U.S. Department of Labor
Office of Labor-Management Standards
Washington, DC 20210
FORM LM-3 LABOR ORGANIZATION ANNUAL REPORT
Form Approved
Office of Management and Budget
No.
1245-0003
Expires:
01-31-2025
FOR USE ONLY BY LABOR ORGANIZATIONS WITH LESS THAN $250,000 IN TOTAL ANNUAL RECEIPTS
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
027-999
2. PERIOD COVERED
From
01/01/2022
Through
12/31/2022
3.
(a) AMENDED - Is this an amended report:
No
(b) HARDSHIP - Filed
under the hardship procedures:
No
(c) TERMINAL - Is this a terminal report:
No
4. AFFILIATION OR ORGANIZATION NAME
AUTO WORKERS AFL-CIO
5. DESIGNATION (Local, Lodge, etc.)
LOCAL UNION
6. DESIGNATION NBR
62
7. UNIT NAME (if any)
8. MAILING ADDRESS (Type or print in capital letters)
First Name
PATRICK
Last Name
MATTESON
P.O Box - Building and Room Number
P O BOX 1088
Number and Street
City
JACKSON
State
MI
ZIP Code + 4
492041088
9. Are your organization's records kept at its mailing address?
No
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 VI on penalties in the instructions.)
57. SIGNED:
Jerry D Shanes
PRESIDENT
58. SIGNED:
Patrick Matteson
TREASURER
Date:
Feb 26, 2023
Contact Info:
517-783-1316
Date:
Feb 26, 2023
Contact Info:
517-937-6900
Form LM-3 (Revised 2016)
FILE NUMBER:
027-999
During the Reporting Period Did Your Organization:
10. Have a "subsidiary organization" as defined in Section X of the instructions?
No
11. Create or participate in the administration of a trust or other fund or organization which provides benefits for members or their beneficiaries?
No
12. Have a Political Action Committee (PAC) fund?
No
13. Acquire or dispose of any goods or property in any manner other than purchase or sale?
No
14. Have an audit or review of its books and records by an outside accountant or by a parent body auditor/representative?
No
15. Discover any loss or shortage of funds or other property? (Answer "Yes" even if there has been repayment or recovery.)
No
16.Have any officer who was paid $10,000 or more by your organization and also received $10,000 or more as an officer or employee of another labor organization or of an employee benefit plan?
No
17. Pay any employee salary, allowances, and other expenses which, together with any payments from affiliates, totaled more than $10,000?
No
18. Have loans totaling more than $250 to any officer, employee, or member, or make any loans to a business enterprise?
No
19. How many members did your organization have at the end of the reporting period?
104
20. What is the maximum amount recoverable under your organization's fidelity bond for a loss caused by any officer or employee of your organization?
$50,000
21. During the reporting period, did your 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
22. What is the date of the labor organization's next regular election of officers?
06/2024
23. 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
2.5 hr. pay
per
month
2.5 hours pay
2.5 hours pay
(b) Initiation Fees
20.00
per
1 time
20.00
20.00
(c) Transfer Fees
per
(d) Work Permits
per
Form LM-3 (Revised 2016)
24. ALL OFFICERS AND DISBURSEMENTS TO OFFICERS
FILE NUMBER:
027-999
(A) Name (List all persons who held office during the reporting period even if they received no salary or other disbursements)
Gross Salary (before taxes and other deductions)
(D)
Allowances and Other Disbursements
(E)
TOTAL
(F)
(B) Title (Enter title of officer, such as PRESIDENT or TREASURER)
(C) Status *
Total Disbursements to Officers
$3,245
$7,920
$11,165
Less Deductions
$1,560
The Total from Net Disbursements will be entered in Item 45
Net Disbursements
$9,605
** Code (C) Status: past officer - P; continuing officer - C; new officer during the reporting period - N.
(If any officer was not elected at a regular election in accordance with your organzation's constitution and bylaws, explain in Item 56.)
MATTESON
PATRICK
$2,276
$1,320
$3,596
FINANCIAL SECRETARY
C
SHANES
JERRY
$3,000
$3,000
PRESIDENT
C
BURZYNSKI
DAVID
$1,800
$1,800
VICE PRESIDENT
C
WARNER
ANNETTE
$1,800
$1,800
RECORDING SECRETARY
C
CLARK
BRENT
$323
$323
TRUSTEE CHAIR
C
DOERING
DAVID
$323
$323
TRUSTEE
C
CRABTREE
CHRISTINE
$323
$323
TRUSTEE
P
Form LM-3 (Revised 2016)
STATEMENT A - ASSETS AND LIABILITIES
FILE NUMBER:
027-999
ASSETS
Start of Reporting Period
(A)
End of Reporting Period
(B)
25. Cash
$284,869
$285,256
26. Loans Receivable
$0
$0
27. U.S. Treasury Securities
$0
$0
28. Investments
$0
$0
29. Fixed Assets
$1,145
$1,145
30. Other Assets
$0
$0
31. TOTAL ASSETS
$286,014
$286,401
LIABILITIES
Start of Reporting Period
(C)
End of Reporting Period
(D)
32. Accounts Payable
$875
$3,240
33. Loans Payable
$0
$0
34. Mortgages Payable
$0
$0
35. Other Liabilities
$1,356
$1,457
36. TOTAL LIABILITIES
$2,231
$4,697
37. NET ASSETS
$283,783
$281,704
STATEMENT B - RECEIPTS AND DISBURSEMENTS
CASH RECEIPTS
AMOUNT
38. Dues
$68,889
39. Per Capita Tax
$0
40. Fees, Fines, Assessments, Work Permits
$440
41. Interest and Dividends
$743
42. Sale of Investments and Fixed Assets
$0
43. Other Receipts
$2,041
44. TOTAL RECEIPTS
$72,113
If total receipts reported in Item 44 are $250,000 or more, your organization must file Form LM-2 instead of this form.
CASH DISBURSEMENTS
AMOUNT
45. To Officers (from item 24)
$9,605
46. To Employees (less deductions)
$5,104
47. Per Capita Tax
$40,454
48. Office and Administrative Expense
$3,731
49. Professional Fees
$0
50. Benefits
$0
51. Contributions, Gifts, and Grants
$150
52. Purchase of Investments and Fixed Assets
$0
53. Loans Made
$0
54. Other Disbursements
$12,682
55. TOTAL DISBURSEMENTS
$71,726
Form LM-3 (Revised 2016)
56. ADDITIONAL INFORMATION SUMMARY
FILE NUMBER:
027-999
Address of Record: Records are kept at: 3432 Northlands Avenue, Jackson, MI 49201