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
007-381
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
TEAMSTERS
5. DESIGNATION (Local, Lodge, etc.)
JOINT COUNCIL
6. DESIGNATION NBR
41
7. UNIT NAME (if any)
8. MAILING ADDRESS (Type or print in capital
letters)
First Name
PATRICK J.
Last Name
DARROW
P.O Box - Building and Room Number
Number and Street
6051 CAREY DRIVE
City
VALLEY VIEW
State
OH
ZIP Code + 4
44125
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:
Patrick J Darrow
PRESIDENT
71. SIGNED:
Travis W Bornstein
TREASURER
Date:
Mar 29, 2017
Telephone
Number:
330-434-3424
Date:
Mar 28, 2017
Telephone
Number:
330-434-8126
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21
FILE NUMBER:
007-381
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?
$225,000
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?
Yes
19. What is the date of the labor
organization's next regular election of officers?
12/2018
20. How many members did the labor organization
have at the end of the reporting period?
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
1.30
per
MBR/MNTH
N/A
N/A
(b) Working Dues/Fees
per
(c) Initiation Fees
per
(d) Transfer Fees
per
(e) Work Permits
per
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS
AND LIABILITIES
FILE NUMBER:
007-381
ASSETS
ASSETS
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
22. Cash
$166,045
$276,977
23. Accounts Receivable
1
$0
$0
24. Loans Receivable
2
$0
$0
25. U.S. Treasury
Securities
$0
$0
26. Investments
5
$218,449
$245,215
27. Fixed Assets
6
$375
$1,481
28. Other Assets
7
$145
$145
29.
TOTAL ASSETS
$385,014
$523,818
LIABILITIES
LIABILITIES
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
30. Accounts Payable
8
$0
$0
31. Loans Payable
9
$0
32. Mortgages Payable
$0
$0
33. Other Liabilities
10
$177,416
$168,888
34. TOTAL
LIABILITIES
$177,416
$168,888
35. NET
ASSETS
$207,598
$354,930
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B -
RECEIPTS AND DISBURSEMENTS
FILE NUMBER:
007-381
CASH
RECEIPTS
SCH
AMOUNT
36. Dues and Agency Fees
$0
37. Per Capita Tax
$672,561
38. Fees, Fines,
Assessments, Work Permits
$0
39. Sale of Supplies
$0
40. Interest
$1,933
41. Dividends
$3,634
42. Rents
$0
43. Sale of Investments
and Fixed Assets
3
$25,253
44. Loans Obtained
9
45. Repayments of Loans
Made
2
$0
46. On Behalf of
Affiliates for Transmittal to Them
$0
47. From Members for
Disbursement on Their Behalf
$6,804
48. Other Receipts
14
$27,703
49. TOTAL RECEIPTS
$737,888
CASH DISBURSEMENTS
SCH
AMOUNT
50.
Representational Activities
15
$43,632
51.
Political Activities and Lobbying
16
$450
52.
Contributions, Gifts, and Grants
17
$60,433
53. General
Overhead
18
$98,475
54. Union
Administration
19
$141,464
55. Benefits
20
$206,442
56. Per
Capita Tax
$0
57. Strike
Benefits
$0
58. Fees,
Fines, Assessments, etc.
$0
59. Supplies
for Resale
$0
60. Purchase
of Investments and Fixed Assets
4
$54,209
61. Loans
Made
2
$0
62.
Repayment of Loans Obtained
9
63. To
Affiliates of Funds Collected on Their Behalf
$0
64. On
Behalf of Individual Members
$6,804
65. Direct
Taxes
$15,047
66. Subtotal
$626,956
67.
Withholding Taxes and Payroll Deductions
67a. Total
Withheld
$42,380
67b. Less Total
Disbursed
$42,380
67c.
Total Withheld But Not Disbursed
68.
TOTAL DISBURSEMENTS
$626,956
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS
RECEIVABLE AGING SCHEDULE
FILE NUMBER:
007-381
Entity or Individual Name
(A)
Total Account Receivable
(B)
90-180 Days
Past Due
(C)
180+ Days
Past Due
(D)
Liquidated Account
Receivable
(E)
Total of all itemized
accounts receivable
$0
$0
$0
$0
Totals from all other
accounts receivable
$0
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:
007-381
List below loans to officers, employees, or members which
at any time during the reporting period exceeded $250 and
list all loans to business enterprises regardless of amount.
