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
007-381
2. PERIOD COVERED
From01/01/2017
Through12/31/2017
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
TEAMSTERS
5. DESIGNATION (Local, Lodge, etc.)
JOINT COUNCIL
 6. DESIGNATION NBR
41
7. UNIT NAME (if any)

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

Number and Street
6051 CAREY DRIVE
City
VALLEY VIEW
State
OH		 ZIP Code + 4
44125


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:Patrick J DarrowPRESIDENT71. SIGNED:Travis W BornsteinTREASURER
Date:Mar 25, 2018Telephone Number:330-434-3424Date:Mar 20, 2018Telephone Number:330-434-8126
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21 FILE NUMBER: 007-381
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?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?Yes
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?$225,000
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?12/2018
20. How many members did the labor organization have at the end of the reporting period?0
21. What are the labor organization's rates of dues and fees?
Rates of Dues and Fees
Dues/FeesAmount UnitMinimumMaximum
(a) Regular Dues/Fees1.30perMBR/MNTHN/AN/A
(b) Working Dues/Feesper
(c) Initiation Feesper
(d) Transfer Feesper
(e) Work Permitsper

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS AND LIABILITIES FILE NUMBER: 007-381

ASSETS
ASSETS Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
22. Cash $276,977$274,568
23. Accounts Receivable1$0$0
24. Loans Receivable2$0$0
25. U.S. Treasury Securities $0$0
26. Investments5$245,215$256,219
27. Fixed Assets6$1,481$2,123
28. Other Assets7$145$145
29. TOTAL ASSETS $523,818$533,055

LIABILITIES
LIABILITIES Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
30. Accounts Payable8$0$0
31. Loans Payable9$0$0
32. Mortgages Payable $0$0
33. Other Liabilities10$168,888$157,112
34. TOTAL LIABILITIES $168,888$157,112
35. NET ASSETS$354,930$375,943
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B - RECEIPTS AND DISBURSEMENTS FILE NUMBER: 007-381

CASH RECEIPTSSCHAMOUNT
36. Dues and Agency Fees $0
37. Per Capita Tax $686,455
38. Fees, Fines, Assessments, Work Permits $0
39. Sale of Supplies $0
40. Interest $2,214
41. Dividends $11,707
42. Rents $0
43. Sale of Investments and Fixed Assets3$50,078
44. Loans Obtained9$0
45. Repayments of Loans Made2$0
46. On Behalf of Affiliates for Transmittal to Them $0
47. From Members for Disbursement on Their Behalf $4,838
48. Other Receipts14$23,479
49. TOTAL RECEIPTS $778,771
CASH DISBURSEMENTSSCHAMOUNT
50. Representational Activities15$110,631
51. Political Activities and Lobbying16$9,607
52. Contributions, Gifts, and Grants17$50,456
53. General Overhead18$119,257
54. Union Administration19$169,662
55. Benefits20$235,400
56. Per Capita Tax $0
57. Strike Benefits $0
58. Fees, Fines, Assessments, etc. $0
59. Supplies for Resale $0
60. Purchase of Investments and Fixed Assets4$62,574
61. Loans Made2$0
62. Repayment of Loans Obtained9$0
63. To Affiliates of Funds Collected on Their Behalf $0
64. On Behalf of Individual Members $4,838
65. Direct Taxes $18,755
  
66. Subtotal $781,180
67. Withholding Taxes and Payroll Deductions  
  67a. Total Withheld$54,883  
  67b. Less Total Disbursed$54,883  
  67c. Total Withheld But Not Disbursed 
68. TOTAL DISBURSEMENTS $781,180
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE FILE NUMBER: 007-381

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: 007-381

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: 007-381

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$50,321$50,321$50,078$50,078
INVESTMENTS$50,321$50,321$50,078$50,078
Less Reinvestments$0
(The total from Net Sales Line will be automatically entered in Item 43)Net Sales$50,078
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 4 - PURCHASE OF INVESTMENTS AND FIXED ASSETS FILE NUMBER: 007-381

