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
040-094
2. PERIOD COVERED
From07/01/2020
Through06/30/2021
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
TEACHERS AFL-CIO
5. DESIGNATION (Local, Lodge, etc.)
STATE ASSOCIATION
 6. DESIGNATION NBR

7. UNIT NAME (if any)
OHIO NURSES ASSOCIATION -- OH 5903
8. MAILING ADDRESS (Type or print in capital letters)
First Name
LISA
 Last Name
OCHS
P.O Box - Building and Room Number

Number and Street
3760 RIDGE MILL DR.
City
HILLIARD
State
OH		 ZIP Code + 4
43026


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:Robert B WeitzelPRESIDENT71. SIGNED:Janet R CorbinTREASURER
Date:Jan 11, 2022Telephone Number:513-324-0988Date:Jan 11, 2022Telephone Number:614-206-0269
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21 FILE NUMBER: 040-094
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?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?10/2021
20. How many members did the labor organization have at the end of the reporting period?9,118
21. What are the labor organization's rates of dues and fees?
Rates of Dues and Fees
Dues/FeesAmount UnitMinimumMaximum
(a) Regular Dues/FeesRangeperYear510.71653.92
(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: 040-094

ASSETS
ASSETS Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
22. Cash $890,989$1,299,696
23. Accounts Receivable1$248,377$15,216
24. Loans Receivable2$0$0
25. U.S. Treasury Securities $0$0
26. Investments5$1,558,078$1,727,875
27. Fixed Assets6$1,351,491$1,325,659
28. Other Assets7$93,415$38,040
29. TOTAL ASSETS $4,142,350$4,406,486

LIABILITIES
LIABILITIES Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
30. Accounts Payable8$92,252$278,205
31. Loans Payable9$0$0
32. Mortgages Payable $0$0
33. Other Liabilities10$630,729$601,901
34. TOTAL LIABILITIES $722,981$880,106
35. NET ASSETS$3,419,369$3,526,380
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B - RECEIPTS AND DISBURSEMENTS FILE NUMBER: 040-094

CASH RECEIPTSSCHAMOUNT
36. Dues and Agency Fees $4,005,023
37. Per Capita Tax $0
38. Fees, Fines, Assessments, Work Permits $0
39. Sale of Supplies $0
40. Interest $86
41. Dividends $87,368
42. Rents $0
43. Sale of Investments and Fixed Assets3$0
44. Loans Obtained9$0
45. Repayments of Loans Made2$0
46. On Behalf of Affiliates for Transmittal to Them $2,841,954
47. From Members for Disbursement on Their Behalf $0
48. Other Receipts14$575,608
49. TOTAL RECEIPTS $7,510,039
CASH DISBURSEMENTSSCHAMOUNT
50. Representational Activities15$1,202,243
51. Political Activities and Lobbying16$232,543
52. Contributions, Gifts, and Grants17$7,300
53. General Overhead18$1,490,916
54. Union Administration19$220,219
55. Benefits20$838,932
56. Per Capita Tax $90,367
57. Strike Benefits $0
58. Fees, Fines, Assessments, etc. $0
59. Supplies for Resale $0
60. Purchase of Investments and Fixed Assets4$124,274
61. Loans Made2$0
62. Repayment of Loans Obtained9$0
63. To Affiliates of Funds Collected on Their Behalf $2,698,220
64. On Behalf of Individual Members $0
65. Direct Taxes $196,318
  
66. Subtotal $7,101,332
67. Withholding Taxes and Payroll Deductions  
  67a. Total Withheld$738,071  
  67b. Less Total Disbursed$738,071  
  67c. Total Withheld But Not Disbursed 
68. TOTAL DISBURSEMENTS $7,101,332
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE FILE NUMBER: 040-094

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$15,216$1,397  
Totals (Total of Column (B) will be automatically entered in Item 23, Column(B)) $15,216$1,397$0$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 2 - LOANS RECEIVABLE FILE NUMBER: 040-094

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: 040-094

Description (if land or buildings, give location)
(A) 		Cost
(B) 		Book Value
(C) 		Gross Sales Price
(D) 		Amount Received
(E)
Total of all lines above$0$0$0$0
Less Reinvestments$0
(The total from Net Sales Line will be automatically entered in Item 43)Net Sales$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 4 - PURCHASE OF INVESTMENTS AND FIXED ASSETS FILE NUMBER: 040-094

