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
051-368
2.
PERIOD COVERED
From
01/01/2016
Through
12/31/2016
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
957
7. UNIT NAME (if any)
8. MAILING ADDRESS (Type or print in capital
letters)
First Name
VICKI K.
Last Name
HICKS
P.O Box - Building and Room Number
Number and Street
1401 W. C.R. 600 S.
City
MUNCIE
State
IN
ZIP Code + 4
47302
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 V on penalties in the
instructions.)
70. SIGNED:
Donna L Windell
PRESIDENT
71. SIGNED:
Vicki K Hicks
TREASURER
Date:
Mar 15, 2017
Telephone
Number:
765-617-1729
Date:
Mar 15, 2017
Telephone
Number:
765-748-1127
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21
FILE NUMBER:
051-368
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?
28
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
"Two and a half hours straight-time pay per month
per
N/A
N/A
N/A
(b) Working Dues/Fees
O
per
N/A
N/A
N/A
(c) Initiation Fees
20.00
per
N/A
N/A
N/A
(d) Transfer Fees
0
per
N/A
N/A
N/A
(e) Work Permits
0
per
N/A
N/A
N/A
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS
AND LIABILITIES
FILE NUMBER:
051-368
ASSETS
ASSETS
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
22. Cash
$608,614
$589,763
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
$0
$7,510
28. Other Assets
7
$475
$231
29.
TOTAL ASSETS
$609,089
$597,504
LIABILITIES
LIABILITIES
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
30. Accounts Payable
8
$0
$804
31. Loans Payable
9
$0
$0
32. Mortgages Payable
$0
$0
33. Other Liabilities
10
$1,313
$575
34. TOTAL
LIABILITIES
$1,313
$1,379
35. NET
ASSETS
$607,776
$596,125
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B -
RECEIPTS AND DISBURSEMENTS
FILE NUMBER:
051-368
CASH
RECEIPTS
SCH
AMOUNT
36. Dues and Agency Fees
$60,461
37. Per Capita Tax
$0
38. Fees, Fines,
Assessments, Work Permits
$40
39. Sale of Supplies
$0
40. Interest
$7,815
41. Dividends
$0
42. Rents
$0
43. Sale of Investments
and Fixed Assets
3
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
$0
48. Other Receipts
14
$7,719
49. TOTAL RECEIPTS
$76,035
CASH DISBURSEMENTS
SCH
AMOUNT
50.
Representational Activities
15
$60,273
51.
Political Activities and Lobbying
16
$0
52.
Contributions, Gifts, and Grants
17
$11,840
53. General
Overhead
18
$67
54. Union
Administration
19
$12,517
55. Benefits
20
56. Per
Capita Tax
$9,577
57. Strike
Benefits
$0
58. Fees,
Fines, Assessments, etc.
$100
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
$0
65. Direct
Taxes
$545
66. Subtotal
$94,919
67.
Withholding Taxes and Payroll Deductions
67a. Total
Withheld
$994
67b. Less Total
Disbursed
$961
67c.
Total Withheld But Not Disbursed
$33
68.
TOTAL DISBURSEMENTS
$94,886
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS
RECEIVABLE AGING SCHEDULE
FILE NUMBER:
051-368
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:
051-368
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:
051-368
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
(The
total from Net Sales Line will be automatically entered
in Item 43)
Net Sales
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 4 - PURCHASE
OF INVESTMENTS AND FIXED ASSETS
FILE NUMBER:
051-368
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:
051-368
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:
051-368
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
$7,510
$7,510
$7,510
E.