(A)
Loans
Outstanding at
Start of Period
(B)
Loans Made
During Period
(C)
Repayments Received During Period
Cash
(D)(1)
Other Than Cash
(D)(2)
Loans
Outstanding at
End of Period
(E)
Total of loans not
listed above
$0
$0
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:
007-381
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
$25,862
$25,862
$25,253
$25,253
INVESTMENTS
$25,862
$25,862
$25,253
$25,253
Less Reinvestments
$0
(The
total from Net Sales Line will be automatically entered
in Item 43)
Net Sales
$25,253
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 4 - PURCHASE
OF INVESTMENTS AND FIXED ASSETS
FILE NUMBER:
007-381
Description (if land or buildings, give location)
(A)
Cost
(B)
Book Value
(C)
Cash Paid
(D)
Total
of all lines above
$54,209
$54,209
$54,209
INVESTMENTS
$52,628
$52,628
$52,628
OFFICE EQUIPMENT
$1,581
$1,581
$1,581
Less Reinvestments
$0
(The
total from Net Purchases Line will be automatically
entered in Item 60.)
Net Purchases
$54,209
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 -
INVESTMENTS
FILE NUMBER:
007-381
Description
(A)
Amount
(B)
Marketable Securities
A. Total Cost
$245,215
B. Total Book Value
$245,215
C. List each
marketable security which has a book value over $5,000
and exceeds 5% of Line B.
25,000 UNITS, FEDERAL HOME LOAN BANK
$25,038
25,000 UNITS, FANNIE MAE
$24,996
25,000 UNITS, UNITED STATES TREASURY NOTES
$24,751
25,000 UNITS, UNITED STATES TREASURY NOTES
$24,941
25,000 UNITS, UNITED STATES TREASURY NOTES
$25,117
25,000 UNITS, UNITED STATES TREASURY NOTES
$25,283
25.000 UNITS, UNITED STATES TREASURY NOTES
$25,187
1,382 UNITS, MFS VALUE FUND CLASS I
$26,076
865.56 UNITS, T. ROWE PRICE GROWTH STOCK FUND
$30,525
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))
$245,215
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 6 - FIXED
ASSETS
FILE NUMBER:
007-381
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
$17,014
$15,533
$1,481
$1,400
E.
Other Fixed Assets
F. Totals of Lines A through E
(Column(D) Total will be automatically entered in Item
27, Column(B))
$17,014
$15,533
$1,481
$1,400
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER
ASSETS
FILE NUMBER:
007-381
Description
(A)
Book Value
(B)
Total
(Total will be automatically entered in Item 28, Column(B))
$145
DEPOSIT - WORKERS COMPENSATION
$145
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS
PAYABLE AGING SCHEDULE
FILE NUMBER:
007-381
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:
007-381
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:
007-381
Description
(A)
Amount at End of Period
(B)
Total Other Liabilities
(Total will be automatically entered in Item 33, Column(D))
$168,888
WITHDRAWAL LIABILITY
$168,888
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL
OFFICERS AND DISBURSEMENTS TO OFFICERS
FILE NUMBER:
007-381
(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
DARROW
,
PATRICK
J PRESIDENT C
$30,000
$97
$30,097
I
Schedule 15
Representational Activities
5
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
5
%
Schedule 19
Administration
90
%
A
B
C
BORNSTEIN
,
TRAVIS
SECRETARY-TREASURER C
$15,600
$15,600
I
Schedule 15
Representational Activities
5
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
5
%
Schedule 19
Administration
90
%
A
B
C
DUDAS
,
DAVID
D VICE PRESIDENT C
$15,600
$15,600
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
NARDI
,
NICHOLAS
RECORDING SECRETARY C
$10,400
$13
$10,413
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
3
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
97
%
A
B
C
BAIRD
,
DOYLE
TRUSTEE C
$6,000
$13
$6,013
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
PECORARO
,
CARL
TRUSTEE C
$6,000
$6,000
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
COLLINSON
,
RICHARD
TRUSTEE N
$2,750
$2,750
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
5
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
95
%
A
B
C
LICHTENWALD
,
WILLIAM
D VICE PRESIDENT P
$7,800
$24
$7,824
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
$94,150
$0
$147
$0
$94,297
Less Deductions
$19,041
Net
Disbursements
$75,256
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 -
DISBURSEMENTS TO EMPLOYEES
FILE NUMBER:
007-381
(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
ZART
,
MARY
ADMINISTRATIVE N/A
$24,800
$606
$25,406
I
Schedule 15
Representational Activities
5
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
85
%
Schedule 19
Administration
10
%
A
B
C
BEDNARSKI
,
PAMELA
ADMINISTRATIVE N/A
$11,750
$11,750
I
Schedule 15
Representational Activities
5
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
85
%
Schedule 19
Administration
10
%
TOTALS RECEIVED
BY EMPLOYEES MAKING $10,000 OR LESS
$24,210
$24,210
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
13
%
Schedule 19
Administration
87
%
Total
Employee Disbursements
$60,760
$0
$606
$0
$61,366
Less
Deductions
$23,339
Net Disbursements
$38,027
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 -
MEMBERSHIP STATUS
FILE NUMBER:
007-381
Category of Membership
(A)
Number
(B)
Voting Eligibility
(C)
Members
(Total of all lines above)
0
Agency Fee Payers*
Total Members/Fee Payers
0
*Agency Fee Payers are
not considered members of the labor organization.
