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
542-249
2. PERIOD COVERED
From01/01/2016
Through12/31/2016
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
4911
7. UNIT NAME (if any)

8. MAILING ADDRESS (Type or print in capital letters)
First Name
ROSE
 Last Name
VAN SCHOICK
P.O Box - Building and Room Number

Number and Street
1010 River Street
City
LANSING
State
MI		 ZIP Code + 4
489121030


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:Derrick C McDuffeyPRESIDENT71. SIGNED:Rose M Van SchoickTREASURER
Date:Mar 27, 2017Telephone Number:517-719-6512Date:Mar 27, 2017Telephone Number:517-372-7201
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21 FILE NUMBER: 542-249
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?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.)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?$166,000
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?06/2019
20. How many members did the labor organization have at the end of the reporting period?1,947
21. What are the labor organization's rates of dues and fees?
Rates of Dues and Fees
Dues/FeesAmount UnitMinimumMaximum
(a) Regular Dues/FeesTwo and a half hours of straight time pay per monthperper month2.5 hours2.5 hours
(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: 542-249

ASSETS
ASSETS Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
22. Cash $630,801$616,157
23. Accounts Receivable1$0
24. Loans Receivable2$0$0
25. U.S. Treasury Securities $0$0
26. Investments5$0
27. Fixed Assets6$15,958$10,326
28. Other Assets7$3,518$4,770
29. TOTAL ASSETS $650,277$631,253

LIABILITIES
LIABILITIES Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
30. Accounts Payable8$55,936$54,295
31. Loans Payable9$0$0
32. Mortgages Payable $0$0
33. Other Liabilities10$1,712$1,294
34. TOTAL LIABILITIES $57,648$55,589
35. NET ASSETS$592,629$575,664
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B - RECEIPTS AND DISBURSEMENTS FILE NUMBER: 542-249

CASH RECEIPTSSCHAMOUNT
36. Dues and Agency Fees $997,717
37. Per Capita Tax $0
38. Fees, Fines, Assessments, Work Permits $5,460
39. Sale of Supplies $60
40. Interest $2,901
41. Dividends $0
42. Rents $0
43. Sale of Investments and Fixed Assets3$0
44. Loans Obtained9$0
45. Repayments of Loans Made2$0
46. On Behalf of Affiliates for Transmittal to Them $0
47. From Members for Disbursement on Their Behalf $275
48. Other Receipts14$19,609
49. TOTAL RECEIPTS $1,026,022
CASH DISBURSEMENTSSCHAMOUNT
50. Representational Activities15$131,092
51. Political Activities and Lobbying16$1,562
52. Contributions, Gifts, and Grants17$39,768
53. General Overhead18$14,414
54. Union Administration19$128,576
55. Benefits20$54,996
56. Per Capita Tax $651,325
57. Strike Benefits $0
58. Fees, Fines, Assessments, etc. $0
59. Supplies for Resale $1,500
60. Purchase of Investments and Fixed Assets4$742
61. Loans Made2$0
62. Repayment of Loans Obtained9$0
63. To Affiliates of Funds Collected on Their Behalf $0
64. On Behalf of Individual Members $275
65. Direct Taxes $15,903
  
66. Subtotal $1,040,153
67. Withholding Taxes and Payroll Deductions  
  67a. Total Withheld$52,141  
  67b. Less Total Disbursed$52,654  
  67c. Total Withheld But Not Disbursed -$513
68. TOTAL DISBURSEMENTS $1,040,666
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE FILE NUMBER: 542-249

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: 542-249

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: 542-249

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: 542-249

Description (if land or buildings, give location)
(A) 		Cost
(B) 		Book Value
(C) 		Cash Paid
(D)
Total of all lines above$742$742$742
1 Lanova Yoga laptop$742$742$742
 Less Reinvestments$0
(The total from Net Purchases Line will be automatically entered in Item 60.)Net Purchases$742
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 - INVESTMENTS FILE NUMBER: 542-249

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: 542-249

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$10,326$0$10,326$10,326
E. Other Fixed Assets
F. Totals of Lines A through E (Column(D) Total will be automatically entered in Item 27, Column(B)) $10,326$0$10,326$10,326
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER ASSETS FILE NUMBER: 542-249

Description
(A) 		Book Value
(B)
Total (Total will be automatically entered in Item 28, Column(B)) $4,770
Bibles$810
UAW Local 4911 Solidarity Bookcases$2,520
UAW Local 4911 T-Shirts$1,440
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS PAYABLE AGING SCHEDULE FILE NUMBER: 542-249

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$54,295$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)) $54,295$0$0$0
UAW International$49,824$0$0$0
MI CAP Council$1,001$0$0$0
UAW Region 1-D CAP$1,468$0$0$0
Lansing Labor News$2,002$0$0$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 9 - LOANS PAYABLE FILE NUMBER: 542-249

