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
001-974
2. PERIOD COVERED
From01/01/2016
Through12/31/2016
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
AUTO WORKERS AFL-CIO
5. DESIGNATION (Local, Lodge, etc.)
LOCAL UNION
 6. DESIGNATION NBR
167
7. UNIT NAME (if any)

8. MAILING ADDRESS (Type or print in capital letters)
First Name
CAROLYN
 Last Name
BURDEN
P.O Box - Building and Room Number

Number and Street
1320 BURTON S.W.
City
WYOMING
State
MI		 ZIP Code + 4
495091466


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:Adam UnderhillPRESIDENT71. SIGNED:Carolyn K BurdenTREASURER
Date:Mar 15, 2017Telephone Number:616-245-1129Date:Mar 15, 2017Telephone Number:616-245-1129
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21 FILE NUMBER: 001-974
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?$100,000
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?05/2017
20. How many members did the labor organization have at the end of the reporting period?639
21. What are the labor organization's rates of dues and fees?
Rates of Dues and Fees
Dues/FeesAmount UnitMinimumMaximum
(a) Regular Dues/Fees2 1/2 hoursperMonth00
(b) Working Dues/Fees0per000
(c) Initiation Fees50.00per1 time00
(d) Transfer Fees0per000
(e) Work Permits0per000

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS AND LIABILITIES FILE NUMBER: 001-974

ASSETS
ASSETS Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
22. Cash $386,716$346,533
23. Accounts Receivable1$0
24. Loans Receivable2
25. U.S. Treasury Securities $0$0
26. Investments5
27. Fixed Assets6$145,624$146,665
28. Other Assets7$4,370$5,952
29. TOTAL ASSETS $536,710$499,150

LIABILITIES
LIABILITIES Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
30. Accounts Payable8$47,908$24,275
31. Loans Payable9
32. Mortgages Payable $0$0
33. Other Liabilities10$2,890$2,600
34. TOTAL LIABILITIES $50,798$26,875
35. NET ASSETS$485,912$472,275
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B - RECEIPTS AND DISBURSEMENTS FILE NUMBER: 001-974

CASH RECEIPTSSCHAMOUNT
36. Dues and Agency Fees $512,933
37. Per Capita Tax $0
38. Fees, Fines, Assessments, Work Permits $3,000
39. Sale of Supplies $1,086
40. Interest $1,055
41. Dividends $266
42. Rents $0
43. Sale of Investments and Fixed Assets3$0
44. Loans Obtained9
45. Repayments of Loans Made2
46. On Behalf of Affiliates for Transmittal to Them $0
47. From Members for Disbursement on Their Behalf $3,159
48. Other Receipts14$27,000
49. TOTAL RECEIPTS $548,499
CASH DISBURSEMENTSSCHAMOUNT
50. Representational Activities15$8,584
51. Political Activities and Lobbying16$2,683
52. Contributions, Gifts, and Grants17$8,086
53. General Overhead18$5,368
54. Union Administration19$202,586
55. Benefits20$2,895
56. Per Capita Tax $338,708
57. Strike Benefits $0
58. Fees, Fines, Assessments, etc. $100
59. Supplies for Resale $0
60. Purchase of Investments and Fixed Assets4$1,121
61. Loans Made2
62. Repayment of Loans Obtained9
63. To Affiliates of Funds Collected on Their Behalf $0
64. On Behalf of Individual Members $0
65. Direct Taxes $15,232
  
66. Subtotal $585,363
67. Withholding Taxes and Payroll Deductions  
  67a. Total Withheld$20,433  
  67b. Less Total Disbursed$23,752  
  67c. Total Withheld But Not Disbursed -$3,319
68. TOTAL DISBURSEMENTS $588,682
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE FILE NUMBER: 001-974

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: 001-974

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 61Item 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: 001-974

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$80$80$0$0
2 Fans$40$40$0$0
1 Coffee Maker$40$40$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: 001-974

Description (if land or buildings, give location)
(A) 		Cost
(B) 		Book Value
(C) 		Cash Paid
(D)
Total of all lines above$1,121$1,121$1,121
Copier$1,121$1,121$1,121
 Less Reinvestments$0
(The total from Net Purchases Line will be automatically entered in Item 60.)Net Purchases$1,121
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 - INVESTMENTS FILE NUMBER: 001-974

