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
543-096
2.
PERIOD COVERED
From
01/01/2015
Through
12/31/2015
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
7902
7. UNIT NAME (if any)
8. MAILING ADDRESS (Type or print in capital
letters)
First Name
Fred
Last Name
Murhammer
P.O Box - Building and Room Number
Number and Street
256 West 38th Street, #702
City
NEW YORK
State
NY
ZIP Code + 4
100185807
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:
Emily Barnett
PRESIDENT
71. SIGNED:
Frederick J Murhammer
TREASURER
Date:
Mar 04, 2016
Telephone
Number:
212-432-2120
Date:
Mar 04, 2016
Telephone
Number:
212-432-2120
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21
FILE NUMBER:
543-096
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?
$126,000
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?
04/2017
20. How many members did the labor organization
have at the end of the reporting period?
2,776
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
1.44%
per
monthly wages
0
0
(b) Working Dues/Fees
0
per
0
0
(c) Initiation Fees
50
per
One-Time fee
0
0
(d) Transfer Fees
0
per
0
0
(e) Work Permits
0
per
0
0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS
AND LIABILITIES
FILE NUMBER:
543-096
ASSETS
ASSETS
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
22. Cash
$249,446
$326,590
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
$18,740
$18,740
28. Other Assets
7
$0
$0
29.
TOTAL ASSETS
$268,186
$345,330
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
$63,146
$74,386
34. TOTAL
LIABILITIES
$63,146
$74,386
35. NET
ASSETS
$205,040
$270,944
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B -
RECEIPTS AND DISBURSEMENTS
FILE NUMBER:
543-096
CASH
RECEIPTS
SCH
AMOUNT
36. Dues and Agency Fees
$934,950
37. Per Capita Tax
$0
38. Fees, Fines,
Assessments, Work Permits
$36,600
39. Sale of Supplies
$0
40. Interest
$30
41. Dividends
$0
42. Rents
$0
43. Sale of Investments
and Fixed Assets
3
$0
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
$1,023
48. Other Receipts
14
$29,970
49. TOTAL RECEIPTS
$1,002,573
CASH DISBURSEMENTS
SCH
AMOUNT
50.
Representational Activities
15
$211,329
51.
Political Activities and Lobbying
16
$701
52.
Contributions, Gifts, and Grants
17
$0
53. General
Overhead
18
$4,918
54. Union
Administration
19
$88,058
55. Benefits
20
$23,060
56. Per
Capita Tax
$578,520
57. Strike
Benefits
$0
58. Fees,
Fines, Assessments, etc.
$0
59. Supplies
for Resale
$0
60. Purchase
of Investments and Fixed Assets
4
$0
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
$993
65. Direct
Taxes
$19,085
66. Subtotal
$926,664
67.
Withholding Taxes and Payroll Deductions
67a. Total
Withheld
$53,650
67b. Less Total
Disbursed
$52,415
67c.
Total Withheld But Not Disbursed
$1,235
68.
TOTAL DISBURSEMENTS
$925,429
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS
RECEIVABLE AGING SCHEDULE
FILE NUMBER:
543-096
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:
543-096
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:
543-096
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:
543-096
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:
543-096
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:
543-096
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
$18,740
$18,740
$18,740
E.
Other Fixed Assets
F. Totals of Lines A through E
(Column(D) Total will be automatically entered in Item
27, Column(B))
$18,740
$0
$18,740
$18,740
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER
ASSETS
FILE NUMBER:
543-096
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:
543-096
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:
543-096
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:
543-096
Description
(A)
Amount at End of Period
(B)
Total Other Liabilities
(Total will be automatically entered in Item 33, Column(D))
$74,386
Federal Employee Income Taxes - December 2015
$3,847
FICA/MECA Employee - December 2015
$1,815
FICA/MECA Employer - December 2015
$1,815
FUTA - 2015
$286
New York State Employee Income Taxes - Dec 2015
$1,167
New York City Employee Income Taxes - Dec 2015
$474
New York State Unemployment Tax - 4th Qtr 2015
$703
Int'l Union UAW, Per Capita Tax on Dec 2014's dues
$61,716
NYS UAW Region 9A CAP Council PCT: Dec 2014's dues
$2,507
NYS UAW Region 9A Retiree PCT: Dec 2014's dues
$56
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL
OFFICERS AND DISBURSEMENTS TO OFFICERS
FILE NUMBER:
543-096
(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
Barnett
,
Emily
President C
$37,036
$1,298
$2,357
$0
$40,691
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
Barto
,
Mary
2nd Vice President 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
%
A
B
C
Brown
,
Roger
A Trustee C
$0
$0
$0
$0
$0
I
Schedule 15
Representational Activities
95
%
Schedule 16
Political Activities and Lobbying
5
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
0
%
A
B
C
Coopersmith
,
Benjami
J Recording Secretary C
$2,400
$0
$7
$0
$2,407
I
Schedule 15
Representational Activities
99
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
1
%
A
B
C
Dormuth
,
Marie
NSU Unit Chair C
$0
$0
$302
$0
$302
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
Kenny
,
Kay
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
%
A
B
C
Kolisnyk
,
Mary He
Trustee C
$1,163
$0
$0
$0
$1,163
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
Murhammer
,
Frederi
J Financial Secretary C
$36,292
$2,042
$2,082
$0
$40,416
I
Schedule 15
Representational Activities
29
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
71
%
A
B
C
Rzonca
,
Chris
NYU Unit Chair C
$17,035
$0
$10
$0
$17,045
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
Schaefer Jr.