Description (if land or buildings, give location)
(A) 		Cost
(B) 		Book Value
(C) 		Cash Paid
(D)
Total of all lines above$62,574$62,574$62,574
INVESTMENTS$61,325$61,325$61,325
OFFICE EQUIPMENT$1,249$1,249$1,249
 Less Reinvestments$0
(The total from Net Purchases Line will be automatically entered in Item 60.)Net Purchases$62,574
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 - INVESTMENTS FILE NUMBER: 007-381

Description
(A) 		Amount
(B)
Marketable Securities 
A. Total Cost$256,219
B. Total Book Value$256,219
C. List each marketable security which has a book value over $5,000 and exceeds 5% of Line B.  
  • 25,000 UNITS, UNITED STATES TREASURY NOTES
$24,718
  • 25,000 UNITS, UNITED STATES TREASURY NOTES
$24,697
  • 25,000 UNITS, UNITED STATES TREASURY NOTES
$24,941
  • 25,000 UNITS, UNITED STATES TREASURY NOTES
$24,985
  • 25,000 UNITS, UNITED STATES TREASURY NOTES
$25,034
  • 25,000 UNITS, UNITED STATES TREASURY NOTES
$25,049
  • 25,000 UNITS, UNITED STATES TREASURY NOTES
$24,913
  • 1,446 UNITS, MFS VALUE FUND CLASS I
$28,662
  • 983 UNITS, T. ROWE PRICE GROWTH STOCK
$37,883
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)) $256,219
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 6 - FIXED ASSETS FILE NUMBER: 007-381

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$18,263$16,140$2,123$2,500
E. Other Fixed Assets
F. Totals of Lines A through E (Column(D) Total will be automatically entered in Item 27, Column(B)) $18,263$16,140$2,123$2,500
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER ASSETS FILE NUMBER: 007-381

Description
(A) 		Book Value
(B)
Total (Total will be automatically entered in Item 28, Column(B)) $145
DEPOSIT - WORKERS COMPENSATION$145
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS PAYABLE AGING SCHEDULE FILE NUMBER: 007-381

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: 007-381

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: 007-381

Description
(A) 		Amount at End of Period
(B)
Total Other Liabilities (Total will be automatically entered in Item 33, Column(D)) $157,112
WITHDRAWAL LIABILITY$157,112
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS FILE NUMBER: 007-381

(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 		DARROW ,  PATRICK   J
PRESIDENT
C		$30,000$210$30,210
I
Schedule 15
Representational Activities 		5 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		5 % Schedule 19
Administration 		90 %
A
B
C 		BORNSTEIN ,  TRAVIS  
SECRETARY-TREASURER
C		$15,600$28$15,628
I
Schedule 15
Representational Activities 		5 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		5 % Schedule 19
Administration 		90 %
A
B
C 		DUDAS ,  DAVID   D
VICE PRESIDENT
C		$15,600$13$15,613
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 		NARDI ,  NICHOLAS  
RECORDING SECRETARY
C		$15,600$15,600
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		3 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		97 %
A
B
C 		BAIRD ,  DOYLE  
TRUSTEE
C		$6,000$19$6,019
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 		PECORARO ,  CARL  
TRUSTEE
C		$6,000$40$6,040
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 		COLLINSON ,  RICHARD  
TRUSTEE
C		$5,500$5,500
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		5 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		95 %
Total Officer Disbursements$94,300$0$310$0$94,610
Less Deductions    $18,787
Net Disbursements    $75,823
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES FILE NUMBER: 007-381

(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 		RICHMOND ,  DAVE  
ORGANIZER
N/A		$55,950$5,400$2,425$63,775
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 		ZART ,  MARY  
ADMINISTRATIVE
N/A		$24,350$806$25,156
I
Schedule 15
Representational Activities 		5 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		85 % Schedule 19
Administration 		10 %
A
B
C 		BEDNARSKI ,  PAMELA  
ADMINISTRATIVE
N/A		$11,350$11,350
I
Schedule 15
Representational Activities 		5 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		85 % Schedule 19
Administration 		10 %
TOTALS RECEIVED BY EMPLOYEES MAKING $10,000 OR LESS$29,012$29,012
I Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		30 % Schedule 19
Administration 		70 %
Total Employee Disbursements$120,662$5,400$3,231$0$129,293
Less Deductions    $36,096
Net Disbursements    $93,197
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 - MEMBERSHIP STATUS FILE NUMBER: 007-381