Description (if land or buildings, give location)
(A) 		Cost
(B) 		Book Value
(C) 		Cash Paid
(D)
Total of all lines above$124,274$124,274$124,274
Computer Software$111,978$111,978$111,978
Building$4,120$4,120$4,120
Office Equipment$8,176$8,176$8,176
 Less Reinvestments$0
(The total from Net Purchases Line will be automatically entered in Item 60.)Net Purchases$124,274
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 - INVESTMENTS FILE NUMBER: 040-094

Description
(A) 		Amount
(B)
Marketable Securities 
A. Total Cost$1,556,496
B. Total Book Value$1,727,875
C. List each marketable security which has a book value over $5,000 and exceeds 5% of Line B.  
  • PIMCO Income Fund Class A
$670,647
  • PIMCO Fds Pac Invt Mgm Low Duration Fd Cl A
$180,803
  • PIMCO Fds PAC Invt Mgt Ser Stockplus Absolute Ret
$413,164
  • PIM Fds PAC Invt Mgt SER Stockplus Fund Class A
$116,022
  • PIMCO Fds PAC Invt Mgmt Ser Low Dur Inc Fd Cl A
$110,646
  • PIMCO Funds Rae Fund A
$151,969
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)) $1,727,875
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 6 - FIXED ASSETS FILE NUMBER: 040-094

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)    
Building  1 :      3760 Ridge Mill Drive$1,109,277$84,756$1,024,521$1,400,000
C. Automobiles and Other Vehicles
D. Office Furniture and Equipment$270,853$156,673$114,180$114,180
E. Other Fixed Assets$544,931$357,973$186,958$186,958
F. Totals of Lines A through E (Column(D) Total will be automatically entered in Item 27, Column(B)) $1,925,061$599,402$1,325,659$1,701,138
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER ASSETS FILE NUMBER: 040-094

Description
(A) 		Book Value
(B)
Total (Total will be automatically entered in Item 28, Column(B)) $38,040
Prepaid Expenses$38,040
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS PAYABLE AGING SCHEDULE FILE NUMBER: 040-094

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$278,205$35$0$0
Totals (Total for Column(B) will be automatically entered in Item 30, Column(D)) $278,205$35$0$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 9 - LOANS PAYABLE FILE NUMBER: 040-094

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: 040-094

Description
(A) 		Amount at End of Period
(B)
Total Other Liabilities (Total will be automatically entered in Item 33, Column(D)) $601,901
Accrued Payroll Expenses$284,249
Payables to Affiliates$207,590
Lease Obligations$13,334
Other Liabilities$96,728
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS FILE NUMBER: 040-094

(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 		Arms ,  Deborah  
President
C		$4,800$4,800
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Roe ,  Carol  
1st Vice President
C		$43$43
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Tucker ,  Jacinta  
2nd Vice President
C		$33$33
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Powell ,  Joyce  
Secretary
C		$144$144
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Bowen ,  Annie  
Treasurer
C		$0$0
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Frymyer ,  Jessie  
Director
C		$0$0
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Weitzel ,  Robert  
Director
C		$250$250
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Marcentile ,  Iris  
Director
C		$224$224
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Lucas ,  Rick  
Director
C		$72$72
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Thoman ,  Michelle  
Director
C		$267$267
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Anderson ,  Paula  
Director
C		$0$0
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Garrett ,  Benitha  
Director
C		$139$139
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Severino ,  Gina  
Director
C		$0$0
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Burchett ,  Jamie  
Director
C		$0$0
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Renninger ,  Holly  
Director
C		$0$0
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
Total Officer Disbursements$0$4,800$1,172$0$5,972
Less Deductions     
Net Disbursements    $5,972
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES FILE NUMBER: 040-094

