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: 09-30-2021
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
506-906
2. PERIOD COVERED
From07/01/2019
Through06/30/2020
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
SERVICE EMPLOYEES
5. DESIGNATION (Local, Lodge, etc.)
LOCAL UNION
 6. DESIGNATION NBR

7. UNIT NAME (if any)
COMMITTEE OF INTERNS AND RESIDENTS
8. MAILING ADDRESS (Type or print in capital letters)
First Name
Margot
 Last Name
Riphagen
P.O Box - Building and Room Number

Number and Street
10-27 46th Ave, Suite 300-2
City
Long Island City
State
NY		 ZIP Code + 4
11101


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:Jessica EdwardsPRESIDENT71. SIGNED:Linda AlvarezTREASURER
Date:Sep 29, 2020Telephone Number:214-695-9158Date:Sep 28, 2020Telephone Number:845-274-7418
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21 FILE NUMBER: 506-906
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?Yes
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?$500,000
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?Yes
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?03/2021
20. How many members did the labor organization have at the end of the reporting period?14,494
21. What are the labor organization's rates of dues and fees?
Rates of Dues and Fees
Dues/FeesAmount UnitMinimumMaximum
(a) Regular Dues/Fees1.6perYear745.182317.58
(b) Working Dues/Fees0per000
(c) Initiation Fees0per000
(d) Transfer Fees0per000
(e) Work Permits0per000

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS AND LIABILITIES FILE NUMBER: 506-906

ASSETS
ASSETS Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
22. Cash $3,831,185$5,044,185
23. Accounts Receivable1$870,473$2,682,873
24. Loans Receivable2$2,817$2,743
25. U.S. Treasury Securities $2,695,729$2,845,409
26. Investments5$0$0
27. Fixed Assets6$506,928$589,978
28. Other Assets7$1,391,061$1,721,449
29. TOTAL ASSETS $9,298,193$12,886,637

LIABILITIES
LIABILITIES Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
30. Accounts Payable8$448,775$976,732
31. Loans Payable9$0
32. Mortgages Payable $0$0
33. Other Liabilities10$389,394$1,087,043
34. TOTAL LIABILITIES $838,169$2,063,775
35. NET ASSETS$8,460,024$10,822,862
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B - RECEIPTS AND DISBURSEMENTS FILE NUMBER: 506-906

CASH RECEIPTSSCHAMOUNT
36. Dues and Agency Fees $12,042,609
37. Per Capita Tax $0
38. Fees, Fines, Assessments, Work Permits $0
39. Sale of Supplies $0
40. Interest $60,013
41. Dividends $0
42. Rents $0
43. Sale of Investments and Fixed Assets3$415,292
44. Loans Obtained9$0
45. Repayments of Loans Made2$9,086
46. On Behalf of Affiliates for Transmittal to Them $39,263
47. From Members for Disbursement on Their Behalf $0
48. Other Receipts14$2,744,015
49. TOTAL RECEIPTS $15,310,278
CASH DISBURSEMENTSSCHAMOUNT
50. Representational Activities15$5,480,684
51. Political Activities and Lobbying16$169,248
52. Contributions, Gifts, and Grants17$86,913
53. General Overhead18$2,648,310
54. Union Administration19$1,188,161
55. Benefits20$1,737,457
56. Per Capita Tax $1,716,673
57. Strike Benefits $0
58. Fees, Fines, Assessments, etc. $0
59. Supplies for Resale $0
60. Purchase of Investments and Fixed Assets4$568,773
61. Loans Made2$9,012
62. Repayment of Loans Obtained9$0
63. To Affiliates of Funds Collected on Their Behalf $49,616
64. On Behalf of Individual Members $0
65. Direct Taxes $448,325
  
66. Subtotal $14,103,172
67. Withholding Taxes and Payroll Deductions  
  67a. Total Withheld$1,756,132  
  67b. Less Total Disbursed$1,750,238  
  67c. Total Withheld But Not Disbursed $5,894
68. TOTAL DISBURSEMENTS $14,097,278
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE FILE NUMBER: 506-906

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$2,682,873   
Totals (Total of Column (B) will be automatically entered in Item 23, Column(B)) $2,682,873$0$0$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 2 - LOANS RECEIVABLE FILE NUMBER: 506-906

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$380$0$380$0$0
Total of all lines above$2,817$9,012$9,086$0$2,743
Totals will be automatically entered in... Item 24
Column (A) 		Item 61Item 45 Item 69
with Explanation 		Item 24
Column (B)
Name: Casey Gin (E)
Purpose: 1yr Loan
Security: Payroll deduction
Terms of Repayment: $71/pay period
$1,289$0$1,289$0$0
Name: George Morse (E)
Purpose: 1yr Loan
Security: Payroll deduction
Terms of Repayment: $80/pay period
$0$1,999$1,999$0$0
Name: Susan Naranjo (E)
Purpose: Expense Overpayment
Security: Expense Reimb.
Terms of Repayment: 1 pay period
$0$1,923$0$0$1,923
Name: Alphonso Nyenuh (E)
Purpose: 6mo Loan
Security: Payroll deduction
Terms of Repayment: $192/pay period
$0$2,300$1,920$0$380
Name: Anya Snow (E)
Purpose: Personal charge
Security: Expense Reimb.
Terms of Repayment: 1 pay period
$841$0$841$0$0
Name: Sabrina Struth (E)
Purpose: 6mo Loan
Security: Payroll deduction
Terms of Repayment: $235/pay period
$0$2,400$2,350$0$50
Name: Sharome Wiggins (E)
Purpose: Personal charge
Security: Expense Reimb.
Terms of Repayment: 1 pay period
$307$0$307$0$0
Name: Rashina Young (E)
Purpose: Personal charge
Security: Expense Reimb.
Terms of Repayment: 1 pay period
$0$390$0$0$390
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 3 - SALE OF INVESTMENTS AND FIXED ASSETS FILE NUMBER: 506-906

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$415,158$415,158$415,292$415,292
US Treasury & agency securities$415,158$415,158$415,292$415,292
Less Reinvestments$0
(The total from Net Sales Line will be automatically entered in Item 43)Net Sales$415,292
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 4 - PURCHASE OF INVESTMENTS AND FIXED ASSETS FILE NUMBER: 506-906

Description (if land or buildings, give location)
(A) 		Cost
(B) 		Book Value
(C) 		Cash Paid
(D)
Total of all lines above$660,520$660,520$568,773
Furniture & Fixtures$18,622$18,622$18,622
Computer equipment$26,624$26,624$26,624
Computer software$35,768$35,768$4,523
Leasehold improvements$108,947$108,947$48,445
US Treasury & agency securities$470,559$470,559$470,559
 Less Reinvestments$0
(The total from Net Purchases Line will be automatically entered in Item 60.)Net Purchases$568,773
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 - INVESTMENTS FILE NUMBER: 506-906

