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:
08-31-2016
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
034-132
2.
PERIOD COVERED
From
01/01/2013
Through
12/31/2013
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
833
7. UNIT NAME (if any)
8. MAILING ADDRESS (Type or print in capital
letters)
First Name
PAM
Last Name
BLOCK
P.O Box - Building and Room Number
Number and Street
5425 SUPERIOR AVE
City
SHEBOYGAN
State
WI
ZIP Code + 4
53083
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:
PAMELA J BLOCK
PRESIDENT
71. SIGNED:
DAVID N BOUCHER
TREASURER
Date:
Mar 17, 2014
Telephone
Number:
920-458-2173
Date:
Mar 17, 2014
Telephone
Number:
920-452-6596
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21
FILE NUMBER:
034-132
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?
Yes
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?
$161,000
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?
06/2014
20. How many members did the labor organization
have at the end of the reporting period?
1,855
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
2
per
month
NA
NA
(b) Working Dues/Fees
0
per
NA
NA
NA
(c) Initiation Fees
20
per
initiation
NA
NA
(d) Transfer Fees
0
per
NA
NA
NA
(e) Work Permits
0
per
NA
NA
NA
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS
AND LIABILITIES
FILE NUMBER:
034-132
ASSETS
ASSETS
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
22. Cash
$412,765
$493,434
23. Accounts Receivable
1
$0
$0
24. Loans Receivable
2
$0
$0
25. U.S. Treasury
Securities
$0
$0
26. Investments
5
$0
$0
27. Fixed Assets
6
$854,432
$860,340
28. Other Assets
7
$15,873
$15,299
29.
TOTAL ASSETS
$1,283,070
$1,369,073
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
$0
32. Mortgages Payable
$0
$0
33. Other Liabilities
10
$0
$627
34. TOTAL
LIABILITIES
$0
$627
35. NET
ASSETS
$1,283,070
$1,368,446
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B -
RECEIPTS AND DISBURSEMENTS
FILE NUMBER:
034-132
CASH
RECEIPTS
SCH
AMOUNT
36. Dues and Agency Fees
$989,379
37. Per Capita Tax
$0
38. Fees, Fines,
Assessments, Work Permits
$1,080
39. Sale of Supplies
$2,136
40. Interest
$2,060
41. Dividends
$0
42. Rents
$14,055
43. Sale of Investments
and Fixed Assets
3
$582
44. Loans Obtained
9
$0
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
$18,747
48. Other Receipts
14
$173,699
49. TOTAL RECEIPTS
$1,201,738
CASH DISBURSEMENTS
SCH
AMOUNT
50.
Representational Activities
15
$293,567
51.
Political Activities and Lobbying
16
$6,260
52.
Contributions, Gifts, and Grants
17
$32,201
53. General
Overhead
18
$129,206
54. Union
Administration
19
$90,297
55. Benefits
20
$4,199
56. Per
Capita Tax
$510,962
57. Strike
Benefits
$0
58. Fees,
Fines, Assessments, etc.
$50
59. Supplies
for Resale
$2,294
60. Purchase
of Investments and Fixed Assets
4
$7,244
61. Loans
Made
2
$0
62.
Repayment of Loans Obtained
9
$0
63. To
Affiliates of Funds Collected on Their Behalf
$0
64. On
Behalf of Individual Members
$19,421
65. Direct
Taxes
$23,937
66. Subtotal
$1,119,638
67.
Withholding Taxes and Payroll Deductions
67a. Total
Withheld
$16,711
67b. Less Total
Disbursed
$18,142
67c.
Total Withheld But Not Disbursed
-$1,431
68.
TOTAL DISBURSEMENTS
$1,121,069
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS
RECEIVABLE AGING SCHEDULE
FILE NUMBER:
034-132
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:
034-132
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 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:
034-132
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
$1,336
$1,336
$582
$582
Outdoor lighted billboard
$850
$850
$300
$300
Misc Scrap
$25
$25
$18
$18
Folding Metal chairs from the hall
$461
$461
$264
$264
Less Reinvestments
$0
(The
total from Net Sales Line will be automatically entered
in Item 43)
Net Sales
$582
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 4 - PURCHASE
OF INVESTMENTS AND FIXED ASSETS
FILE NUMBER:
034-132
Description (if land or buildings, give location)
(A)
Cost
(B)
Book Value
(C)
Cash Paid
(D)
Total
of all lines above
$7,244
$7,244
$7,244
Presidents computer
$1,144
$1,144
$1,144
300 Folding chairs
$6,100
$6,100
$6,100
Less Reinvestments
$0
(The
total from Net Purchases Line will be automatically
entered in Item 60.)