(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 		Bailey ,  Kristen  
Labor Representative
None		$79,592$3,410$83,002
I
Schedule 15
Representational Activities 		94 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		5 %
A
B
C 		Bennett ,  Sharon  
Executive Assistant
None		$27,312$27,312
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		100 % Schedule 19
Administration
A
B
C 		Bloomer ,  Phillip  
Organizer
None		$31,965$537$32,502
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Bukoffsky ,  Tiffany  
Director of Health Policy
None		$108,269$108,269
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		100 % Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Carmack ,  Carolyn  
Labor Representative
None		$84,016$899$84,915
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Cousins ,  Bob  
DEO Labor Representative
None		$150,043$1,645$151,688
I
Schedule 15
Representational Activities 		44 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		55 % Schedule 19
Administration 		1 %
A
B
C 		Donovan ,  Michelle  
Comm and Development
None		$51,558$169$51,727
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		100 % Schedule 19
Administration
A
B
C 		Dowden ,  Dodie  
Membership Engagement
None		$65,159$65,159
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		52 % Schedule 19
Administration 		48 %
A
B
C 		Dugan ,  Dennis  
Labor Representative
None		$81,800$81,800
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		0 % Schedule 19
Administration
A
B
C 		Dzubak ,  Jessica  
Dir of Nurse Practice
None		$79,233$849$80,082
I
Schedule 15
Representational Activities 		99 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		1 % Schedule 19
Administration
A
B
C 		Gehrisch ,  Alex  
Membership Controller
None		$47,608$47,608
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Homan ,  Molly  
Dir of Marketing & Tech
None		$91,319$345$91,664
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		99 % Schedule 19
Administration 		1 %
A
B
C 		Humphreys ,  James  
Organizer
None		$64,344$577$64,921
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		Koparde ,  Sangita  
Organizer
None		$65,963$1,398$67,361
I
Schedule 15
Representational Activities 		99 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		1 % Schedule 19
Administration
A
B
C 		Lemery ,  Angela  
Business Office Admin
None		$81,984$40$82,024
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		100 % Schedule 19
Administration
A
B
C 		Marlow ,  Brandon  
Labor Representative
None		$83,784$3,255$87,039
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
A
B
C 		McClelland ,  Cathy  
Finance Manager
None		$74,052$74,052
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		100 % Schedule 19
Administration
A
B
C 		Mendiola ,  Dominic  
Labor Representative
None		$80,402$4,463$84,865
I
Schedule 15
Representational Activities 		99 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		1 % Schedule 19
Administration
A
B
C 		Mueller ,  Anne  
Labor Representative
None		$87,265$7,750$95,015
I
Schedule 15
Representational Activities 		97 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		1 % Schedule 19
Administration 		2 %
A
B
C 		Ochs ,  Lisa  
CEO
None		$160,103$931$161,034
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		100 % Schedule 19
Administration
A
B
C 		Ransone ,  Anne  
DEO Operations
None		$131,442$215$131,657
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		100 % Schedule 19
Administration
A
B
C 		Schweitzer ,  Kelli  
Sr. Director of Pro Pract
None		$105,613$105,613
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		100 % Schedule 19
Administration
A
B
C 		Smith ,  Robin  
Membership Controller
None		$82,002$121$82,123
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration 		100 %
A
B
C 		Swearingen ,  Sandy  
CE Specialist
None		$65,093$65,093
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		100 % Schedule 19
Administration
A
B
C 		Turner ,  Brittany  
Nurse Planner
None		$70,212$70,212
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		Schedule 18
General Overhead 		99 % Schedule 19
Administration
A
B
C 		Walker ,  Lisa  
Health Policy Specialist
None		$68,120$78$68,198
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		92 % Schedule 17
Contributions 		Schedule 18
General Overhead 		8 % Schedule 19
Administration
A
B
C 		Whitehurst ,  Jacob  
Cust Ser Admin & Mem Supp
None		$18,690$18,690
I
Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		100 % Schedule 19
Administration
A
B
C 		Wolfe ,  Rachel  
Executive Assistant
None		$74,043$74,043
I
Schedule 15
Representational Activities 		93 % Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		5 % Schedule 19
Administration 		2 %
TOTALS RECEIVED BY EMPLOYEES MAKING $10,000 OR LESS$0
I Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
Total Employee Disbursements$2,210,986$0$26,682$0$2,237,668
Less Deductions    $738,071
Net Disbursements    $1,499,597
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 - MEMBERSHIP STATUS FILE NUMBER: 040-094