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: 542-249

Description
(A) 		Amount at End of Period
(B)
Total Other Liabilities (Total will be automatically entered in Item 33, Column(D)) $1,294
State of Michigan$487
SUTA$150
FUTA$364
City of Lansing$293
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS FILE NUMBER: 542-249

(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 		BRAMER ,  RAYMOND  
GUIDE
C		$0$0$0$0$0
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 		NORCROSS ,  JANE   E
UNIT CHAIR
C		$0$0$0$0$0
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 		SLIVENSKY ,  ERICH  
RECORDING SECRETARY
P		$0$975$0$0$975
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 		NEAR ,  DAVID  
UNIT CHAIR
N		$1,661$975$0$0$2,636
I
Schedule 15
Representational Activities 		99 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		MUELLER ,  JERRY  
SGT AT ARMS
C		$0$0$0$0$0
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 		JONES ,  STEPHANIE  
TRUSTEE
N		$795$0$516$0$1,311
I
Schedule 15
Representational Activities 		94 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		6 %
A
B
C 		HAZEL ,  NATALIE  
TRUSTEE
P		$133$0$0$0$133
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 		MCDUFFEY ,  DERRICK  
PRESIDENT
N		$21,833$0$643$0$22,476
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 		SLONE ,  WILBERT  
VICE PRESIDENT
C		$1,868$0$239$0$2,107
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 		ERWAY ,  TRISHA  
RECORDING SECRETARY
P		$1,294$975$81$0$2,350
I
Schedule 15
Representational Activities 		78 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		22 %
A
B
C 		FENBY ,  GERALD  
UNIT CHAIR
C		$1,039$0$469$0$1,508
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		QAWWEE ,  MUHAMMAD  
UNIT CHAIR
C		$1,856$1,950$1,091$0$4,897
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		VANSCHOICK ,  ROSE  
FINANCIAL SECRETARY
C		$76,219$0$997$0$77,216
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		99 %
A
B
C 		DOUGLAS ,  JOSEPH  
PRESIDENT
P		$35,536$0$1,434$0$36,970
I
Schedule 15
Representational Activities 		96 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		4 %
A
B
C 		ALDRICH ,  DEBRA  
UNIT CHAIR
P		$2,285$975$1,102$0$4,362
I
Schedule 15
Representational Activities 		96 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		4 %
A
B
C 		SIAD ,  KYMBERLYNN  
TRUSTEE
C		$1,296$0$225$0$1,521
I
Schedule 15
Representational Activities 		7 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		91 %
A
B
C 		KREFT ,  MICHELINA  
TRUSTEE
C		$833$0$7$0$840
I
Schedule 15
Representational Activities 		47 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		53 %
Total Officer Disbursements$146,648$5,850$6,804$0$159,302
Less Deductions    $44,004
Net Disbursements    $115,298
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES FILE NUMBER: 542-249

(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 		STENSKE ,  SANDRA   F
BOOKKEEPER
none		$24,206$0$387$0$24,593
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 %
TOTALS RECEIVED BY EMPLOYEES MAKING $10,000 OR LESS$13,786$0$3,091$0$16,877
I Schedule 15
Representational Activities 		74 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		5 % Schedule 19
Administration 		21 %
Total Employee Disbursements$37,992$0$3,478$0$41,470
Less Deductions    $8,137
Net Disbursements    $33,333
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 - MEMBERSHIP STATUS FILE NUMBER: 542-249

Category of Membership
(A) 		Number
(B) 		Voting Eligibility
(C)
Members (Total of all lines above) 1,947 
Agency Fee Payers*
Total Members/Fee Payers1,947 
*Agency Fee Payers are not considered members of the labor organization.
Regular Members1,947Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19 FILE NUMBER: 542-249

SCHEDULE 14   OTHER RECEIPTS
1. Named Payer Itemized Receipts$16,401
2. Named Payer Non-itemized Receipts$0
3. All Other Receipts$3,208
4. Total Receipts$19,609
     
     
SCHEDULE 17   CONTRIBUTIONS, GIFTS & GRANTS
1. Named Payee Itemized Disbursements$17,000
2. Named Payee Non-itemized Disbursements$3,000
3. To Officers$0
4. To Employees$0
5. All Other Disbursements$19,768
6. Total Disbursements$39,768
SCHEDULE 15   REPRESENTATIONAL ACTIVITIES
1. Named Payee Itemized Disbursements$5,500
2. Named Payee Non-itemized Disbursements$11,915
3. To Officers$76,715
4. To Employees$12,489
5. All Other Disbursements$24,473
6. Total Disbursements$131,092
SCHEDULE 18   GENERAL OVERHEAD
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$12,000
3. To Officers$0
4. To Employees$844
5. All Other Disbursements$1,570
6. Total Disbursements$14,414
SCHEDULE 16   POLITICAL ACTIVITIES AND LOBBYING
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$956
4. To Employees$0
5. All Other Disbursements$606
6. Total Disbursements$1,562
SCHEDULE 19   UNION ADMINISTRATION
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$81,630
4. To Employees$28,137
5. All Other Disbursements$18,809
6. Total Disbursements$128,576
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER RECEIPTS FILE NUMBER: 542-249