Description
(A) 		Amount
(B)
Marketable Securities 
A. Total Cost$0
B. Total Book Value$0
C. List each marketable security which has a book value over $5,000 and exceeds 5% of Line B.  
Other Investments 
D. Total Cost$0
E. Total Book Value$0
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: 506-906

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$402,824$169,263$233,561$233,561
E. Other Fixed Assets$433,440$77,023$356,417$356,417
F. Totals of Lines A through E (Column(D) Total will be automatically entered in Item 27, Column(B)) $836,264$246,286$589,978$589,978
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER ASSETS FILE NUMBER: 506-906

Description
(A) 		Book Value
(B)
Total (Total will be automatically entered in Item 28, Column(B)) $1,721,449
Prepaid Expenses$114,633
Accrued Income Receivable$11,343
Rebates Receivable$228,231
Security Deposits$88,309
Other receivables$354,981
Due from Related Entities$923,952
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS PAYABLE AGING SCHEDULE FILE NUMBER: 506-906

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$976,732$0$0$0
Totals (Total for Column(B) will be automatically entered in Item 30, Column(D)) $976,732$0$0$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 9 - LOANS PAYABLE FILE NUMBER: 506-906

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: 506-906

Description
(A) 		Amount at End of Period
(B)
Total Other Liabilities (Total will be automatically entered in Item 33, Column(D)) $1,087,043
Accrued Salaries Payable$153,327
Accrued Vacation & Sick Pay Payable$313,018
Withheld payable$14,283
Other Payables$606,415
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS FILE NUMBER: 506-906

(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 		Edwards DO ,  Jessica  
President
C		$100,392$418$395$0$101,205
I
Schedule 15
Representational Activities 		97 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		2 % Schedule 19
Administration 		0 %
A
B
C 		Plasencia MD ,  Amy  
Executive Vice President
C		$0$0$0$0$0
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 		Alvarez MD ,  Linda  
Secretary-Treasurer
C		$94,649$0$0$0$94,649
I
Schedule 15
Representational Activities 		97 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		2 % Schedule 19
Administration 		0 %
A
B
C 		Barrios MD ,  Erica  
Regional VP - So CA No
P		$0$0$1,404$0$1,404
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 		Borkowski MD ,  Suzanne  
Regional VP - NJ/DC
C		$0$0$590$0$590
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 		Breyre MD ,  Amelia  
Regional VP - No CA
C		$0$0$156$0$156
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 		Davies MD ,  Georgia  
Regional VP - NJ/DC
C		$0$0$273$0$273
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 		Elnajjar MD ,  Alaa  
Regional VP - NY
C		$0$0$827$0$827
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 		Gabrellas MD ,  Greg  
UCLA Representative
C		$0$0$0$0$0
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 		Garg MBBS MS ,  Mohit  
Regional VP - NY
C		$0$0$0$0$0
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 		Gaudiot MD ,  Christopher  
Regional VP - NM
C		$0$0$0$0$0
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 		Gomez-Juge MD ,  Christina  
Regional VP - NY
C		$0$0$590$0$590
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 		Gordon MD MPH ,  Alexis  
Regional VP - So CA No
C		$0$0$3,655$0$3,655
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 		Manalo DO ,  Rachel  
Regional VP - FL
C		$0$0$1,000$0$1,000
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 		Nandam MD MPH ,  Aneesh  
Regional VP - No CA
C		$0$0$69$0$69
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 		Newsome MD ,  Brandon  
Regional VP - MA
C		$0$0$267$0$267
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 		Oppong-Dwamena M ,  Adelaide  
Regional VP - NY
C		$0$0$0$0$0
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 		Somvanshi MD ,  Saurabh  
Regional VP - NY
C		$0$0$0$0$0
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 		Ugwu MD ,  Chidiebere  
Regional VP - NY
C		$0$28$172$0$200
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 		Vo MD ,  Christpher  
Regional VP - So CAL
N		$0$0$0$0$0
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 		Yap MD ,  Anna  
UCLA Representative
C		$0$0$343$0$343
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 %
Total Officer Disbursements$195,041$446$9,741$0$205,228
Less Deductions    $92,051
Net Disbursements    $113,177
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES FILE NUMBER: 506-906