Net Purchases
$7,244
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 -
INVESTMENTS
FILE NUMBER:
034-132
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:
034-132
Description
(A)
Cost or Other Basis
(B)
Total Depreciation or
Amount Expensed
(C)
Book Value
(D)
Value
(E)
A.
Land (give location)
Land
1
:
5425 SUPERIOR AVE, SHEBOYGAN, WI
$73,953
$73,953
$80,537
B.
Buildings (give location)
Building
1
:
5425 SUPERIOR AVE, SHEBOYGAN, WI
$539,706
$539,706
$689,500
C. Automobiles
and
Other Vehicles
$0
$0
$0
$0
D. Office
Furniture
and Equipment
$106,565
$0
$106,565
$106,565
E.
Other Fixed Assets
$140,116
$0
$140,116
$140,116
F. Totals of Lines A through E
(Column(D) Total will be automatically entered in Item
27, Column(B))
$860,340
$0
$860,340
$1,016,718
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER
ASSETS
FILE NUMBER:
034-132
Description
(A)
Book Value
(B)
Total
(Total will be automatically entered in Item 28, Column(B))
$15,299
T-SHIRTS/CAPS
$6,123
BAR INVENTORY
$9,176
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS
PAYABLE AGING SCHEDULE
FILE NUMBER:
034-132
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:
034-132
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:
034-132
Description
(A)
Amount at End of Period
(B)
Total Other Liabilities
(Total will be automatically entered in Item 33, Column(D))
$627
NOVEMBER PER CAPITA WITHHELD. PAID OUT IN 2014
$627
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL
OFFICERS AND DISBURSEMENTS TO OFFICERS
FILE NUMBER:
034-132
(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
BLOCK
,
PAMELA
J FST C
$49,712
$1,500
$3,270
$54,482
I
Schedule 15
Representational Activities
20
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
20
%
Schedule 19
Administration
60
%
A
B
C
BOUCHER
,
David
N PRESIDENT C
$19
$2,205
$5,328
$7,552
I
Schedule 15
Representational Activities
80
%
Schedule 16
Political Activities and Lobbying
5
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
5
%
Schedule 19
Administration
10
%
A
B
C
BROCK
,
Jim
E VICE PRESIDENT C
$1,980
$85
$2,065
I
Schedule 15
Representational Activities
85
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
5
%
Schedule 19
Administration
10
%
A
B
C
PRENING
,
Bill
R TRUSTEE C
$2,025
$540
$126
$2,691
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
15
%
Schedule 19
Administration
85
%
A
B
C
QUINN
,
JAMES
SGT AT ARMS C
$357
$540
$897
I
Schedule 15
Representational Activities
5
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
40
%
Schedule 19
Administration
55
%
A
B
C
SAWALL
,
PENNY
L RECORDING SEC C
$49,712
$1,560
$1,090
$52,362
I
Schedule 15
Representational Activities
20
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
10
%
Schedule 19
Administration
70
%
A
B
C
SCHMITZ
,
RANDY
J GUIDE C
$945
$188
$1,133
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
90
%
Schedule 19
Administration
10
%
A
B
C
STROHSCHOEN
,
JAMES
TRUSTEE C
$9,579
$540
$34
$10,153
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
10
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
5
%
Schedule 19
Administration
85
%
A
B
C
STROHSCHOEN
,
David
W TRUSTEE C
$1,160
$1,710
$1,631
$4,501
I
Schedule 15
Representational Activities
0
%
Schedule 16
Political Activities and Lobbying
80
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
10
%
Schedule 19
Administration
10
%
Total Officer
Disbursements
$112,564
$11,520
$11,752
$0
$135,836
Less Deductions
$4,846
Net
Disbursements
$130,990
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 -
DISBURSEMENTS TO EMPLOYEES
FILE NUMBER:
034-132
(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
TOTALS RECEIVED
BY EMPLOYEES MAKING $10,000 OR LESS
$73,814
$42,877
$11,400
$0
$128,091
I
Schedule 15
Representational Activities
80
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
20
%
Schedule 19
Administration
0
%
Total
Employee Disbursements
$73,814
$42,877
$11,400
$0
$128,091
Less
Deductions
$11,865
Net Disbursements
$116,226
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 -
MEMBERSHIP STATUS
FILE NUMBER:
034-132
Category of Membership
(A)
Number
(B)
Voting Eligibility
(C)
Members
(Total of all lines above)
1,855
Agency Fee Payers*
0
Total Members/Fee Payers
1,855
*Agency Fee Payers are
not considered members of the labor organization.