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: 001-974

Description
(A) 		Cost or Other Basis
(B) 		Total Depreciation or
Amount Expensed
(C) 		Book Value
(D) 		Value
(E)
A. Land (give location)    
Land  1 :      2025 Martindale SW, Wyoming MI$9,551 $9,551$9,551
B. Buildings (give location)    
Building  1 :      1320 Burton St SW. Wyoming MI$92,633$92,633$92,633
C. Automobiles and Other Vehicles
D. Office Furniture and Equipment$44,481$44,481$44,481
E. Other Fixed Assets
F. Totals of Lines A through E (Column(D) Total will be automatically entered in Item 27, Column(B)) $146,665$0$146,665$146,665
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER ASSETS FILE NUMBER: 001-974

Description
(A) 		Book Value
(B)
Total (Total will be automatically entered in Item 28, Column(B)) $5,952
52 - Bibles$1,560
30 - Wallets$300
372 - T-Shirts$4,092
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS PAYABLE AGING SCHEDULE FILE NUMBER: 001-974

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$24,275$0$0$0
Totals (Total for Column(B) will be automatically entered in Item 30, Column(D)) $24,275$0$0$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 9 - LOANS PAYABLE FILE NUMBER: 001-974

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 44Item 62 Item 69
with Explanation 		Item 31
Column (D)
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 10 - OTHER LIABILITIES FILE NUMBER: 001-974

Description
(A) 		Amount at End of Period
(B)
Total Other Liabilities (Total will be automatically entered in Item 33, Column(D)) $2,600
Federal Taxes Paid and Fwded$1,273
Federal Unemployment Tax (940)$103
State Unemployment Tax$223
State Taxes Paid and Fwded$1,001
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS FILE NUMBER: 001-974

(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 		Averill ,  Penny   M
Recording Sec.
C		$1,993$0$2,070$0$4,063
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 		Boorsma ,  Michael  
Sgt-At-Arms
C		$3,082$0$596$0$3,678
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 		Burden ,  Carolyn   K
Financial Secretary
C		$5,306$0$877$0$6,183
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 		Cronover ,  James   L
Retiree Chair
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 		Fisher ,  Jeffery   D
Bosch Barg. Chair
C		$1,732$0$822$0$2,554
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 		Hoffman ,  Emily  
Trustee
C		$537$0$9$0$546
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 		Kuikstra ,  Nick  
Guide
C		$256$0$0$0$256
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 		Kuk ,  John   L
Gm Bargaining Chair
P		$2,095$0$747$0$2,842
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 %
A
B
C 		Monroe ,  Mark   D
Vice-President
P		$200$0$0$0$200
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 		Newman ,  Christopher   M
GM Barg. Chair
N		$662$0$118$0$780
I
Schedule 15
Representational Activities 		75 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		25 %
A
B
C 		Osburn ,  Daren   N
Caravan Barg. Chair
P		$364$0$0$0$364
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 		Ralston ,  James   H
Head Trustee
C		$1,486$0$180$0$1,666
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 		Smith ,  Wendy  
Trustee
C		$1,155$0$277$0$1,432
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		12 % Schedule 19
Administration 		88 %
A
B
C 		Tu ,  Jennifer  
NAFSR Bargaining Cha
N		$2,849$0$342$0$3,191
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 		Underhill ,  Adam  
President
C		$3,171$0$1,717$0$4,888
I
Schedule 15
Representational Activities 		20 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		80 %
A
B
C 		Van Aman ,  Michael   J
NAFSR Barg. Chair
P		$1,653$0$522$0$2,175
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$26,541$0$8,277$0$34,818
Less Deductions    $4,699
Net Disbursements    $30,119
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES FILE NUMBER: 001-974

(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 		Anderson ,  Teresa   S
Bookkeeper
NA		$33,984$0$457$0$34,441
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$37,803$0$9,790$0$47,593
I Schedule 15
Representational Activities 		1 % Schedule 16
Political Activities and Lobbying 		3 % Schedule 17
Contributions 		1 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		95 %
Total Employee Disbursements$71,787$0$10,247$0$82,034
Less Deductions    $15,734
Net Disbursements    $66,300
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 - MEMBERSHIP STATUS FILE NUMBER: 001-974