(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 		Riphagen ,  Margot  
Executive Director
None		$181,707$2,665$70,440$0$254,812
I
Schedule 15
Representational Activities 		85 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		13 % Schedule 19
Administration 		0 %
A
B
C 		Altenor ,  Jennifer   J
Media Coordinator
None		$92,656$530$12,791$0$105,977
I
Schedule 15
Representational Activities 		2 % Schedule 16
Political Activities and Lobbying 		10 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		87 % Schedule 19
Administration 		1 %
A
B
C 		Blado ,  Christopher   M
Research-Negotiations Mgr
None		$44,072$828$1,707$0$46,607
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 		Bush ,  Alexandra   H
No. CA Contract Organizer
None		$64,517$4,700$6,891$0$76,108
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Cardenas ,  Andrea  
Communication Coordinator
None		$54,017$65$457$0$54,539
I
Schedule 15
Representational Activities 		23 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		10 % Schedule 19
Administration 		67 %
A
B
C 		Carrube ,  Linda  
Office Manager
None		$96,540$410$6,267$0$103,217
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		2 % Schedule 19
Administration 		98 %
A
B
C 		Carter Martinez ,  Kimberley  
No CA-NM Area Director
None		$87,071$1,099$28,041$0$116,211
I
Schedule 15
Representational Activities 		91 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		5 % Schedule 19
Administration 		3 %
A
B
C 		Cerdina ,  Nina   A
Organizing Director
None		$103,325$7,596$82,396$0$193,317
I
Schedule 15
Representational Activities 		90 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		10 % Schedule 19
Administration 		0 %
A
B
C 		Chow ,  Timothy  
Dir Spec Projects-Systems
None		$115,746$0$567$0$116,313
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 		Clarkson ,  Lalit  
Lead Contract OrganizerNY
None		$90,188$110$11,112$0$101,410
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 		Cundari Roelans ,  Alyssa   G
Florida Area Director
None		$119,951$0$9,314$0$129,265
I
Schedule 15
Representational Activities 		82 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		18 % Schedule 19
Administration 		0 %
A
B
C 		Currier ,  Morgan   R
Organizer
None		$58,383$3,610$2,362$0$64,355
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Daniel-Hill ,  Cheryle  
Executive Assistant
None		$88,605$656$255$0$89,516
I
Schedule 15
Representational Activities 		5 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		90 % Schedule 19
Administration 		5 %
A
B
C 		Dashefsky ,  David   J
Dir Strategic Campaigns
None		$117,443$4,444$36,955$0$158,842
I
Schedule 15
Representational Activities 		96 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		2 % Schedule 19
Administration 		1 %
A
B
C 		Derosa ,  Ralph  
General Counsel
None		$158,254$1,157$14,641$0$174,052
I
Schedule 15
Representational Activities 		91 % Schedule 16
Political Activities and Lobbying 		3 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		3 % Schedule 19
Administration 		3 %
A
B
C 		Devlin ,  Samantha   N
Clerical Staff
None		$14,530$0$0$0$14,530
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		2 % Schedule 19
Administration 		98 %
A
B
C 		Devoe ,  Dwane  
So. CA Contract Organizer
None		$79,243$7,699$3,898$0$90,840
I
Schedule 15
Representational Activities 		97 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		2 % Schedule 19
Administration 		0 %
A
B
C 		Dunham ,  Carol   G
Senior Counsel
None		$96,726$0$0$0$96,726
I
Schedule 15
Representational Activities 		95 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		5 %
A
B
C 		Eliot ,  Anita  
Director Legal Services
None		$152,357$0$638$0$152,995
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 		Ergasheva ,  Zaynab   S
FL Contract Organizer
None		$67,834$128$6,890$0$74,852
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Feldberg ,  Eve  
NY Contract Organizer
None		$68,281$82$6,435$0$74,798
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 		Fernandez ,  Vivian   M
QI Director
None		$106,219$0$367$0$106,586
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		5 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		95 % Schedule 19
Administration 		0 %
A
B
C 		Foldes ,  Lila   S
NY Contract Organizer
None		$75,010$0$0$0$75,010
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 		Gamboa ,  Jonathan   A
Senior Accountant
None		$63,910$86$2,728$0$66,724
I
Schedule 15
Representational Activities 		5 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		95 %
A
B
C 		Gil ,  Marie   I
Employee
None		$12,000$0$0$0$12,000
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		100 % Schedule 19
Administration 		0 %
A
B
C 		Gin ,  Casey  
NY Contract Organizer
None		$76,190$7,594$13,730$0$97,514
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Holden ,  Sara   A
NY Contract Organizer
None		$89,032$7,200$1,124$0$97,356
I
Schedule 15
Representational Activities 		99 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		1 % Schedule 19
Administration 		0 %
A
B
C 		Hom ,  Stephen   J
Accountant
None		$85,820$86$1,786$0$87,692
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 		Hull ,  Christopher  
Director of Legal Affairs
None		$154,407$226$2,709$0$157,342
I
Schedule 15
Representational Activities 		92 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		8 % Schedule 19
Administration 		0 %
A
B
C 		Lindsey ,  Marley-Vince  
NJ Contract Organizer
None		$64,954$16$5,066$0$70,036
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 		Loreto ,  Romina   F
External Organizer
None		$24,223$2,812$9,974$0$37,009
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 		Mahabir ,  Rebecca   L
Sr. Legal Assistant
None		$31,566$0$46$0$31,612
I
Schedule 15
Representational Activities 		17 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		7 % Schedule 19
Administration 		76 %
A
B
C 		Maingrette ,  Wiener  
Controller
None		$142,432$87$3,836$0$146,355
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		3 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		88 % Schedule 19
Administration 		9 %
A
B
C 		Master ,  Karen  
Lead Contract OrganizerNY
None		$94,046$7,200$8,989$0$110,235
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 		Mathurin ,  Earl  
Associate Director
None		$186,036$1,289$50,514$0$237,839
I
Schedule 15
Representational Activities 		80 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		5 % Schedule 19
Administration 		14 %
A
B
C 		Morse ,  George   M
So. CA Contract Organizer
None		$70,360$4,764$9,214$0$84,338
I
Schedule 15
Representational Activities 		99 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Naranjo ,  Susan  
Lead Contract Orgzr No CA
None		$139,683$4,023$21,805$0$165,511
I
Schedule 15
Representational Activities 		70 % Schedule 16
Political Activities and Lobbying 		30 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Nazzaro ,  Suzette   I
Human Resources Director
None		$107,487$86$30,763$0$138,336
I
Schedule 15
Representational Activities 		10 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		10 % Schedule 19
Administration 		80 %
A
B
C 		Nyenuh ,  Alphonso  
NY Contract Organizer
None		$68,467$0$3,097$0$71,564
I
Schedule 15
Representational Activities 		97 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		2 % Schedule 19
Administration 		0 %
A
B
C 		Paz ,  Edwin   J
Organizer
None		$23,523$0$0$0$23,523
I
Schedule 15
Representational Activities 		99 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Phillip ,  Sandra  
Secretary
None		$71,001$86$998$0$72,085
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 		Pratali ,  Aimee   R
Contract Organizer
None		$82,874$9,909$25,149$0$117,932
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Ramirez ,  Marah  
HE Coordinator
None		$88,413$0$1,011$0$89,424
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 		Ramirez ,  Sarah   M
Paralegal
None		$37,019$0$0$0$37,019
I
Schedule 15
Representational Activities 		2 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		98 %
A
B
C 		Reason ,  Phillip   K
MA Contract Organizer
None		$39,774$0$4,115$0$43,889
I
Schedule 15
Representational Activities 		99 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Ricks ,  Asantewaa  
Regional Director NY-MA
None		$90,877$0$7,321$0$98,198
I
Schedule 15
Representational Activities 		99 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Robinson ,  Carmen  
Organizing AdminAssistant
None		$80,920$86$1,268$0$82,274
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 		Roldan ,  Priscilla   C
Sr. Legal Secretary
None		$35,611$0$0$0$35,611
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 		Rudich ,  Micaela  
New Organizer
None		$51,352$7,626$10,189$0$69,167
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 		Ruiz ,  Alyssa  
Health Equity Director
None		$103,252$40$12,181$0$115,473
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 		Schubert ,  Coralie   A
NY Contract Organizer
None		$64,521$0$8,420$0$72,941
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 ,  Seneca   C
Organizer
None		$39,652$1,700$837$0$42,189
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 		Shatabdy ,  Shaila   S
NY Contract Organizer
None		$74,388$0$1,811$0$76,199
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		2 % Schedule 19
Administration 		0 %
A
B
C 		Snow ,  Anya  
Socal Lead Organizer
None		$88,109$2,926$10,680$0$101,715
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Snurpus ,  Suzanne   A
Organizer
None		$21,743$0$98$0$21,841
I
Schedule 15
Representational Activities 		99 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Struth ,  Sabrina  
No. CA Contract Organizer
None		$81,117$11,742$8,499$0$101,358
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Szeps ,  Marisa   M
Political Coordinator
None		$94,396$5,014$26,686$0$126,096
I
Schedule 15
Representational Activities 		60 % Schedule 16
Political Activities and Lobbying 		38 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		2 % Schedule 19
Administration 		0 %
A
B
C 		Tyrpak ,  Jed   D
NY/NJ Regional Director
None		$116,858$7,797$13,480$0$138,135
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Warburton ,  Harry   R
Lead Contract OrganizerDC
None		$88,696$8,694$28,519$0$125,909
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Warner ,  Rosemary  
Secretary
None		$72,853$86$872$0$73,811
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 		Washburn ,  Ira   B
New Organizer
None		$69,401$11,944$18,525$0$99,870
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 		Wiggins ,  Sharome   R
NJ Contract Organizer
None		$82,386$6,450$1,680$0$90,516
I
Schedule 15
Representational Activities 		99 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Williams ,  Arthur   J
Clerical/Admin Asst.
None		$66,295$86$1,003$0$67,384
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 		Winkler ,  Joy   I
So CA Area Director
None		$56,476$1,288$3,439$0$61,203
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Young ,  Rashina   D
NY Public Area Director
None		$52,446$1,380$3,210$0$57,036
I
Schedule 15
Representational Activities 		98 % Schedule 16
Political Activities and Lobbying 		2 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
TOTALS RECEIVED BY EMPLOYEES MAKING $10,000 OR LESS$9,676$0$339$0$10,015
I Schedule 15
Representational Activities 		32 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		2 % Schedule 19
Administration 		66 %
Total Employee Disbursements$5,326,917$148,102$658,135$0$6,133,154
Less Deductions    $1,664,081
Net Disbursements    $4,469,073
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 - MEMBERSHIP STATUS FILE NUMBER: 506-906