Category of Membership
(A) 		Number
(B) 		Voting Eligibility
(C)
Members (Total of all lines above) 0 
Agency Fee Payers*
Total Members/Fee Payers0 
*Agency Fee Payers are not considered members of the labor organization.
0No
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19 FILE NUMBER: 007-381

SCHEDULE 14   OTHER RECEIPTS
1. Named Payer Itemized Receipts$22,542
2. Named Payer Non-itemized Receipts$0
3. All Other Receipts$937
4. Total Receipts$23,479
     
     
SCHEDULE 17   CONTRIBUTIONS, GIFTS & GRANTS
1. Named Payee Itemized Disbursements$21,204
2. Named Payee Non-itemized Disbursements$2,316
3. To Officers$0
4. To Employees$0
5. All Other Disbursements$26,936
6. Total Disbursements$50,456
SCHEDULE 15   REPRESENTATIONAL ACTIVITIES
1. Named Payee Itemized Disbursements$18,582
2. Named Payee Non-itemized Disbursements$16,821
3. To Officers$2,292
4. To Employees$65,601
5. All Other Disbursements$7,335
6. Total Disbursements$110,631
SCHEDULE 18   GENERAL OVERHEAD
1. Named Payee Itemized Disbursements$26,295
2. Named Payee Non-itemized Disbursements$23,241
3. To Officers$2,292
4. To Employees$39,735
5. All Other Disbursements$27,694
6. Total Disbursements$119,257
SCHEDULE 16   POLITICAL ACTIVITIES AND LOBBYING
1. Named Payee Itemized Disbursements$8,864
2. Named Payee Non-itemized Disbursements$0
3. To Officers$743
4. To Employees$0
5. All Other Disbursements
6. Total Disbursements$9,607
SCHEDULE 19   UNION ADMINISTRATION
1. Named Payee Itemized Disbursements$19,535
2. Named Payee Non-itemized Disbursements$25,427
3. To Officers$89,283
4. To Employees$23,959
5. All Other Disbursements$11,458
6. Total Disbursements$169,662
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER RECEIPTS FILE NUMBER: 007-381

Name and Address
(A)
ULLICO CASUALTY GROUP

1625 EYE ST., N.W.
WASHINGTON
DC
20006
Type or Classification
(B)
INSURANCE COMPANY
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$22,542
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$22,542
REIMBURSED LEGAL FEES07/07/2017$22,542
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 - REPRESENTATIONAL ACTIVITIES FILE NUMBER: 007-381

Name and Address
(A)
FAULKNER HOFFMAN & PHILLIPS

20445 EMERALD PARKWAY
CLEVELAND
OH
44135
Type or Classification
(B)
LAW FIRM
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$18,582
Total Non-Itemized Transactions with this Payee/Payer$16,821
Total of All Transactions with this Payee/Payer for This Schedule$35,403
LEGAL SERVICES04/13/2017$6,927
LEGAL SERVICES06/21/2017$5,656
LEGAL SERVICES10/19/2017$5,999
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 - POLITICAL ACTIVITIES AND LOBBYING FILE NUMBER 007-381

Name and Address
(A)
TEAMSTERS LOCAL 507

5425 WARNER ROAD
CLEVELAND
OH
44125
Type or Classification
(B)
LABOR ORGANIZATION
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$8,864
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$8,864
REIMBURSED LOST TIME WAGES03/21/2017$8,864
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 17 - CONTRIBUTIONS, GIFTS & GRANTS FILE NUMBER: 007-381

Name and Address
(A)
FOLEY AND ASSOCIATES
450647

WESTLAKE
OH
44145
Type or Classification
(B)
MERCHANDISE VENDOR
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,444
Total Non-Itemized Transactions with this Payee/Payer$2,316
Total of All Transactions with this Payee/Payer for This Schedule$7,760
GOLF OUTING GIFTS08/09/2017$5,444
Name and Address
(A)
RAINTREE COUNTRY CLUB

