U.S. Department of Labor
Office of Labor-Management Standards
Washington, DC 20210
FORM LM-4 LABOR ORGANIZATION ANNUAL REPORT
Form Approved
Office of Management and Budget
No.
1245-0003
Expires:
09-30-2021
FOR USE ONLY BY LABOR ORGANIZATIONS WITH LESS THAN
$10,000 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
530-926
2.
PERIOD COVERED
From
01/01/2020
Through
12/31/2020
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
SERVICE EMPLOYEES
5. DESIGNATION (Local, Lodge, etc.)
JOINT COUNCIL
6. DESIGNATION NBR
28
7. UNIT NAME (if any)
8. MAILING ADDRESS (Type or print in capital
letters)
First Name
TIMOTHY
Last Name
HASAMEAR
P.O Box - Building and Room Number
Number and Street
2923 ARLINGTON
City
COLLINSVILLE
State
IL
ZIP Code + 4
62234
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.)
20. SIGNED:
Timothy R Hasamear
PRESIiDENT
21. SIGNED:
Timothy R Hasamear
TREASURER
Date:
Mar 26, 2021
Contact
Info:
618-401-2208
Date:
Mar 26, 2021
Contact
Info:
618-401-2208
Form LM-4 (Revised 2016)
ITEMS 9 THROUGH 18
9. During the reporting
period, did your organization have any changes in its
constitution and bylaws (other than rates of dues and fees)
or in practices/procedures listed in the instructions? (If
the constitution and bylaws have changed, attach two new
dated copies. If practices/ procedures have changed, see
instructions.)
No
10. Did your
organization change its rates of dues and fees during the
reporting period? (If "Yes," report the new rates
in Item 19 on page 1.)
No
11. Did your
organization discover any loss or shortage of funds or
property during the reporting period? (If "Yes,"
provide details in Item 19. Answer "Yes" even if
there has been repayment or recovery.)
No
12. Was your
organization insured by a fidelity bond during the
reporting period?
No
If "Yes,"
enter the maximum amount recoverable under the bond for
loss caused by any person.
13. How many members did
your organization have at the end of the reporting period?
927
14. Enter the total
value of your organizations assets at the end of the period
(cash, bank accounts, equipment, etc.).
$7,282
15. Enter the total
liabilities (debts) of your organization at the end of the
period (unpaid bills, loans owed, etc.).
$0
16. Enter the total
receipts of your organization during the reporting period
(dues, fees, interest received, etc.). (If $10,000 or more,
your organization must file Form LM-2 or LM-3 instead of
this form.)
$1,472
17. Enter the total
disbursements made by your organization during the
reporting period (per capita tax, loans made, net payment
to officers, payments for office supplies, etc.).
$0
18. Enter the total
payments to officers and employees made by your
organization during the reporting period (gross salaries,
lost time payments, allowances, expenses, etc.).