Category of Membership
(A) 		Number
(B) 		Voting Eligibility
(C)
Members (Total of all lines above) 14,494 
Agency Fee Payers*42
Total Members/Fee Payers14,536 
*Agency Fee Payers are not considered members of the labor organization.
Members14,494Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19 FILE NUMBER: 506-906

SCHEDULE 14   OTHER RECEIPTS
1. Named Payer Itemized Receipts$2,684,436
2. Named Payer Non-itemized Receipts$27,804
3. All Other Receipts$31,775
4. Total Receipts$2,744,015
     
     
SCHEDULE 17   CONTRIBUTIONS, GIFTS & GRANTS
1. Named Payee Itemized Disbursements$75,470
2. Named Payee Non-itemized Disbursements$6,000
3. To Officers$0
4. To Employees$0
5. All Other Disbursements$5,443
6. Total Disbursements$86,913
SCHEDULE 15   REPRESENTATIONAL ACTIVITIES
1. Named Payee Itemized Disbursements$666,354
2. Named Payee Non-itemized Disbursements$102,282
3. To Officers$194,669
4. To Employees$4,380,809
5. All Other Disbursements$136,570
6. Total Disbursements$5,480,684
SCHEDULE 18   GENERAL OVERHEAD
1. Named Payee Itemized Disbursements$1,231,387
2. Named Payee Non-itemized Disbursements$493,137
3. To Officers$3,917
4. To Employees$561,552
5. All Other Disbursements$358,317
6. Total Disbursements$2,648,310
SCHEDULE 16   POLITICAL ACTIVITIES AND LOBBYING
1. Named Payee Itemized Disbursements$5,000
2. Named Payee Non-itemized Disbursements$0
3. To Officers$1,958
4. To Employees$158,901
5. All Other Disbursements$3,389
6. Total Disbursements$169,248
SCHEDULE 19   UNION ADMINISTRATION
1. Named Payee Itemized Disbursements$105,000
2. Named Payee Non-itemized Disbursements$4,597
3. To Officers$4,690
4. To Employees$1,031,893
5. All Other Disbursements$41,981
6. Total Disbursements$1,188,161
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER RECEIPTS FILE NUMBER: 506-906

Name and Address
(A)
Cambridge Health Alliance

195 Canal Street
Malden
MA
02148
Type or Classification
(B)
Hospital
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$25,453
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$25,453
Deposit Error Returned to HSBP on 12/10/1908/22/2019$8,001
Deposit Error Returned to HSBP on 12/10/1908/22/2019$10,396
Deposit Error Returned to HSBP on 1/10/202001/06/2020$7,056
Name and Address
(A)
Housestaff Benefit Plan

520 Eighth Ave Suite 1200
New York
NY
10018
Type or Classification
(B)
Affiliate Benefit Plan
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$107,203
Total Non-Itemized Transactions with this Payee/Payer$179
Total of All Transactions with this Payee/Payer for This Schedule$107,382
Share allocat. exp pursuant to allocation studies07/19/2019$36,028
Share allocat. exp pursuant to allocation studies08/28/2019$12,517
Share allocat. exp pursuant to allocation studies10/16/2019$25,120
Share allocat. exp pursuant to allocation studies11/27/2019$5,100
Share allocat. exp pursuant to allocation studies02/05/2020$13,693
Share allocat. exp pursuant to allocation studies02/21/2020$14,745
Name and Address
(A)
Jackson Health System

1611 NW 12th Ave
Miami
FL
33136
Type or Classification
(B)
Hospital
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$175,000
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$175,000
Public Health Trust Fund07/22/2019$175,000
Name and Address
(A)
Joint Quality Improvement Assoc.

520 Eighth Ave Suite 1200
New York
NY
10018
Type or Classification
(B)
Affiliate Association
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$14,636
Total Non-Itemized Transactions with this Payee/Payer$146
Total of All Transactions with this Payee/Payer for This Schedule$14,782
Expense Reimbursement07/11/2019$14,636
Name and Address
(A)
Patient Care Trust Fund

520 Eighth Ave Suite 1200
New York
NY
10018
Type or Classification
(B)
Affiliate Association
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$304,850
Total Non-Itemized Transactions with this Payee/Payer$1,050
Total of All Transactions with this Payee/Payer for This Schedule$305,900
Share allocat. exp pursuant to allocation studies08/16/2019$161,162
Share allocat. exp pursuant to allocation studies10/16/2019$128,364
Share allocat. exp pursuant to allocation studies02/21/2020$15,324
Name and Address
(A)
Policy and Education Initiative

520 Eighth Ave Suite 1200
New York
NY
10018
Type or Classification
(B)
Affiliate Association
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$30,541
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$30,541
Expense Reimbursement07/11/2019$30,541
Name and Address
(A)
Professional Educational Plan

1375 Broadway 6th Floor
New York
NY
10018
Type or Classification
(B)
Affiliate Association
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$14,905
Total of All Transactions with this Payee/Payer for This Schedule$14,905
Name and Address
(A)
Schwartz, Steinsapir, Dohrman and Sommers

6300 Wilshire Blvd Ste 2000
Los Angeles
CA
90048-5202
Type or Classification
(B)
Legal Firm
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$31,957
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$31,957
Insurance Claim for Legal Services10/16/2019$31,957
Name and Address
(A)
Seneca Insurance Company, Inc.