Category of Membership
(A) 		Number
(B) 		Voting Eligibility
(C)
Members (Total of all lines above) 639 
Agency Fee Payers*0
Total Members/Fee Payers639 
*Agency Fee Payers are not considered members of the labor organization.
Regular Members639Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19 FILE NUMBER: 001-974

SCHEDULE 14   OTHER RECEIPTS
1. Named Payer Itemized Receipts$7,729
2. Named Payer Non-itemized Receipts$12,588
3. All Other Receipts$6,683
4. Total Receipts$27,000
     
     
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$476
5. All Other Disbursements$7,610
6. Total Disbursements$8,086
SCHEDULE 15   REPRESENTATIONAL ACTIVITIES
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$1,563
4. To Employees$476
5. All Other Disbursements$6,545
6. Total Disbursements$8,584
SCHEDULE 18   GENERAL OVERHEAD
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$172
4. To Employees$0
5. All Other Disbursements$5,196
6. Total Disbursements$5,368
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$1,428
5. All Other Disbursements$1,255
6. Total Disbursements$2,683
SCHEDULE 19   UNION ADMINISTRATION
1. Named Payee Itemized Disbursements$11,000
2. Named Payee Non-itemized Disbursements$28,606
3. To Officers$33,083
4. To Employees$79,654
5. All Other Disbursements$50,243
6. Total Disbursements$202,586
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER RECEIPTS FILE NUMBER: 001-974

Name and Address
(A)
GM - Delphi
2100 Burlingame Ave. SW

Wyoming
MI
49509
Type or Classification
(B)
Automaker
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$6,500
Total of All Transactions with this Payee/Payer for This Schedule$6,500
Name and Address
(A)
International Union - UAW
8000 East Jefferson Ave.

Detroit
MI
48214
Type or Classification
(B)
UAW
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$7,729
Total Non-Itemized Transactions with this Payee/Payer$1,000
Total of All Transactions with this Payee/Payer for This Schedule$8,729
13TH REBATE/DUES04/20/2016$7,729
Name and Address
(A)
Marriott Warman Park Hotel
2660 Woodley Road NW

Washington
DC
20008
Type or Classification
(B)
Hotel
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$5,088
Total of All Transactions with this Payee/Payer for This Schedule$5,088
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 - REPRESENTATIONAL ACTIVITIES FILE NUMBER: 001-974

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 16 - POLITICAL ACTIVITIES AND LOBBYING FILE NUMBER 001-974

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: 001-974

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: 001-974

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: 001-974

Name and Address
(A)
Roberts Custom Software
3667 First St.

East Moline
IL
61244-3321
Type or Classification
(B)
Software Provider
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$5,156
Total of All Transactions with this Payee/Payer for This Schedule$5,156
Name and Address
(A)
Screen Graphix Inc.
950 Vitality Dr.

Comstock Park
MI
49321
Type or Classification
(B)
T-Shirt Printing
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$11,000
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$11,000
T-Shirts for membership04/27/2016$11,000
Name and Address
(A)
Swift Printing
404 Bridge St. NW

Grand Rapids
MI
49504
Type or Classification
(B)
Printing Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$13,260
Total of All Transactions with this Payee/Payer for This Schedule$13,260
Name and Address
(A)
UAW Region 1-D
1940 W. Atherton Rd.

Flint
MI
48507
Type or Classification
(B)
Regional Office
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$10,190
Total of All Transactions with this Payee/Payer for This Schedule$10,190
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 20 - BENEFITS FILE NUMBER: 001-974

Description
(A) 		To Whom Paid
(B) 		Amount
(C)
Total of all lines above (Total will be automatically entered in Item 55.)$2,895
Workers Compension InsuranceAccident Fund Company$1,665
Medical Fees - OtherGM - Delphi$615
Medical Fees - OtherNova Care Rahabilitation$615
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL INFORMATION SUMMARY FILE NUMBER: 001-974


Statement A,

Cash Begin Total: Increase in beginning balance due to voided checks in the amount of $459 from previous year.

Schedule 13, Row1:

Schedule 13, Row1::Anyone who has applied and been accepted for membership is a regular member. Regular members pay full dues.

Schedule 13, Row1:

Schedule 13, Row1:
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)