REGULAR MEMBERS
1,855
Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE
- SCHEDULES 14 THROUGH 19
FILE NUMBER:
034-132
SCHEDULE 14 OTHER RECEIPTS
1. Named Payer
Itemized Receipts
$50,053
2. Named Payer
Non-itemized Receipts
$81,649
3. All Other Receipts
$41,997
4. Total
Receipts
$173,699
SCHEDULE 17 CONTRIBUTIONS,
GIFTS & GRANTS
1. Named Payee
Itemized Disbursements
$6,351
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$0
4. To Employees
$0
5. All Other
Disbursements
$25,850
6. Total
Disbursements
$32,201
SCHEDULE 15 REPRESENTATIONAL
ACTIVITIES
1. Named Payee
Itemized Disbursements
$34,293
2. Named Payee
Non-itemized Disbursements
$45,634
3. To Officers
$29,210
4. To Employees
$102,473
5. All Other
Disbursements
$81,957
6. Total
Disbursements
$293,567
SCHEDULE 18 GENERAL OVERHEAD
1. Named Payee
Itemized Disbursements
$12,702
2. Named Payee
Non-itemized Disbursements
$19,536
3. To Officers
$19,354
4. To Employees
$25,618
5. All Other
Disbursements
$51,996
6. Total
Disbursements
$129,206
SCHEDULE 16 POLITICAL
ACTIVITIES AND LOBBYING
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$4,994
4. To Employees
$0
5. All Other
Disbursements
$1,266
6. Total
Disbursements
$6,260
SCHEDULE 19 UNION
ADMINISTRATION
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$8,000
3. To Officers
$82,277
4. To Employees
$0
5. All Other
Disbursements
$20
6. Total
Disbursements
$90,297
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER
RECEIPTS
FILE NUMBER:
034-132
Name and Address
(A)
BILL BOLGERT 1704 S 22ND ST
SHEBOYGAN WI 53081-0000
Type or Classification
(B)
CMT CHAIR
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$21,212
Total
Non-Itemized Transactions with this Payee/Payer
$0
Total of All Transactions with this
Payee/Payer for This Schedule
$21,212
BANQUET PROCEEDS
09/12/2013
$21,212
Name and Address
(A)
CAPITOL INDEMNITY CORPORATION P.O. BOX 673110
MILWAUKEE WI 53267-3110
Type or Classification
(B)
INSURANCE PROVIDER
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$5,760
Total
Non-Itemized Transactions with this Payee/Payer
$0
Total of All Transactions with this
Payee/Payer for This Schedule
$5,760
CLAIM PAID FROM BREAK-IN
02/01/2013
$5,760
Name and Address
(A)
DON AND JOAN OTTO COVINGTON DR
SHEBOYGAN FALLS WI 53085-0000
Type or Classification
(B)
RETIREE CHAIR/COORDINATOR
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$0
Total
Non-Itemized Transactions with this Payee/Payer
$18,858
Total of All Transactions with this
Payee/Payer for This Schedule
$18,858
Name and Address
(A)
FLOYD AMMERMAN 153 NORTH EAST ST PO 335
ELKHART LAKE WI 53020-0000
Type or Classification
(B)
CMT CHAIR
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$8,732
Total
Non-Itemized Transactions with this Payee/Payer
$2,275
Total of All Transactions with this
Payee/Payer for This Schedule
$11,007
FOOD BEER RAFFLES
04/17/2013
$8,732
Name and Address
(A)
International Union-UAW 8000 East Jefferson Ave
Detroit MI 48214-3448
Type or Classification
(B)
INTERNATIONAL BODY
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$14,349
Total
Non-Itemized Transactions with this Payee/Payer
$1,952
Total of All Transactions with this
Payee/Payer for This Schedule
$16,301
13TH MONTH REBATE
05/01/2013
$14,349
Name and Address
(A)
PAM BLOCK N6847 SWALLOW DRIVE
SHEBOYGAN WI 53083-0000
Type or Classification
(B)
FINANCIAL SECRETARY
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$0
Total
Non-Itemized Transactions with this Payee/Payer
$22,086
Total of All Transactions with this
Payee/Payer for This Schedule
$22,086
Name and Address
(A)
PENNY SAWALL N 8917 DAIRYLAND DR