160 Water Street
New York
NY
10038-4922
Type or Classification
(B)
Insurance Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$8,826
Total Non-Itemized Transactions with this Payee/Payer$1,103
Total of All Transactions with this Payee/Payer for This Schedule$9,929
Insurance Premium Refund03/18/2020$8,826
Name and Address
(A)
Service Employees International Union

1800 Massachusetts Ave NW
Washington
DC
20038
Type or Classification
(B)
Affiliate Labor Union
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$1,057,106
Total Non-Itemized Transactions with this Payee/Payer$1,635
Total of All Transactions with this Payee/Payer for This Schedule$1,058,741
Per Capita Rebate07/12/2019$207,829
Per Capita Rebate08/16/2019$43,335
Per Capita Rebate10/04/2019$102,234
Per Capita Rebate12/13/2019$131,539
Per Capita Rebate12/27/2019$210,000
Per Capita Rebate02/07/2020$82,174
Per Capita Rebate03/27/2020$62,774
Per Capita Rebate04/03/2020$95,356
Per Capita Rebate05/29/2020$25,000
Per Capita Rebate06/19/2020$96,865
Name and Address
(A)
St. Barnabas Medical Center

94 Old Short Hills Road
Livingston
NJ
07039
Type or Classification
(B)
Hospital
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$21,991
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$21,991
Expense Reimbursement04/13/2020$21,991
Name and Address
(A)
Ullico Casualty Group

333 West 34th St 2nd Flr
New York
NY
10001-2402
Type or Classification
(B)
Insurance Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$200,000
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$200,000
Insurance Claim for Lawsuit Settlement10/23/2019$200,000
Name and Address
(A)
University of Southern California

16200 Amber Valley Dr
Whittier
CA
90604
Type or Classification
(B)
University
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$12,650
Total Non-Itemized Transactions with this Payee/Payer$3,986
Total of All Transactions with this Payee/Payer for This Schedule$16,636
Quality Improvement Program Refund11/27/2019$7,500
Quality Improvement Program Refund03/18/2020$5,150
Name and Address
(A)
Voluntary Hospitals HSBP

520 Eighth Ave Suite 1200
New York
NY
10018
Type or Classification
(B)
Affiliate Benefit Plan
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$685,588
Total Non-Itemized Transactions with this Payee/Payer$4,800
Total of All Transactions with this Payee/Payer for This Schedule$690,388
Share allocat. exp pursuant to allocation studies07/19/2019$39,628
Share allocat. exp pursuant to allocation studies08/28/2019$13,737
Share allocat. exp pursuant to allocation studies10/16/2019$27,417
Share allocat. exp pursuant to allocation studies02/05/2020$15,041
Share allocat. exp pursuant to allocation studies02/21/2020$15,945
Deposit Error Returned to VHHSBP on 5/15/202004/24/2020$573,820
Name and Address
(A)
Wyckoff Heights Medical Center

374 Stockholm Street
Brooklyn
NY
11237
Type or Classification
(B)
Hospital
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$8,635
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$8,635
Expense Reimbursement04/13/2020$8,635
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 - REPRESENTATIONAL ACTIVITIES FILE NUMBER: 506-906

Name and Address
(A)
American Airlines
P.O. Box 619616
DFW Intl Apirport
Dallas
TX
75261
Type or Classification
(B)
Airline
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$9,396
Total of All Transactions with this Payee/Payer for This Schedule$9,396
Name and Address
(A)
Cohen Weiss and Simon LLP

900 Third Avenuue
New York
NY
10022-4869
Type or Classification
(B)
Legal Firm
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$6,199
Total of All Transactions with this Payee/Payer for This Schedule$6,199
Name and Address
(A)
Delta Airlines

1030 Delta Blvd
Atlanta
GA
30320
Type or Classification
(B)
Airline
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$7,542
Total of All Transactions with this Payee/Payer for This Schedule$7,542
Name and Address
(A)
Jessica Bell-Masterson

203 Chestnut Avenue #2
Jamaica Plain
MA
02130
Type or Classification
(B)
Consultant
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$17,840
Total Non-Itemized Transactions with this Payee/Payer$5,883
Total of All Transactions with this Payee/Payer for This Schedule$23,723
Consulting10/10/2019$7,165
Consulting12/31/2019$10,675
Name and Address
(A)
Kauff, McGuire and Margolis LLP

950 Third Avenue 14th Floor
New York
NY
10022
Type or Classification
(B)
Legal Firm
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$26,565
Total Non-Itemized Transactions with this Payee/Payer$2,688
Total of All Transactions with this Payee/Payer for This Schedule$29,253
Legal fees Labor Issues10/10/2019$26,565
Name and Address
(A)
Law Office of Joshua Burt
P.O. Box 3317
Client Trust Acct
Ventura
CA
93006
Type or Classification
(B)
Attorney
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$188,000
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$188,000
Settlement10/22/2019$188,000
Name and Address
(A)
Law Office of Justin Lesky

8210 La Mirada Pl NE S#600
Albuquerque
NM
87109
Type or Classification
(B)
Attorney
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$5,618
Total of All Transactions with this Payee/Payer for This Schedule$5,618
Name and Address
(A)
Marie Gil.

771 Skyridge Lane
Oak Park
CA
91377
Type or Classification
(B)
Former Employee
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$8,383
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$8,383
Settlement10/22/2019$8,383
Name and Address
(A)
Ponty Bistro

2375 Adam C Powell Jr Blvd
New York
NY
10030
Type or Classification
(B)
Restaurant
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,192
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$5,192
Orientation Meeting07/01/2019$5,192
Name and Address
(A)
Purpose Campaigns LLC

115 5th Avenue 6th Flr
New York
NY
10003
Type or Classification
(B)
Marketing Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$195,000
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$195,000
Bill of Rights Organizing Campaign01/08/2020$39,000
Bill of Rights Organizing Campaign02/21/2020$39,000
Bill of Rights Organizing Campaign03/03/2020$39,000
Bill of Rights Organizing Campaign05/06/2020$39,000
Bill of Rights Organizing Campaign05/11/2020$39,000
Name and Address
(A)
Schwartz, Steinsapir, Dohrman and Sommers

6300 Wilshire Blvd Ste 2000
Los Angeles
CA
90048-5202
Type or Classification
(B)
Legal Firm
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$87,389
Total Non-Itemized Transactions with this Payee/Payer$7,639
Total of All Transactions with this Payee/Payer for This Schedule$95,028
Legal fees Labor Issues08/27/2019$7,862
Legal fees Labor Issues09/23/2019$19,470
Legal fees Labor Issues11/22/2019$9,689
Legal fees Labor Issues12/05/2019$17,232
Legal fees Labor Issues03/06/2020$23,032
Legal fees Labor Issues04/21/2020$10,104
Name and Address
(A)
Segal Roitman, LLP

