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
514-445
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
2300
7. UNIT NAME (if any)

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

Number and Street
840 HANSHAW RD., SUITE 5
City
ITHACA
State
NY
ZIP Code + 4
148501589


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:Jason D DavidPRESIDENT71. SIGNED:Ronda L ParkTREASURER
Date:Mar 28, 2017Telephone Number:607-342-5745Date:Mar 28, 2017Telephone Number:607-272-4108
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21 FILE NUMBER: 514-445
10. During the reporting period did the labor organization create or participate in the administration of a trust or a fund or organization, as defined in the instructions, which provides benefits for members or beneficiaries?No
11(a). During the reporting period did the labor organization have a political action committee (PAC) fund?No
11(b). During the reporting period did the labor organization have a subsidiary organization as defined in Section X of these Instructions?No
12. During the reporting period did the labor organization have an audit or review of its books and records by an outside accountant or by a parent body auditor/representative?No
13. During the reporting period did the labor organization discover any loss or shortage of funds or other assets? (Answer "Yes" even if there has been repayment or recovery.)No
14. What is the maximum amount recoverable under the labor organization's fidelity bond for a loss caused by any officer, employee or agent of the labor organization who handled union funds?$128,000
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?05/2020
20. How many members did the labor organization have at the end of the reporting period?1,193
21. What are the labor organization's rates of dues and fees?
Rates of Dues and Fees
Dues/FeesAmount UnitMinimumMaximum
(a) Regular Dues/Fees2.5permonth24.0050.00
(b) Working Dues/Fees0per
(c) Initiation Fees10perone-time
(d) Transfer Fees0per
(e) Work Permits0per

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS AND LIABILITIES FILE NUMBER: 514-445

ASSETS
ASSETS Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
22. Cash $590,165$559,315
23. Accounts Receivable1$0$0
24. Loans Receivable2$0
25. U.S. Treasury Securities $0$0
26. Investments5$0$0
27. Fixed Assets6$19,097$19,097
28. Other Assets7$0
29. TOTAL ASSETS $609,262$578,412

LIABILITIES
LIABILITIES Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
30. Accounts Payable8$31,057$30,174
31. Loans Payable9$0$0
32. Mortgages Payable $0$0
33. Other Liabilities10$6,797$4,891
34. TOTAL LIABILITIES $37,854$35,065
35. NET ASSETS$571,408$543,347
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B - RECEIPTS AND DISBURSEMENTS FILE NUMBER: 514-445

CASH RECEIPTSSCHAMOUNT
36. Dues and Agency Fees $649,597
37. Per Capita Tax $0
38. Fees, Fines, Assessments, Work Permits $840
39. Sale of Supplies $10
40. Interest $3,291
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 $0
48. Other Receipts14$26,037
49. TOTAL RECEIPTS $679,775
CASH DISBURSEMENTSSCHAMOUNT
50. Representational Activities15$151,412
51. Political Activities and Lobbying16$2,703
52. Contributions, Gifts, and Grants17$14,788
53. General Overhead18$1,309
54. Union Administration19$114,066
55. Benefits20$18,730
56. Per Capita Tax $380,232
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$0
62. Repayment of Loans Obtained9$0
63. To Affiliates of Funds Collected on Their Behalf $0
64. On Behalf of Individual Members $0
65. Direct Taxes $16,635
  
66. Subtotal $699,875
67. Withholding Taxes and Payroll Deductions  
  67a. Total Withheld$31,481  
  67b. Less Total Disbursed$42,231  
  67c. Total Withheld But Not Disbursed -$10,750
68. TOTAL DISBURSEMENTS $710,625
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE FILE NUMBER: 514-445

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: 514-445

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: 514-445

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: 514-445

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: 514-445

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: 514-445

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$19,097$19,097$19,097
E. Other Fixed Assets
F. Totals of Lines A through E (Column(D) Total will be automatically entered in Item 27, Column(B)) $19,097$0$19,097$19,097
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER ASSETS FILE NUMBER: 514-445

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: 514-445

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$30,174$0$0$0
Totals (Total for Column(B) will be automatically entered in Item 30, Column(D)) $30,174$0$0$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 9 - LOANS PAYABLE FILE NUMBER: 514-445