CLEVELAND WI 53015-0000
Type or Classification
(B)
RECORDING SECRETARY
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$0
Total
Non-Itemized Transactions with this Payee/Payer
$10,903
Total of All Transactions with this
Payee/Payer for This Schedule
$10,903
Name and Address
(A)
STAN WICK 221 ORCHARD RD
KOHLER WI 53044-0000
Type or Classification
(B)
BAR MANAGER
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$0
Total
Non-Itemized Transactions with this Payee/Payer
$18,639
Total of All Transactions with this
Payee/Payer for This Schedule
$18,639
Name and Address
(A)
UAW SHEB AREA CAP 5425 SUPERIOR AVE
SHEBOYGAN WI 53083-0000
Type or Classification
(B)
AREA CAP COUNCIL
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$6,936
Total of All Transactions with this
Payee/Payer for This Schedule
$6,936
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 -
REPRESENTATIONAL ACTIVITIES
FILE NUMBER:
034-132
Name and Address
(A)
Alliant Energy PO BOX 3068
CEDAR RAPIDS IA 52406-3068
Type or Classification
(B)
ENERGY
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$20,665
Total of All Transactions with this
Payee/Payer for This Schedule
$20,665
Name and Address
(A)
CAPITOL INDEMNITY CORPORATION P.O. BOX 673110
MILWAUKEE WI 53267-3110
Type or Classification
(B)
INSURANCE PROVIDER
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$7,393
Total
Non-Itemized Transactions with this Payee/Payer
$3,368
Total of All Transactions with this
Payee/Payer for This Schedule
$10,761
GENERAL PACKAGE INSURANCE
02/19/2013
$7,393
Name and Address
(A)
HICKORY HILLS COUNTRY CLUB W3095 HICKORY HILLS RD
CHILTON WI 53014-0000
Type or Classification
(B)
GOLF COURSE
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$8,647
Total
Non-Itemized Transactions with this Payee/Payer
$0
Total of All Transactions with this
Payee/Payer for This Schedule
$8,647
2013 GOLF OUTING
10/29/2013
$8,647
Name and Address
(A)
Jon' Sport Shop 2968 Jackson Dr.Road
Oshkosh WI 54901-0000
Type or Classification
(B)
SPORTS STORE
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$10,057
Total
Non-Itemized Transactions with this Payee/Payer
$6,635
Total of All Transactions with this
Payee/Payer for This Schedule
$16,692
CONSERVATION BANQUET DOOR
04/29/2013
$10,057
Name and Address
(A)
PIGGLY WIGGLY HOWARDS 714 S WISCONSIN DRIVE
HOWARDS GROVE WI 53083-0000
Type or Classification
(B)
GROCERY STORE
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$10,799
Total of All Transactions with this
Payee/Payer for This Schedule
$10,799
Name and Address
(A)
Rupp's ON WASHINGTON 1102 W WASHINGTON AVE
CLEVELAND WI 53015-0000
Type or Classification
(B)
CATERER
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$8,196
Total
Non-Itemized Transactions with this Payee/Payer
$4,167
Total of All Transactions with this
Payee/Payer for This Schedule
$12,363
MEAL FOR RETIREES CHRISTM
12/16/2013
$8,196
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 -
POLITICAL ACTIVITIES AND LOBBYING
FILE NUMBER
034-132
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:
034-132
Name and Address
(A)
WINDWALKER PHEASANTRY
W2032 BIRCH LANE MT CALVARY WI 53057
Type or Classification
(B)
GAME SELLER,, PHEASANTS
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$6,351
Total
Non-Itemized Transactions with this Payee/Payer
$0
Total of All Transactions with this
Payee/Payer for This Schedule
$6,351
PURCHASE PHEASANTS
08/05/2013
$6,351
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 18 - GENERAL
OVERHEAD
FILE NUMBER:
034-132
Name and Address
(A)
C.A. Flipse Sons Inc. P.O. Box 1104
Sheboygan WI 53082-1104
Type or Classification