,
Robert
A Sgt At Arms 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
%
A
B
C
Scott
,
Earl
1st Vice President C
$0
$0
$290
$0
$290
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
deVerteuil
,
Phyllis
Guide C
$885
$0
$0
$0
$885
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
$94,811
$3,340
$5,048
$0
$103,199
Less Deductions
$33,046
Net
Disbursements
$70,153
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 -
DISBURSEMENTS TO EMPLOYEES
FILE NUMBER:
543-096
(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
Coles
,
Cheryl
Office Admin Ass NA
$46,842
$0
$0
$0
$46,842
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
$13,714
$1,460
$33
$15,207
I
Schedule 15
Representational Activities
100
%
Schedule 16
Political Activities and Lobbying
Schedule 17
Contributions
Schedule 18
General Overhead
Schedule 19
Administration
Total
Employee Disbursements
$60,556
$1,460
$33
$0
$62,049
Less
Deductions
$20,605
Net Disbursements
$41,444
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 -
MEMBERSHIP STATUS
FILE NUMBER:
543-096
Category of Membership
(A)
Number
(B)
Voting Eligibility
(C)
Members
(Total of all lines above)
2,776
Agency Fee Payers*
115
Total Members/Fee Payers
2,891
*Agency Fee Payers are
not considered members of the labor organization.
regular members
2,776
Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE
- SCHEDULES 14 THROUGH 19
FILE NUMBER:
543-096
SCHEDULE 14 OTHER RECEIPTS
1. Named Payer
Itemized Receipts
$23,488
2. Named Payer
Non-itemized Receipts
$6,066
3. All Other Receipts
$416
4. Total
Receipts
$29,970
SCHEDULE 17 CONTRIBUTIONS,
GIFTS & GRANTS
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$0
4. To Employees
$0
5. All Other
Disbursements
$0
6. Total
Disbursements
$0
SCHEDULE 15 REPRESENTATIONAL
ACTIVITIES
1. Named Payee
Itemized Disbursements
$36,216
2. Named Payee
Non-itemized Disbursements
$65,694
3. To Officers
$74,480
4. To Employees
$15,207
5. All Other
Disbursements
$19,732
6. Total
Disbursements
$211,329
SCHEDULE 18 GENERAL OVERHEAD
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$0
4. To Employees
$0
5. All Other
Disbursements
$4,918
6. Total
Disbursements
$4,918
SCHEDULE 16 POLITICAL
ACTIVITIES AND LOBBYING
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$0
4. To Employees
$0
5. All Other
Disbursements
$701
6. Total
Disbursements
$701
SCHEDULE 19 UNION
ADMINISTRATION
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$8,832
3. To Officers
$28,719
4. To Employees
$46,842
5. All Other
Disbursements
$3,665
6. Total
Disbursements
$88,058
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER
RECEIPTS
FILE NUMBER:
543-096
Name and Address
(A)
International Union UAW 8000 East Jefferson
Detroit MI 48214-3963
Type or Classification
(B)
Labor organization
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$23,488
Total
Non-Itemized Transactions with this Payee/Payer
$6,066
Total of All Transactions with this
Payee/Payer for This Schedule
$29,554
13th Rebate Check
05/05/2015
$12,570
4 Subsidy Organizing Chec
12/15/2015
$10,918
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 -
REPRESENTATIONAL ACTIVITIES
FILE NUMBER:
543-096
Name and Address
(A)
113 University Pl. 5th Floor T 256 West 38th St. 7th Fl
New York NY 10018-0000
Type or Classification
(B)
Co-Tenants Association
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$45,812
Total of All Transactions with this
Payee/Payer for This Schedule
$45,812
Name and Address
(A)
Levy Ratner P.C. 80 Eighth Avenue Floor 8
New York NY 10011-5126
Type or Classification
(B)
Law Firm
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$36,216
Total
Non-Itemized Transactions with this Payee/Payer
$19,882
Total of All Transactions with this
Payee/Payer for This Schedule
$56,098
Statement 5670
10/16/2015
$9,087
Statement 5737
11/06/2015
$7,891
Statement No. 5786
12/07/2015
$6,813
Statement No. 5185
01/20/2015
$6,685
Statement 5517
07/14/2015
$5,740
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 -
POLITICAL ACTIVITIES AND LOBBYING
FILE NUMBER
543-096
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:
543-096
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 18 - GENERAL
OVERHEAD
FILE NUMBER:
543-096
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:
543-096
Name and Address
(A)
113 University Pl. 5th Floor T 256 West 38th St. 7th Fl
New York NY 10018-0000
Type or Classification
(B)
Co-Tenants Association
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$8,832
Total of All Transactions with this
Payee/Payer for This Schedule
$8,832
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 20 -
BENEFITS
FILE NUMBER:
543-096
Description
(A)
To Whom Paid
(B)
Amount
(C)
Total of all
lines above (Total will be automatically entered in Item
55.)
$23,060
Dental/Hearing/Medical/Vision Insurance
Local 2110
$21,098
Disability/Sick & Accident Insurance
Amtrust North America Inc.
$142
Workers Compension Insurance
Amtrust North America Inc.
$1,820
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL
INFORMATION SUMMARY
FILE NUMBER:
543-096
Schedule 13, Row1:
Schedule 13, Row1::Anyone who has applied and been accepted for membership is a regular member. Regular members pay full dues.