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE
- SCHEDULES 14 THROUGH 19
FILE NUMBER:
007-381
SCHEDULE 14 OTHER RECEIPTS
1. Named Payer
Itemized Receipts
$0
2. Named Payer
Non-itemized Receipts
$0
3. All Other Receipts
$27,703
4. Total
Receipts
$27,703
SCHEDULE 17 CONTRIBUTIONS,
GIFTS & GRANTS
1. Named Payee
Itemized Disbursements
$36,263
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$0
4. To Employees
$0
5. All Other
Disbursements
$24,170
6. Total
Disbursements
$60,433
SCHEDULE 15 REPRESENTATIONAL
ACTIVITIES
1. Named Payee
Itemized Disbursements
$22,721
2. Named Payee
Non-itemized Disbursements
$16,610
3. To Officers
$2,285
4. To Employees
$1,858
5. All Other
Disbursements
$158
6. Total
Disbursements
$43,632
SCHEDULE 18 GENERAL OVERHEAD
1. Named Payee
Itemized Disbursements
$21,036
2. Named Payee
Non-itemized Disbursements
$21,085
3. To Officers
$2,285
4. To Employees
$34,730
5. All Other
Disbursements
$19,339
6. Total
Disbursements
$98,475
SCHEDULE 16 POLITICAL
ACTIVITIES AND LOBBYING
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$450
4. To Employees
$0
5. All Other
Disbursements
$0
6. Total
Disbursements
$450
SCHEDULE 19 UNION
ADMINISTRATION
1. Named Payee
Itemized Disbursements
$9,162
2. Named Payee
Non-itemized Disbursements
$12,977
3. To Officers
$89,278
4. To Employees
$24,779
5. All Other
Disbursements
$5,268
6. Total
Disbursements
$141,464
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER
RECEIPTS
FILE NUMBER:
007-381
There was no data
found for this schedule.
SCHEDULE 15 -
REPRESENTATIONAL ACTIVITIES
FILE NUMBER:
007-381
Name and Address
(A)
FAULKNER HOFFMAN & PHILLIPS
20445 EMERALD PARKWAY CLEVELAND OH 44135
Type or Classification
(B)
LAW FIRM
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$22,721
Total
Non-Itemized Transactions with this Payee/Payer
$16,610
Total of All Transactions with this
Payee/Payer for This Schedule
$39,331
LEGAL SERVICES
02/24/2016
$15,977
LEGAL SERVICES
09/21/2016
$6,744
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 -
POLITICAL ACTIVITIES AND LOBBYING
FILE NUMBER
007-381
There was no data
found for this schedule.