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: 514-445

Description
(A)
Amount at End of Period
(B)
Total Other Liabilities (Total will be automatically entered in Item 33, Column(D)) $4,891
Fed. 941$2,997
State income Tax$1,599
Federal umemployment$290
State umemployment$5
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS FILE NUMBER: 514-445

(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
Brotherton ,  Thomas  
Trustee
P
$0$0$75$0$75
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
Chupp ,  Steve  
Recording Secretary
C
$1,666$0$600$0$2,266
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
Collins ,  Keith  
trustee
N
$0$0$450$0$450
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
David ,  Jason  
President
N
$118$360$5,012$0$5,490
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
Finch ,  Lesley  
SECOND VICE PRES
C
$0$0$1,070$0$1,070
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
Howells ,  Frank  
Guide
P
$2,903$0$674$0$3,577
I
Schedule 15
Representational Activities
73 % Schedule 16
Political Activities and Lobbying
0 % Schedule 17
Contributions
0 % Schedule 18
General Overhead
0 % Schedule 19
Administration
27 %
A
B
C
Hulslander ,  Lois  
1st vice president
N
$3,182$0$1,322$0$4,504
I
Schedule 15
Representational Activities
56 % Schedule 16
Political Activities and Lobbying
44 % Schedule 17
Contributions
0 % Schedule 18
General Overhead
0 % Schedule 19
Administration
0 %
A
B
C
Johnson ,  Christine  
guide
N
$37,555$0$2,241$0$39,796
I
Schedule 15
Representational Activities
35 % Schedule 16
Political Activities and Lobbying
0 % Schedule 17
Contributions
0 % Schedule 18
General Overhead
0 % Schedule 19
Administration
65 %
A
B
C
Moss ,  Edgar  
Trustee
C
$0$0$457$0$457
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
Park ,  Ronda   L
Finacial Secretary
C
$43,433$0$2,139$0$45,572
I
Schedule 15
Representational Activities
44 % Schedule 16
Political Activities and Lobbying
0 % Schedule 17
Contributions
0 % Schedule 18
General Overhead
1 % Schedule 19
Administration
55 %
A
B
C
Park ,  Tim  
Sgt-At-Arms
C
$175$0$300$0$475
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
Sharpe ,  Terry   A
President
P
$160$0$902$0$1,062
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
Valentino ,  Catherine  
Trustee
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 %
Total Officer Disbursements$89,192$360$15,242$0$104,794
Less Deductions    $26,568
Net Disbursements    $78,226
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES FILE NUMBER: 514-445

(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
Lockwood ,  D   J
NA
NA
$16,055$0$65$0$16,120
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$11,119$0$3,124$0$14,243
I Schedule 15
Representational Activities
71 % Schedule 16
Political Activities and Lobbying
0 % Schedule 17
Contributions
0 % Schedule 18
General Overhead
0 % Schedule 19
Administration
29 %
Total Employee Disbursements$27,174$0$3,189$0$30,363
Less Deductions    $4,915
Net Disbursements    $25,448
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 - MEMBERSHIP STATUS FILE NUMBER: 514-445

Category of Membership
(A)
Number
(B)
Voting Eligibility
(C)
Members (Total of all lines above) 1,193 
Agency Fee Payers*0
Total Members/Fee Payers1,193 
*Agency Fee Payers are not considered members of the labor organization.
Regular Members1,193Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19 FILE NUMBER: 514-445

SCHEDULE 14   OTHER RECEIPTS
1. Named Payer Itemized Receipts$9,945
2. Named Payer Non-itemized Receipts$6,429
3. All Other Receipts$9,663
4. Total Receipts$26,037
     
