
Roberts Custom Software 3667 1st Street
East Moline IL 61244
Type or Classification
(B)
Software Provider
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$0
Total
Non-Itemized Transactions with this Payee/Payer
$6,543
Total of All Transactions with this
Payee/Payer for This Schedule
$6,543
Name and Address
(A)
The Illuminating Company P O Box 3638
Akron OH 44309-3638
Type or Classification
(B)
Electric Distributor
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$0
Total
Non-Itemized Transactions with this Payee/Payer
$10,814
Total of All Transactions with this
Payee/Payer for This Schedule
$10,814
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 20 -
BENEFITS
FILE NUMBER:
034-229
Description
(A)
To Whom Paid
(B)
Amount
(C)
Total of all
lines above (Total will be automatically entered in Item
55.)
$34,123
Dental/Hearing/Medical/Vision Insurance
Cose/Medical Mutual Health Program
$11,862
Dental/Hearing/Medical/Vision Insurance
Diane Andrasak
$6,074
Dental/Hearing/Medical/Vision Insurance
Health Benefit Fund 1794
$3,076
Dental/Hearing/Medical/Vision Insurance
Theresa Medina
$3,513
Workers Compension Insurance
Minute Men Hr Management Services
$126
Workers Compension Insurance
Ohio Bureau Of Workers Compensation
$606
Pension Allocations
National Integrated Group Pension Plan
$6,366
Retirement Savings(401K etc)Employer
Capital One Investing Llc
$2,500
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL
INFORMATION SUMMARY
FILE NUMBER:
034-229
Question 10: Operations of the Building Corporation are handled through the books of the Local Union and are therefore, included in this report.
Question 11(b): Operations of the Building Corporation are handled through the books of the Local Union are are therefore, included in this report.
Question 15: The Local disposed of and antiquated telephone system at a $0 dollar value.
Statement A,
Cash Begin Total: Beginning balance adjusted by $36 for voided checks that were issued in a previous year.
Schedule 8, Row2:
Schedule 8, Row2::
Schedule 8, Row1:
Schedule 8, Row1::
Schedule 13, Row1:
Schedule 13, Row1:Anyone who has applied and been accepted for membership is a regular member. Regular members pay full dues.