SCHEDULE 17 -
CONTRIBUTIONS, GIFTS & GRANTS
FILE NUMBER:
007-381
Name and Address
(A)
BREAKING BARRIERS - HOPE IS ALIVE 534
UNIONTOWN OH
Type or Classification
(B)
CHARITY
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$10,000
Total
Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this
Payee/Payer for This Schedule
$10,000
DONATION
07/21/2016
$10,000
Name and Address
(A)
RAINTREE COUNTRY CLUB
4350 MAYFAIR ROAD UNIONTOWN OH 44685
Type or Classification
(B)
GOLF COURSE
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$10,896
Total
Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this
Payee/Payer for This Schedule
$10,896
GREEN FEES, CARTS AND LUNCH
08/16/2016
$10,896
Name and Address
(A)
TEAMSTERS LOCAL 507 CER FUND
5425 WARNER ROAD CLEVELAND OH 44125
Type or Classification
(B)
CHARITABLE LABOR ORGANIZATION
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$5,219
Total
Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this
Payee/Payer for This Schedule
$5,219
REIMBURSED BLOOD BANK EXPENSES
06/06/2016
$5,219
Name and Address
(A)
THE SHOE HORN INC 2410 STATE ROAD
CUYAHOGA FALLS OH 44223
Type or Classification
(B)
MERCHANDISR DISTRIBUTOR
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$10,148
Total
Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this
Payee/Payer for This Schedule
$10,148
GOLF OUTING GIFT MERCHANDISE
08/24/2016
$10,148
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 18 - GENERAL
OVERHEAD
FILE NUMBER:
007-381
Name and Address
(A)
FIRST INSURANCE FUND 66468
CHICAGO IL 60666
Type or Classification
(B)
INSURANCE AGENCY
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$9,545
Total of All Transactions with this
Payee/Payer for This Schedule
$9,545
Name and Address
(A)
GARY M. TIBONI, CPA 630
COLUMBIA STATION OH 44028
Type or Classification
(B)
ACCOUNTING SERVICES
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$11,540
Total of All Transactions with this
Payee/Payer for This Schedule
$11,540
Name and Address
(A)
TEAMSTERS LOCAL 436 PENSION FUND
6051 CAREY DRIVE VALLEY VIEW OH 44125
Type or Classification
(B)
BENEFIT PLAN
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$21,036
Total
Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this
Payee/Payer for This Schedule
$21,036
WITHDRAWAL LIABILITY PAYMENT
02/10/2016
$5,259
WITHDRAWAL LIABILITY PAYMENT
04/01/2016
$5,259
WITHDRAWAL LIABILITY PAYMENT
06/21/2016
$5,259
WITHDRAWAL LIABILITY PAYMENT
09/13/2016
$5,259
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 19 - UNION
ADMINISTRATION
FILE NUMBER:
007-381
Name and Address
(A)
FAULKNER HOFFMAN & PHILLIPS
20445 EMERALD PARKWAY CLEVELAND OH 44135
Type or Classification
(B)
LAW FIRM
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$12,977
Total of All Transactions with this
Payee/Payer for This Schedule
$12,977
Name and Address
(A)
THACKER ROBINSON ZINZ LPA 1375 EAST 9TH STREET
CLEVELAND OH 44114
Type or Classification
(B)
LAW FIRM
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$9,162
Total
Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this
Payee/Payer for This Schedule
$9,162
LEGAL SERVICES
11/28/2016
$9,162
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 20 -
BENEFITS
FILE NUMBER:
007-381
Description
(A)
To Whom Paid
(B)
Amount
(C)
Total of all
lines above (Total will be automatically entered in Item
55.)
$206,442
SEVERANCE BENEFITS
JOINT COUNCIL NO. 41 SEVERANCE PLAN
$206,442
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL
INFORMATION SUMMARY
FILE NUMBER:
007-381
Question 10: JOINT COUNCIL NO. 41 SEVERANCE PLAN, EIN 34-6541609, PLAN NO. 001, PROVIDES SEVERANCE BENEFITS TO ELIGIBLE PARTICIPANTS AND IS ADMINISTERED AT 6051 CAREY DRIVE, VALLEY VIEW, OHIO 44125. THE PLAN FILES FORM 5500 WITH THE U.S. DEPARTMENT OF LABOR.
Question 15: AN OBSOLETE FULLY DEPRECIATED COMPUTER WITH A HISTORICAL COST OF $727, ACCUMULATED DEPRECIATION OF $727 AND A NET BOOK VALUE OF $0 WAS SCRAPPED.
Question 12: THE BOOKS AND RECORDS HAVE BEEN AUDITED BY OUTSIDE ACCOUNTANT GARY M. TIBONI, CPA.
Question 18: THE JOINT COUNCIL IS GOVERNED BY A UNIFORM CONSTITUTION PRESCRIBED BY THE INTERNATIONAL UNION, AND THE INTERNATIONAL UNION WILL FILE ON THE JOINT COUNCIL'S BEHALF.
General Information: JOINT COUNCIL NO. 41 COLLECTED PER CAPITA TAXES FROM 24 AFFILIATED LOCAL UNIONS AT THE RATE OF $1.30 PER MEMBER PER MONTH.