     
SCHEDULE 17   CONTRIBUTIONS, GIFTS & GRANTS
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$9,829
3. To Officers$0
4. To Employees$0
5. All Other Disbursements$4,959
6. Total Disbursements$14,788
SCHEDULE 15   REPRESENTATIONAL ACTIVITIES
1. Named Payee Itemized Disbursements$6,803
2. Named Payee Non-itemized Disbursements$46,073
3. To Officers$50,459
4. To Employees$10,113
5. All Other Disbursements$37,964
6. Total Disbursements$151,412
SCHEDULE 18   GENERAL OVERHEAD
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$456
4. To Employees$0
5. All Other Disbursements$853
6. Total Disbursements$1,309
SCHEDULE 16   POLITICAL ACTIVITIES AND LOBBYING
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$1,982
4. To Employees$0
5. All Other Disbursements$721
6. Total Disbursements$2,703
SCHEDULE 19   UNION ADMINISTRATION
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$22,814
3. To Officers$51,898
4. To Employees$20,250
5. All Other Disbursements$19,104
6. Total Disbursements$114,066
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER RECEIPTS FILE NUMBER: 514-445

Name and Address
(A)
Cornell University
395 Pine Tree Rd

Ithaca
NY
14850
Type or Classification
(B)
Educational Institution
Purpose
(C)
Date
(D)
Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$5,910
Total of All Transactions with this Payee/Payer for This Schedule$5,910
Name and Address
(A)
International Union Uaw
PO Box 77000

Detroit
MI
48277-1277
Type or Classification
(B)
Labor Organization
Purpose
(C)
Date
(D)
Amount
(E)
Total Itemized Transactions with this Payee/Payer$9,945
Total Non-Itemized Transactions with this Payee/Payer$519
Total of All Transactions with this Payee/Payer for This Schedule$10,464
Strike Rebate04/20/2016$9,945
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 - REPRESENTATIONAL ACTIVITIES FILE NUMBER: 514-445

Name and Address
(A)
James N. Mccauley
701 W. State St.

Ithaca
NY
14850
Type or Classification
(B)
Legal Services
Purpose
(C)
Date
(D)
Amount
(E)
Total Itemized Transactions with this Payee/Payer$6,803
Total Non-Itemized Transactions with this Payee/Payer$11,192
Total of All Transactions with this Payee/Payer for This Schedule$17,995
ARBRATRAION JON LONG05/17/2016$6,803
Name and Address
(A)
Kinaneco Printing Systems
2925 Milton Ave.

Syracuse
NY
13209-2519
Type or Classification
(B)
Print Local's Newspapers
Purpose
(C)
Date
(D)
Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$12,433
Total of All Transactions with this Payee/Payer for This Schedule$12,433
Name and Address
(A)
Tomkins Visa Cathy
PO BOX 790408

Saint Louis
MO
63179
Type or Classification
(B)
Credit Card
Purpose
(C)
Date
(D)
Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$5,337
Total of All Transactions with this Payee/Payer for This Schedule$5,337
Name and Address
(A)
Village Green
840 Hanshaw Rd

Ithaca
NY
14850
Type or Classification
(B)
Landlord
Purpose
(C)
Date
(D)
Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$17,111
Total of All Transactions with this Payee/Payer for This Schedule$17,111
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 - POLITICAL ACTIVITIES AND LOBBYING FILE NUMBER 514-445

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: 514-445

Name and Address
(A)
Robins Fund
310 FIRST STREET

Ithaca
NY
14850
Type or Classification
(B)
DONATIONS
Purpose
(C)
Date
(D)
Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$9,829
Total of All Transactions with this Payee/Payer for This Schedule$9,829
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 18 - GENERAL OVERHEAD FILE NUMBER: 514-445

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: 514-445

Name and Address
(A)
Village Green
840 Hanshaw Rd

Ithaca
NY
14850
Type or Classification
(B)
Landlord
Purpose
(C)
Date
(D)
Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$22,814
Total of All Transactions with this Payee/Payer for This Schedule$22,814
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 20 - BENEFITS FILE NUMBER: 514-445

Description
(A)
To Whom Paid
(B)
Amount
(C)
Total of all lines above (Total will be automatically entered in Item 55.)$18,730
Dental/Hearing/Medical/Vision InsuranceCornell University$17,486
Disability/Sick & Accident InsuranceNysif Disability Benifits$531
Workers Compensation InsuranceNysif Disability Benifits$437
Workers Compensation InsuranceThe State Insurance Fund$276
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL INFORMATION SUMMARY FILE NUMBER: 514-445


Schedule 13, Row1:

Schedule 13, Row1:::::

Schedule 13, Row1:

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