4350 MAYFAIR ROAD
UNIONTOWN
OH
44685
Type or Classification
(B)
GOLF COURSE
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$9,267
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$9,267
GREEN FEES, CARTS AND LUNCH12/13/2017$9,267
Name and Address
(A)
TEAMSTERS LOCAL 507 CER FUND

5425 WARNER ROAD
CLEVELAND
OH
44125
Type or Classification
(B)
BENEFIT PLAN
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$6,493
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$6,493
REIMBURSED BLOOD BANK EXPENSES06/27/2017$6,493
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 18 - GENERAL OVERHEAD FILE NUMBER: 007-381

Name and Address
(A)
FIRST INSURANCE FUNDING CORP
7000

CAROL STREAM
IL
60197-7000
Type or Classification
(B)
INSURANCE AGENCY
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$8,201
Total of All Transactions with this Payee/Payer for This Schedule$8,201
Name and Address
(A)
GARY M. TIBONI, CPA
630

COLUMBIA STATION
OH
44028
Type or Classification
(B)
AUDIT, ACCOUNTING AND TAX SERVICES
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$15,040
Total of All Transactions with this Payee/Payer for This Schedule$15,040
Name and Address
(A)
TEAMSTERS LOCAL 436 PENSION FUND

6051 CAREY DRIVE
VALLEY VIEW
OH
44125
Type or Classification
(B)
BENEFIT PLAN
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$26,295
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$26,295
WITHDRAWAL LIABILITY PAYMENT01/03/2017$5,259
WITHDRAWAL LIABILITY PAYMENT03/24/2017$5,259
WITHDRAWAL LIABILITY PAYMENT06/27/2017$5,259
WITHDRAWAL LIABILITY PAYMENT09/27/2017$5,259
WITHDRAWAL LIABILITY PAYMENT12/26/2017$5,259
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 19 - UNION ADMINISTRATION FILE NUMBER: 007-381

Name and Address
(A)
FAULKNER HOFFMAN & PHILLIPS

20445 EMERALD PARKWAY
CLEVELAND
OH
44135
Type or Classification
(B)
LAW FIRM
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$15,864
Total of All Transactions with this Payee/Payer for This Schedule$15,864
Name and Address
(A)
THACKER ROBSINSON ZINZ LPA

1375 EAST 9TH STREET
CLEVELAND
OH
44114
Type or Classification
(B)
LAW FIRM
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$19,535
Total Non-Itemized Transactions with this Payee/Payer$9,563
Total of All Transactions with this Payee/Payer for This Schedule$29,098
LEGAL SERVICES03/15/2017$9,767
LEGAL SERVICES04/12/2017$9,768
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 20 - BENEFITS FILE NUMBER: 007-381

Description
(A) 		To Whom Paid
(B) 		Amount
(C)
Total of all lines above (Total will be automatically entered in Item 55.)$235,400
PENSION 401(K)GEMGROUP$5,200
HEALTH AND WELFARECENTRAL STATES FUND$19,543
SEVERANCE BENEFITSTEAMSTERS JOINT COUNCIL NO. 41 SEVERANCE PLAN$210,657
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL INFORMATION SUMMARY FILE NUMBER: 007-381


Question 10: JOINT COUNCIL NO. 41 SEVERANCE PLAN, EIN 34-6541609, PLAN NO. 001, PROVIDES SEVERANCE BENEFITS TO ELIGIBLE PARTICIPANTS AND IS ADMINISTERED AT 6051 CAREY DRIVE, VALLEY VIEW, OHIO 44125. THE PLAN FILES FORM 5500 WITH THE U.S. DEPARTMENT OF LABOR.

Question 12: THE BOOKS AND RECORDS HAVE BEEN AUDITED BY OUTSIDE ACCOUNTANT GARY M. TIBONI, CPA.

Statement A,

Loans Payable Begin Total: THE BEGINNING BALANCE WAS CORRECTLY REPORTED AS ZERO.

General Information: JOINT COUNCIL NO. 41 COLLECTED PER CAPITA TAXES FROM 24 AFFILIATED LOCAL UNION AT THE RATE OF $1.30 PER MEMBER PER MONTH.
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)