33 Harrison Ave 7th Flr
Boston
MA
02111
Type or Classification
(B)
Legal Firm
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$6,353
Total of All Transactions with this Payee/Payer for This Schedule$6,353
Name and Address
(A)
SEIU Local 73

300 S Ashland Ave #400
Chicago
IL
60607
Type or Classification
(B)
Labor Union
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$7,830
Total of All Transactions with this Payee/Payer for This Schedule$7,830
Name and Address
(A)
Southwest Airlines
P.O. Box 36647

Dallas
TX
75235
Type or Classification
(B)
Airline
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$5,375
Total of All Transactions with this Payee/Payer for This Schedule$5,375
Name and Address
(A)
Telegraph

1611 Telegraph Ave Ste 725
Oakland
CA
94612
Type or Classification
(B)
Media Consultants
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$137,985
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$137,985
Media Consulting for CA Labor Negotiations08/08/2019$9,975
Media Consulting for CA Labor Negotiations09/06/2019$11,694
Media Consulting for CA Labor Negotiations09/30/2019$8,504
Media Consulting for CA Labor Negotiations11/04/2019$8,800
Media Consulting for CA Labor Negotiations12/05/2019$12,165
Media Consulting for CA Labor Negotiations12/31/2019$11,056
Media Consulting for CA Labor Negotiations01/24/2020$8,250
Media Consulting for CA Labor Negotiations02/04/2020$19,320
Media Consulting for CA Labor Negotiations05/06/2020$13,105
Media Consulting for CA Labor Negotiations05/06/2020$24,131
Media Consulting for CA Labor Negotiations06/12/2020$10,985
Name and Address
(A)
United Airlines

77 W Wacker Dr
Chicago
IL
60601
Type or Classification
(B)
Airline
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$19,759
Total of All Transactions with this Payee/Payer for This Schedule$19,759
Name and Address
(A)
Weinberg, Roger and Rosenfeld

1001 Marina Village Pky 200
Alameda
CA
94501-6430
Type or Classification
(B)
Legal Firm
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$18,000
Total of All Transactions with this Payee/Payer for This Schedule$18,000
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 - POLITICAL ACTIVITIES AND LOBBYING FILE NUMBER 506-906

Name and Address
(A)
Doctors for America

1303 Wildwood Drive
Chapel Hill
NC
27517
Type or Classification
(B)
Medical Association
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,000
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$5,000
Contribution12/20/2019$5,000
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 17 - CONTRIBUTIONS, GIFTS & GRANTS FILE NUMBER: 506-906

Name and Address
(A)
American Medical Student Assoc.

45610 Woodland Rd #300
Sterling
VA
20166
Type or Classification
(B)
Medical Association
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$6,000
Total of All Transactions with this Payee/Payer for This Schedule$6,000
Name and Address
(A)
Latino Medical Student Association

1 E. Erie St Suite 525-4395
Chicago
IL
60611
Type or Classification
(B)
Medical Association
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$13,000
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$13,000
Sponsorship01/24/2020$13,000
Name and Address
(A)
Source M, LLC

1601 Vine Street
Los Angeles
CA
90028
Type or Classification
(B)
Promotional Products
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$42,470
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$42,470
Face Masks04/14/2020$42,470
Name and Address
(A)
University of Southern California
Clinical Sciences Bldg
2250 Alcazar Street
Los Angeles
CA
90033
Type or Classification
(B)
University
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$20,000
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$20,000
Sponsorship11/15/2019$20,000
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 18 - GENERAL OVERHEAD FILE NUMBER: 506-906

Name and Address
(A)
10-27 46th Avenue, LLC
c/o GFP Real Estate LLC
125 Park Avenue
New York
NY
10017
Type or Classification
(B)
Landlord
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$167,809
Total Non-Itemized Transactions with this Payee/Payer$11,877
Total of All Transactions with this Payee/Payer for This Schedule$179,686
Rent for National Office12/02/2019$16,415
Rent for National Office01/08/2020$24,868
Rent for National Office02/03/2020$24,940
Rent for National Office03/03/2020$24,830
Rent for National Office04/03/2020$25,311
Rent for National Office05/18/2020$25,927
Rent for National Office06/09/2020$25,518
Name and Address
(A)
1541-1545 Wilshire SEIU 721 Holding, LLC

1545 Wilshire Blvd Ste 100
Los Angeles
CA
90017
Type or Classification
(B)
Landlord
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$20,664
Total of All Transactions with this Payee/Payer for This Schedule$20,664
Name and Address
(A)
ABM Parking Services
SEIU Local 721
1545 Wilshire Blvd Ste 100
Los Angeles
CA
90017
Type or Classification
(B)
Landlord
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$9,785
Total of All Transactions with this Payee/Payer for This Schedule$9,785
Name and Address
(A)
Accountemps

12400 Collections Center Dr
Chicago
IL
60693
Type or Classification
(B)
Temporary Staffing Agency
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$8,195
Total Non-Itemized Transactions with this Payee/Payer$41,860
Total of All Transactions with this Payee/Payer for This Schedule$50,055
Temporary Office Staff04/20/2020$8,195
Name and Address
(A)
Adobe Systems Incorporated

345 Park Avenue
San Jose
CA
95110-2704
Type or Classification
(B)
Software Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$12,100
Total Non-Itemized Transactions with this Payee/Payer$823
Total of All Transactions with this Payee/Payer for This Schedule$12,923
Annual Contract-Software02/13/2020$12,100
Name and Address
(A)
ADP, Inc.
P.O. Box 842875

Boston
MA
02284-2875
Type or Classification
(B)
Payroll Processor
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$14,244
Total of All Transactions with this Payee/Payer for This Schedule$14,244
Name and Address
(A)
AmTrust North America
P.O. Box 6939

Cleveland
OH
44101-1939
Type or Classification
(B)
Insurance Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$50,695
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$50,695
Workers Compensation Insurance12/10/2019$50,695
Name and Address
(A)
Broadstripes

760 Chapel Street
New Haven
CT
06510
Type or Classification
(B)
Software Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$8,333
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$8,333
Leadership development software.07/25/2019$8,333
Name and Address
(A)
Career Center

185 Madison Avenue
New York
NY
10016
Type or Classification
(B)
Computer Consultants
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$7,000
Total of All Transactions with this Payee/Payer for This Schedule$7,000
Name and Address
(A)
Certify Inc.

20 York Street Suite 201
Portland
ME
04101
Type or Classification
(B)
Accounting Services
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$9,464
Total of All Transactions with this Payee/Payer for This Schedule$9,464
Name and Address
(A)
Cleaning Service Industries, Inc.