Category of Membership
(A) 		Number
(B) 		Voting Eligibility
(C)
Members (Total of all lines above) 9,118 
Agency Fee Payers*
Total Members/Fee Payers9,118 
*Agency Fee Payers are not considered members of the labor organization.
Members Full Rate 100%8,321Yes
Members Full Rate 50%446Yes
Members Full Rate 25%351Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19 FILE NUMBER: 040-094

SCHEDULE 14   OTHER RECEIPTS
1. Named Payer Itemized Receipts$97,395
2. Named Payer Non-itemized Receipts$0
3. All Other Receipts$478,213
4. Total Receipts$575,608
     
     
SCHEDULE 17   CONTRIBUTIONS, GIFTS & GRANTS
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$0
4. To Employees$0
5. All Other Disbursements$7,300
6. Total Disbursements$7,300
SCHEDULE 15   REPRESENTATIONAL ACTIVITIES
1. Named Payee Itemized Disbursements$218,480
2. Named Payee Non-itemized Disbursements$70,744
3. To Officers$0
4. To Employees$886,951
5. All Other Disbursements$26,068
6. Total Disbursements$1,202,243
SCHEDULE 18   GENERAL OVERHEAD
1. Named Payee Itemized Disbursements$186,241
2. Named Payee Non-itemized Disbursements$224,177
3. To Officers$0
4. To Employees$1,007,202
5. All Other Disbursements$73,296
6. Total Disbursements$1,490,916
SCHEDULE 16   POLITICAL ACTIVITIES AND LOBBYING
1. Named Payee Itemized Disbursements$55,000
2. Named Payee Non-itemized Disbursements$0
3. To Officers$0
4. To Employees$172,543
5. All Other Disbursements$5,000
6. Total Disbursements$232,543
SCHEDULE 19   UNION ADMINISTRATION
1. Named Payee Itemized Disbursements$26,845
2. Named Payee Non-itemized Disbursements$2,081
3. To Officers$5,972
4. To Employees$170,972
5. All Other Disbursements$14,349
6. Total Disbursements$220,219
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER RECEIPTS FILE NUMBER: 040-094

Name and Address
(A)
American Federation of Teachers

55 New Jersey Avenue
Washington
DC
20001
Type or Classification
(B)
National Affiliate
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$86,895
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$86,895
Legal Fees Reimbursed08/27/2020$41,696
Legal Fees Reimbursed08/27/2020$30,200
Legal Fees Reimbursed11/20/2020$14,999
Name and Address
(A)
AON Corporation

200 E. Randolph St.
Chicago
IL
60601
Type or Classification
(B)
Royalties
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,500
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$5,500
Royalties07/23/2020$5,500
Name and Address
(A)
California Casualty Management

1900 Almeda de las Pulga
San Mateo
CA
94403
Type or Classification
(B)
Royalties
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
Royalties09/30/2020$5,000
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 - REPRESENTATIONAL ACTIVITIES FILE NUMBER: 040-094

Name and Address
(A)
Around the Clock Reporting
PO Box 11008

Cincinnati
OH
45211
Type or Classification
(B)
Arbitration
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,827
Total Non-Itemized Transactions with this Payee/Payer$2,967
Total of All Transactions with this Payee/Payer for This Schedule$8,794
Arbitration Services04/22/2021$5,827
Name and Address
(A)
Barkan Meizlish, LP

250 East Broad Street
Columbus
OH
43215
Type or Classification
(B)
Attorney
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$138,585
Total Non-Itemized Transactions with this Payee/Payer$2,008
Total of All Transactions with this Payee/Payer for This Schedule$140,593
Legal Services08/12/2020$5,288
Legal Services10/15/2020$14,711
Legal Services11/23/2020$41,158
Legal Services01/06/2021$10,023
Legal Services02/11/2021$12,655
Legal Services03/09/2021$12,814
Legal Services05/18/2021$20,234
Legal Services05/19/2021$10,281
Legal Services06/15/2021$11,421
Name and Address
(A)
Bloomberg Industry Group
PO Box 419889