(B)
RESTAURANT SUPPLIER
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$5,402
Total of All Transactions with this
Payee/Payer for This Schedule
$5,402
Name and Address
(A)
FELDCO 1125 C TUCKAWAY LN
MENASHA WI 54952-0000
Type or Classification
(B)
INSTALLER DOORS
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$12,702
Total
Non-Itemized Transactions with this Payee/Payer
$0
Total of All Transactions with this
Payee/Payer for This Schedule
$12,702
50% DOWN ON NORTH AND WES
10/08/2013
$12,702
Name and Address
(A)
GENERAL BEER DIST - NORTHEAST 1825 ROSEHILL RD
KAUKAUNA WI 54130-0000
Type or Classification
(B)
BEVERAGE DISTRIBUTOR
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$5,984
Total of All Transactions with this
Payee/Payer for This Schedule
$5,984
Name and Address
(A)
Larry's Distributing Inc. 3815 Playbird Road
Sheboygan WI 53083-0000
Type or Classification
(B)
BEVERAGE DISTRIBUTOR
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$8,150
Total of All Transactions with this
Payee/Payer for This Schedule
$8,150
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 19 - UNION
ADMINISTRATION
FILE NUMBER:
034-132
Name and Address
(A)
ROBERTS CUSTOM SOFTWARE 3667 1ST ST
EAST MOLINE IL 51244
Type or Classification
(B)
SOFTWARE REP
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$8,000
Total of All Transactions with this
Payee/Payer for This Schedule
$8,000
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 20 -
BENEFITS
FILE NUMBER:
034-132
Description
(A)
To Whom Paid
(B)
Amount
(C)
Total of all
lines above (Total will be automatically entered in Item
55.)
$4,199
DENTAL/HEARING/MEDICAL/VISION FOR OFFICERS
KOHLER CO
$4,199
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL
INFORMATION SUMMARY
FILE NUMBER:
034-132
Question 15: Attached, you will find the "Banquet Donor List" and "Casino Donor List" which includes items donated to the 2013 Conservations Banquet and 2013 Casino Night sponsored by various committees for local clubs and charity events.
Food certificates, golf balls, golf times, hats, shirts, dental kits and misc items were donated to the annual golf outing.
During Membership meetings throughout the year, beer and soda are offered to members at no charge.
The local purchases and pays have the cost to members for jackets, hats, t-shirts. Seventeen t-shirts were also given per membership approval to new members.
50 hams and 50 turkeys are give out as monthly door prizes at March and November membership meetings, respectively.
25 Presidential calendars are purchased and given to area businesses and schools.
Members have the opportunity to participate in the UAW bowling, Golf, 3-D and Trapshoot events covered at 50% by the local.
Scholarships were awarded to dependents of member as committee selects. Scholarship total for 2013 was $8600.00
Question 10: : : Operations of the Building Corporation are handled through the books and records of the Local Union and are therefore included in this report.
Question 11(b): : : Operations of the Building Corporation are handled through the books and records of the Local Union and are therefore included in this report.
Statement A,
Cash Begin Total: Checks were voided from previous year totaling $1431
Schedule 13, Row1:ANYONE WHO HAS APPLIED AND BEEN ACCEPTED FOR MEMBERSHIP IS A REGULAR MEMBER. REGULAR MEMBERS PAY FULL DUES.
General Information: Item 64. Collections disbursed. $1321.28, Women''''s Council funds, were transferred to Local 578 to be kept under the books of their local.
$626 was collected for November VCAP and sent out in 2014. Amount was overlooked.