1384 Broadway Suite 407
New York
NY
10018
Type or Classification
(B)
Office Maintenance Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$14,247
Total of All Transactions with this Payee/Payer for This Schedule$14,247
Name and Address
(A)
Dominion Tower

1400 NW 10th Ave Suite 101
Miami
FL
33136
Type or Classification
(B)
Landlord
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$23,171
Total of All Transactions with this Payee/Payer for This Schedule$23,171
Name and Address
(A)
Eric Scherzer

5 Roosevelt Place Apt 2D
Montclair
NJ
07042
Type or Classification
(B)
Consultant
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$7,750
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$7,750
Consulting12/20/2019$7,750
Name and Address
(A)
G-I IX Marina Village Portfolio LP

1050 Marina Village Parkway
Los Angeles
CA
90084
Type or Classification
(B)
Landlord
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$52,578
Total of All Transactions with this Payee/Payer for This Schedule$52,578
Name and Address
(A)
GreenKey Resources

136 Madison Ave 7th Flr
New York
NY
10016
Type or Classification
(B)
Temporary Staffing Agency
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$41,698
Total of All Transactions with this Payee/Payer for This Schedule$41,698
Name and Address
(A)
Health Plan Systems Inc.
2025 Lincoln Highway
State Route 27 Suite 340
Edison
NJ
08817
Type or Classification
(B)
Software Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$67,962
Total Non-Itemized Transactions with this Payee/Payer$4,248
Total of All Transactions with this Payee/Payer for This Schedule$72,210
Website and Computer Support07/24/2019$5,068
Website and Computer Support08/14/2019$8,788
Website and Computer Support09/06/2019$5,068
Website and Computer Support10/10/2019$5,068
Website and Computer Support11/15/2019$9,315
Website and Computer Support01/24/2020$5,068
Website and Computer Support02/04/2020$9,315
Website and Computer Support03/06/2020$5,068
Website and Computer Support04/20/2020$5,068
Website and Computer Support05/18/2020$5,068
Website and Computer Support06/19/2020$5,068
Name and Address
(A)
Housestaff Benefit Plan

520 Eighth Ave Suite 1200
New York
NY
10018
Type or Classification
(B)
Affiliate Benefit Plan
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$55,253
Total Non-Itemized Transactions with this Payee/Payer$3,973
Total of All Transactions with this Payee/Payer for This Schedule$59,226
Payroll Expense Allocation08/01/2019$14,900
Payroll Expense Allocation09/01/2019$14,900
Return Cambridge Deposit Error of 8/22/1912/10/2019$8,001
Return Cambridge Deposit Error of 8/22/1912/10/2019$10,396
Return Cambridge Deposit Error of 1/6/202001/10/2020$7,056
Name and Address
(A)
Jackson Health System

1611 NW 12th Ave
Miami
FL
33136
Type or Classification
(B)
Hospital
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$50,000
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$50,000
Public Health Trust Fund05/06/2020$50,000
Name and Address
(A)
Joy Products, Inc.

14 Vanderventer Avenue
Port Washington
NY
11050
Type or Classification
(B)
Promotional Products
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$14,098
Total of All Transactions with this Payee/Payer for This Schedule$14,098
Name and Address
(A)
Locktight Solutions, Inc.

11 Ridge Road
Creeskill
NJ
07626-1028
Type or Classification
(B)
Computer Consultants
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$24,032
Total Non-Itemized Transactions with this Payee/Payer$53,528
Total of All Transactions with this Payee/Payer for This Schedule$77,560
Google User Licenses09/06/2019$8,966
Google User Licenses11/15/2019$5,021
Google User Licenses06/19/2020$5,022
Google User Licenses06/19/2020$5,023
Name and Address
(A)
Mail Finance

25881 Network Place
Chicago
IL
60673-1258
Type or Classification
(B)
Postage
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,296
Total Non-Itemized Transactions with this Payee/Payer$5,155
Total of All Transactions with this Payee/Payer for This Schedule$10,451
Postage08/14/2019$5,296
Name and Address
(A)
Meltwater News US Inc

Dept LA 23721
Pasadena
CA
91185-3721
Type or Classification
(B)
Software Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$9,581
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$9,581
Media Software Services02/04/2020$9,581
Name and Address
(A)
Moving Service Consultants, Inc.

3100 Brighton 2nd St Apt 3K
Brooklyn
NY
11235
Type or Classification
(B)
Moving Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,575
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$5,575
Moving and Cleaning Services07/12/2019$5,575
Name and Address
(A)
Neofunds By Neopost
P.O. Box 30193

Tampa
FL
33630-3193
Type or Classification
(B)
Postage
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$5,437
Total of All Transactions with this Payee/Payer for This Schedule$5,437
Name and Address
(A)
Office Resources

1501 Broadway Suite 802
New York
NY
10036
Type or Classification
(B)
Furniture Wholesaler
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$9,434
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$9,434
Office Renovations10/22/2019$9,434
Name and Address
(A)
Pace Business Solutions

297 Route 72 West Suite 35
Manahawkin
NJ
08050-2890
Type or Classification
(B)
Software Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$8,809
Total of All Transactions with this Payee/Payer for This Schedule$8,809
Name and Address
(A)
PointPolish

1293 Prospect Ave
Brooklyn
NY
11238
Type or Classification
(B)
Communications Consultants
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$10,125
Total of All Transactions with this Payee/Payer for This Schedule$10,125
Name and Address
(A)
Rogoff and Company, PC

355 Lexington Ave 6th Flr
New York
NY
10017
Type or Classification
(B)
Accounting Firm
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$56,500
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$56,500
Accounting and Auditing Fees07/24/2019$14,125
Accounting and Auditing Fees11/05/2019$14,125
Accounting and Auditing Fees01/24/2020$14,125
Accounting and Auditing Fees04/20/2020$14,125
Name and Address
(A)
Segal Select Insurance Services, Inc.

333 West 34th Street
New York
NY
10001
Type or Classification
(B)
Insurance Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,687
Total Non-Itemized Transactions with this Payee/Payer$300
Total of All Transactions with this Payee/Payer for This Schedule$5,987
Liability Insurance05/11/2020$5,687
Name and Address
(A)
Seneca Insurance Company, Inc.

160 Water Street
New York
NY
10038-4922
Type or Classification
(B)
Insurance Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$17,636
Total Non-Itemized Transactions with this Payee/Payer$3,150
Total of All Transactions with this Payee/Payer for This Schedule$20,786
Commercial Package Insurance01/24/2020$8,818
Commercial Package Insurance02/04/2020$8,818
Name and Address
(A)
Stacy Braun Associates, Inc.