Other Fixed Assets
F. Totals of Lines A through E
(Column(D) Total will be automatically entered in Item
27, Column(B))
$7,510
$0
$7,510
$7,510
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER
ASSETS
FILE NUMBER:
051-368
Description
(A)
Book Value
(B)
Total
(Total will be automatically entered in Item 28, Column(B))
$231
Bible Inventory (7 @ $32.95)
$231
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS
PAYABLE AGING SCHEDULE
FILE NUMBER:
051-368
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
$804
$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))
$804
$0
$0
$0
Per Capita Taxes - International
$763
$0
$0
$0
Per Capita Taxes - CAP Councils
$41
$0
$0
$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 9 - LOANS
PAYABLE
FILE NUMBER:
051-368
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:
051-368
Description
(A)
Amount at End of Period
(B)
Total Other Liabilities
(Total will be automatically entered in Item 33, Column(D))
$575
Federal Income Taxes (941) Forward
$68
FICA-Employee OASDI and HI Forward
$92
State Income Taxes Forward
$184
County Income Taxes Forward
$84
FICA Employer OASDI and HI (941)
$92
Unemployment Taxes Federal (940)
$33
Unemployment Taxes State
$22
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL
OFFICERS AND DISBURSEMENTS TO OFFICERS
FILE NUMBER:
051-368
(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
Coppock
,
Wendallyn
K Chair Trustee C
$129
$0
$26
$0
$155
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
Hicks
,
Vicki
K Financial Secretary C
$138
$0
$0
$0
$138
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
Jones
,
Timothy
R Barg Chairperson 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
Skinner
,
Candice
D Vice President C
$174
$0
$56
$0
$230
I
Schedule 15
Representational Activities
50
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
50
%
A
B
C
Windell
,
Donna
L President C
$184
$600
$238
$0
$1,022
I
Schedule 15
Representational Activities
87
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
13
%
Total Officer
Disbursements
$625
$600
$320
$0
$1,545
Less Deductions
$201
Net
Disbursements
$1,344
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 -
DISBURSEMENTS TO EMPLOYEES
FILE NUMBER:
051-368
(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
$4,200
$3,232
$0
$7,432
I
Schedule 15
Representational Activities
40
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
60
%
Total
Employee Disbursements
$0
$4,200
$3,232
$0
$7,432
Less
Deductions
$792
Net Disbursements
$6,640
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 -
MEMBERSHIP STATUS
FILE NUMBER:
051-368
Category of Membership
(A)
Number
(B)
Voting Eligibility
(C)
Members
(Total of all lines above)
28
Agency Fee Payers*
Total Members/Fee Payers
28
*Agency Fee Payers are
not considered members of the labor organization.
"Regular Members"
28
Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE
- SCHEDULES 14 THROUGH 19
FILE NUMBER:
051-368
SCHEDULE 14 OTHER RECEIPTS
1. Named Payer
Itemized Receipts
$0
2. Named Payer
Non-itemized Receipts
$870
3. All Other Receipts
$6,849
4. Total
Receipts
$7,719
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
$11,840
6. Total
Disbursements
$11,840
SCHEDULE 15 REPRESENTATIONAL
ACTIVITIES
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$43,236
3. To Officers
$1,004
4. To Employees
$2,973
5. All Other
Disbursements
$13,060
6. Total
Disbursements
$60,273
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
$67
6. Total
Disbursements
$67
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
$0
6. Total
Disbursements
$0
SCHEDULE 19 UNION
ADMINISTRATION
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$6,123
3. To Officers
$541
4. To Employees
$4,459
5. All Other
Disbursements
$1,394
6. Total
Disbursements
$12,517
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER
RECEIPTS
FILE NUMBER:
051-368
Name and Address
(A)
Dennis A Cheshier 9656 N County Road 800 W
Daleville IN 47334
Type or Classification
(B)
Member
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$870
Total of All Transactions with this
Payee/Payer for This Schedule
$870
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 -
REPRESENTATIONAL ACTIVITIES
FILE NUMBER:
051-368
Name and Address
(A)
Dennis A Cheshier 9656 N County Road 800 W
Daleville IN 47334
Type or Classification
(B)
Member
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$6,291
Total of All Transactions with this
Payee/Payer for This Schedule
$6,291
Name and Address
(A)
L&r Peace & Plenty 511 South Main Street
Jonesboro IN 46938
Type or Classification
(B)
Caterer
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$23,317
Total of All Transactions with this
Payee/Payer for This Schedule
$23,317
Name and Address
(A)
Local 1963 Building Committee 2840 S Madison Avenue
Anderson IN 46016
Type or Classification
(B)
Local Union
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$13,628
Total of All Transactions with this
Payee/Payer for This Schedule
$13,628
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 -
POLITICAL ACTIVITIES AND LOBBYING
FILE NUMBER
051-368
There was no data
found for this schedule.
SCHEDULE 17 -
CONTRIBUTIONS, GIFTS & GRANTS
FILE NUMBER:
051-368
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:
051-368
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:
051-368
Name and Address
(A)
Local 1963 Building Committee 2840 S Madison Avenue
Anderson IN 46016
Type or Classification
(B)
Local Union
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$6,123
Total of All Transactions with this
Payee/Payer for This Schedule
$6,123
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 20 -
BENEFITS
FILE NUMBER:
051-368
Description
(A)
To Whom Paid
(B)
Amount
(C)
Total of all
lines above (Total will be automatically entered in Item
55.)
$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL
INFORMATION SUMMARY
FILE NUMBER:
051-368
Address of Record: 9803 N County Road 850 W
Daleville, IN 47334
Schedule 8, Row1:
Schedule 8, Row1::
Schedule 8, Row2:
Schedule 8, Row2::
Schedule 13, Row1:
Schedule 13, Row1::"Anyone who has applied and been accepted for membership is a regular member. Regular members pay full dues.