Boston
MA
02241
Type or Classification
(B)
Publications
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$15,899
Total of All Transactions with this Payee/Payer for This Schedule$15,899
Name and Address
(A)
C.W. Designs

253 East Aurora Rd.
Northfield Center
OH
44067
Type or Classification
(B)
Arbitration
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,063
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$5,063
Arbitration Services06/15/2021$5,063
Name and Address
(A)
Cloppert Latanick Sauter Attorney Washburn

225 East Broad Street
Columbus
OH
43215
Type or Classification
(B)
Attorney
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$38,659
Total Non-Itemized Transactions with this Payee/Payer$31,328
Total of All Transactions with this Payee/Payer for This Schedule$69,987
Legal Fees08/11/2020$5,823
Legal Fees08/12/2020$6,008
Legal Fees10/21/2020$5,836
Legal Fees12/17/2020$5,952
Legal Fees05/18/2021$15,040
Name and Address
(A)
James Rimmel

2072 Southview Dr.
Harmony
PA
16037
Type or Classification
(B)
Arbitration
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$6,946
Total of All Transactions with this Payee/Payer for This Schedule$6,946
Name and Address
(A)
Joseph Berning Printing

1850 Dalton Avenue
Cincinnati
OH
45214
Type or Classification
(B)
Printing
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$5,406
Total of All Transactions with this Payee/Payer for This Schedule$5,406
Name and Address
(A)
Patio Printing

6663 Huntley Rd
Columbus
OH
43229
Type or Classification
(B)
Printing
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$6,190
Total of All Transactions with this Payee/Payer for This Schedule$6,190
Name and Address
(A)
UnionWare
PO Box 930473

Atlanta
GA
31193
Type or Classification
(B)
Software
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$12,500
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$12,500
Software08/28/2020$12,500
Name and Address
(A)
William Heekin
PO Box 30466

Cincinnati
OH
45230
Type or Classification
(B)
Professional Services
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$17,846
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$17,846
Arbitration Services08/12/2020$10,545
Arbitration Services02/23/2021$7,301
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 - POLITICAL ACTIVITIES AND LOBBYING FILE NUMBER 040-094

Name and Address
(A)
Government Advantage Group

17 South High St. Suite 750
Columbus
OH
43215
Type or Classification
(B)
Professional Services
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$55,000
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$55,000
Lobbying Consultant08/12/2020$5,000
Lobbying Consultant09/01/2020$5,000
Lobbying Consultant10/02/2020$5,000
Lobbying Consultant11/23/2020$10,000
Lobbying Consultant12/17/2020$5,000
Lobbying Consultant02/26/2021$5,000
Lobbying Consultant03/09/2021$5,000
Lobbying Consultant05/19/2021$5,000
Lobbying Consultant06/15/2021$5,000
Lobbying Consultant06/30/2021$5,000
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 17 - CONTRIBUTIONS, GIFTS & GRANTS FILE NUMBER: 040-094

Name and Address
(A)




-1
Type or Classification
(B)
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 18 - GENERAL OVERHEAD FILE NUMBER: 040-094

Name and Address
(A)
Amazon

410 Terry Ave
Seattle
WA
98109
Type or Classification
(B)
Supplies
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$5,604
Total of All Transactions with this Payee/Payer for This Schedule$5,604
Name and Address
(A)
American Electric Power
PO Box 371496

Pittsburgh
PA
15250
Type or Classification
(B)
Utility
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$22,924
Total of All Transactions with this Payee/Payer for This Schedule$22,924
Name and Address
(A)
Arthur L. Davis Publishing Agency, Inc
PO Box 216

Cedar Falls
IA
50613
Type or Classification
(B)
Publication
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$21,000
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$21,000
ONR Publication09/17/2020$7,000
ONR Publication12/09/2020$7,000
ONR Publication03/19/2021$7,000
Name and Address
(A)
Blue & Co. LLC

2712 Solution Center
Chicago
IL
60677
Type or Classification
(B)
Accounting Services
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$14,250
Total Non-Itemized Transactions with this Payee/Payer$7,350
Total of All Transactions with this Payee/Payer for This Schedule$21,600
Audit & Tax Services10/15/2020$14,250
Name and Address
(A)
Cincinnati Insurance
PO Box 145620