Name and Address
(A)
UAW INTERNATIONAL

8000 S JEFFERSON AVE
DETROIT
MI
Type or Classification
(B)
LABOR ORGANIZATION
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$16,401
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$16,401
13TH REBATE CHECK04/25/2016$16,401
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 - REPRESENTATIONAL ACTIVITIES FILE NUMBER: 542-249

Name and Address
(A)
DEAN TRAILWAYS OF MICHIGAN

4726 AURELIUS ROAD
LANSING
MI
48910
Type or Classification
(B)
TRANSPORTATION
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$5,805
Total of All Transactions with this Payee/Payer for This Schedule$5,805
Name and Address
(A)
DETROIT TIGERS INC.
2100 WOODWARD AVENUE
ATTN: GROUP SALES
DETROIT
MI
48201
Type or Classification
(B)
BASEBALL TEAM
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$5,410
Total of All Transactions with this Payee/Payer for This Schedule$5,410
Name and Address
(A)
UAW REGION 1-D

1940 W ATHERTON ROAD
FLINT
MI
48507
Type or Classification
(B)
MEETINGS/CONFERENCE
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,500
Total Non-Itemized Transactions with this Payee/Payer$700
Total of All Transactions with this Payee/Payer for This Schedule$6,200
REGISTRATION FOR 10 FALL07/15/2016$5,500
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 - POLITICAL ACTIVITIES AND LOBBYING FILE NUMBER 542-249

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: 542-249

Name and Address
(A)
CARE FOR THE CAREGIVERS

1215 EAST MICHIGAN AVENUE
LANSING
MI
48912
Type or Classification
(B)
DONATION
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$12,000
Total Non-Itemized Transactions with this Payee/Payer$3,000
Total of All Transactions with this Payee/Payer for This Schedule$15,000
SEMI ANNUAL DONATION TO05/11/2016$6,000
SEMI ANNUAL DONATION10/26/2016$6,000
Name and Address
(A)
SPARROW FOUNDATION
PO BOX 30480
1110 E MICHIGAN AVE
LANSING
MI
48909
Type or Classification
(B)
FUND RAISING
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,000
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$5,000
$5 000 BRICK FOR THE CANCER CENTER09/28/2016$5,000
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 18 - GENERAL OVERHEAD FILE NUMBER: 542-249

Name and Address
(A)
INTERNATIONAL UNION-UAW

8000 EAST JEFFERSON AVE
DETROIT
MI
48214-3963
Type or Classification
(B)
Labor Organization
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$12,000
Total of All Transactions with this Payee/Payer for This Schedule$12,000
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 19 - UNION ADMINISTRATION FILE NUMBER: 542-249

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: 542-249

Description
(A) 		To Whom Paid
(B) 		Amount
(C)
Total of all lines above (Total will be automatically entered in Item 55.)$54,996
MEDICAL BENEFITSSPARROW HUMAN RESOURCES$46,364
WORK COMP INSURANCE CARRIERACCIDENT FUND$1,529
EMPLOYEE INSURANCESRELIANCE STANDARD LIFE INS CO$5,290
INSURANCEMI AFL CIO$1,250
DENTAL INSURANCEDELTA DENTAL$563
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL INFORMATION SUMMARY FILE NUMBER: 542-249


Question 10: Voluntary Employee Benefit Association (VEBA) is a retiree medical plan which UAW Local 4911 members contribute to via payroll deduction through Sparrow Hospital. The Trust is administered by Richard Lichtenstein c/o Benefits Administrative Services Company.

Question 12: UAW International Auditor, Audit of books from May 21, 2012 through June 30, 2016 by Manuel Romero.

Question 15: A Bible is given to UAW members if they have an immediate family member that dies. A UAW Local 4911 tote bag is given to new members at a membership meeting if they attend the welcoming session. Disposed by scrapping/recycling $5,632 of old obsolete office equipment: 2001 Minolta stand-alone printer; HP laser printers; 2009 Nobilis laptop and donated 2 flagpoles with flags.

Statement A,

Accounts Receivable Begin Total: clicked on in error

Schedule 13, Row1:Scheule 13: Anyone who has applied and been accepted for membership is a regular member. Regular members pay full dues.

General Information:

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