377 Broadway
New York
NY
10013-3934
Type or Classification
(B)
Investment Advisors
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$13,790
Total of All Transactions with this Payee/Payer for This Schedule$13,790
Name and Address
(A)
SurveyMonkey

One Curiosity Way
San Mateo
CA
94403
Type or Classification
(B)
Online Survey Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$5,105
Total of All Transactions with this Payee/Payer for This Schedule$5,105
Name and Address
(A)
Symon Productions

1911 NE 206th Terrace
Miami
FL
33179-2256
Type or Classification
(B)
Film Production Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$10,000
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$10,000
PEI Expense04/20/2020$10,000
Name and Address
(A)
Telco Experts
P.O. Box 945

Oakland
NJ
07436-0945
Type or Classification
(B)
Internet/Web Service Provider
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$13,751
Total of All Transactions with this Payee/Payer for This Schedule$13,751
Name and Address
(A)
Time Warner Cable
P.O. Box 223085

Pittsburgh
PA
15251-2085
Type or Classification
(B)
Internet/Web Service Provider
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$14,328
Total of All Transactions with this Payee/Payer for This Schedule$14,328
Name and Address
(A)
TIAA Commercial Finance, Inc.
P.O. Box 911608

Denver
CO
80291-1608
Type or Classification
(B)
Equipment Rental Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$17,098
Total of All Transactions with this Payee/Payer for This Schedule$17,098
Name and Address
(A)
Union of CA State Workers Properties

1808 14th Street
Sacramento
CA
95811
Type or Classification
(B)
Landlord
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$12,180
Total of All Transactions with this Payee/Payer for This Schedule$12,180
Name and Address
(A)
Union Services Agency

119 Pere Marquette Suite 1A
Lansing
MI
48912
Type or Classification
(B)
Insurance Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$48,717
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$48,717
Union Liability Insurance02/04/2020$48,717
Name and Address
(A)
University of California Davis

1 Shields Avenue
Davis
CA
95616
Type or Classification
(B)
University
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$31,412
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$31,412
Dues Refund11/12/2019$31,412
Name and Address
(A)
University of Miami-Dept of Psychiatry
P.O. Box 405516

Atlanta
GA
30384-5516
Type or Classification
(B)
University
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,600
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$5,600
Public Health Trust Fund03/31/2020$5,600
Name and Address
(A)
Verizon-NJ
P.O. Box 408

Newark
NJ
07101-0408
Type or Classification
(B)
Telecommunications Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$42,729
Total of All Transactions with this Payee/Payer for This Schedule$42,729
Name and Address
(A)
Voluntary Hospitals HSBP

520 Eighth Ave Suite 1200
New York
NY
10018
Type or Classification
(B)
Affiliate Benefit Plan
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$573,820
Total Non-Itemized Transactions with this Payee/Payer$2,629
Total of All Transactions with this Payee/Payer for This Schedule$576,449
Return VHHSBP Deposit Error of 4/24/202005/15/2020$573,820
Name and Address
(A)
W.B. Mason Company, Inc.
P.O. Box 981101

Boston
MA
02298-1101
Type or Classification
(B)
Office Supply Company
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$15,293
Total of All Transactions with this Payee/Payer for This Schedule$15,293
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 19 - UNION ADMINISTRATION FILE NUMBER: 506-906

Name and Address
(A)
Bally's Atlantic City Hotel and Casino

1900 Boardwalk
Atlantic City
NJ
08401
Type or Classification
(B)
Hotel
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$39,217
Total Non-Itemized Transactions with this Payee/Payer$2,000
Total of All Transactions with this Payee/Payer for This Schedule$41,217
Conference and Training Retreat12/04/2019$39,217
Name and Address
(A)
Grand Cascades Lodge Hamburg
Crystal Spring Resort
3 Wild Turkey Way
Hamburg
NJ
07419
Type or Classification
(B)
Hotel
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$27,979
Total Non-Itemized Transactions with this Payee/Payer$597
Total of All Transactions with this Payee/Payer for This Schedule$28,576
Executive Committee Meeting07/18/2019$27,979
Name and Address
(A)
Hyatt Regency Los Angeles Airport

6225 West Century Blvd
Los Angeles
CA
90045
Type or Classification
(B)
Hotel
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$37,804
Total Non-Itemized Transactions with this Payee/Payer$2,000
Total of All Transactions with this Payee/Payer for This Schedule$39,804
Executive Committee Meeting09/04/2019$7,000
Executive Committee Meeting10/04/2019$10,000
Executive Committee Meeting12/10/2019$20,804
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 20 - BENEFITS FILE NUMBER: 506-906

Description
(A) 		To Whom Paid
(B) 		Amount
(C)
Total of all lines above (Total will be automatically entered in Item 55.)$1,737,457
Disability InsuranceStandard Security Life Ins Co.$9,890
Medical InsuranceEmployees$10,105
Medical InsuranceHousestaff Benefit Plan$94,840
Medical InsuranceVoluntary Hospitals HSBP$511,657
Pension BenefitsSEIU Affiliates Officers Employee Pension Fund$1,110,965
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL INFORMATION SUMMARY FILE NUMBER: 506-906


Question 10: HOUSE STAFF BENEFIT PLAN ID # 13-6203291 A TAX EXEMPT 501-C-9 MULTI-EMPLOYER/EMPLOYEE BENEFIT PLAN. VOLUNTARY HOSPITAL HOUSE STAFF BENEFIT PLAN ID # 13-3029280 A TAX EXEMPT 501-C-9 MULTI-EMPLOYER/EMPLOYEE BNTF PLAN. PATIENT CARE TRUST FUND ID# 13- 3045148 A TAX EXEMPT 501-C3. PROFESSIONAL EDUCATION PLAN ID# 13-4071468 A TAX EXEMPT 501-C9 MULTI EMPLOYER/EMPLOYEE BENEFIT PLAN.

Question 11(a): PAC FUND (CIR-SEIU LOCAL 1957 HEALTH CARE ADVOCACY FUND) FILES FORM A17520 WITH THE NEW YORK STATE BOARD OF ELECTIONS.

Question 12: AUDIT IS BEING PERFORMED BY ROGOFF & COMPANY, P.C. CPA'S, 355 LEXINGTON AVENUE 6TH FLOOR, NEW YORK, NY 10017 212-557-5666.

Question 15: DURING THE REPORTING PERIOD 2019-2020, CIR DISPOSED AN AFFINITY OF GOODS WITHOUT COST TO IT'S MEMBERS.

Question 16: CIR MAINTAINED A SECURITY DEPOSIT IN THE AMOUNT OF $80,438 WITH GFP REAL ESTATE LLC(LANDLORD) FOR THE NATIONAL OFFICE LEASE.

Schedule 13, Row1:MEMBERS PAY FULL DUES AND HAVE FULL VOTING RIGHTS.

General Information:

Schedule 2

Loans: Previous union loan policy allowed for loans to be issued to employees up to one paycheck amount which is over the $2,000 threshold set by the DOL. The union has amended the loan policy to issue loans up to a maximum of $1,999 for any future borrowings.
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)