Cincinnati
OH
45250
Type or Classification
(B)
Insurance
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$26,224
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$26,224
Insurance11/23/2020$16,158
Insurance01/06/2021$10,066
Name and Address
(A)
Electronic Commerce

1 City Blvd West #1850
Orange
CA
92868
Type or Classification
(B)
Merchant Services
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$13,010
Total of All Transactions with this Payee/Payer for This Schedule$13,010
Name and Address
(A)
Extra Space

3929 Dublin Rd
Hilliard
OH
43026
Type or Classification
(B)
Storage Facilities
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$11,037
Total of All Transactions with this Payee/Payer for This Schedule$11,037
Name and Address
(A)
Freedom a la Carte

123 E. Spring St
Columbus
OH
43215
Type or Classification
(B)
Restaurant
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,000
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$5,000
Catering02/25/2021$5,000
Name and Address
(A)
GFC Leasing

2675 Research Park Drive
Madison
WI
53711
Type or Classification
(B)
Equipment Lease
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$21,870
Total of All Transactions with this Payee/Payer for This Schedule$21,870
Name and Address
(A)
Higher Logic
PO Box 645579

Pittsburgh
PA
15264
Type or Classification
(B)
Communications
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$51,871
Total Non-Itemized Transactions with this Payee/Payer$3,894
Total of All Transactions with this Payee/Payer for This Schedule$55,765
Software07/09/2020$43,411
Software08/12/2020$8,460
Name and Address
(A)
Howell & Associates, CPA

501 W. Schrock Rd
Westerville
OH
43081
Type or Classification
(B)
Consultant
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$12,500
Total Non-Itemized Transactions with this Payee/Payer$7,500
Total of All Transactions with this Payee/Payer for This Schedule$20,000
Accounting Services04/26/2021$12,500
Name and Address
(A)
JPMorgan Chase Bank

100 E. Broad St.
Columbus
OH
43215
Type or Classification
(B)
Bank Service Fees
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$6,055
Total of All Transactions with this Payee/Payer for This Schedule$6,055
Name and Address
(A)
L&E Landscape
PO Box 1431

Westerville
OH
43081
Type or Classification
(B)
Landscaping
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$6,511
Total of All Transactions with this Payee/Payer for This Schedule$6,511
Name and Address
(A)
Micro Center

747 Bethel Rd
Columbus
OH
43214
Type or Classification
(B)
Computer Repairs
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$5,296
Total of All Transactions with this Payee/Payer for This Schedule$5,296
Name and Address
(A)
NimbleUser

1100 Pittsford Victor Road
Pittsford
NY
14534
Type or Classification
(B)
Membership Database
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$40,080
Total Non-Itemized Transactions with this Payee/Payer$1,200
Total of All Transactions with this Payee/Payer for This Schedule$41,280
Consulting08/12/2020$40,080
Name and Address
(A)
Patio Printing

5663 Huntley Rd
Columbus
OH
43229
Type or Classification
(B)
Printing
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$8,696
Total of All Transactions with this Payee/Payer for This Schedule$8,696
Name and Address
(A)
Pete Thompson

5024 Regional Place
Powell
OH
43065
Type or Classification
(B)
Consultant
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$9,675
Total of All Transactions with this Payee/Payer for This Schedule$9,675
Name and Address
(A)
Pitney Bowes Global Financial
PO Box 371887

Pittsburgh
PA
15250
Type or Classification
(B)
Postage Machine Lease
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$8,595
Total Non-Itemized Transactions with this Payee/Payer$7,970
Total of All Transactions with this Payee/Payer for This Schedule$16,565
Lease and Supplies05/13/2021$8,595
Name and Address
(A)
Pro OnCall Technologies

6902 Kemper Road
Cincinnati
OH
45249
Type or Classification
(B)
IT Consultant
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$6,721
Total Non-Itemized Transactions with this Payee/Payer$25,937
Total of All Transactions with this Payee/Payer for This Schedule$32,658
IT Consultant11/10/2020$6,721
Name and Address
(A)
Shannon Mattern

1105 Harley Run Rd
Blacklick
OH
43004
Type or Classification
(B)
Consultant
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$9,000
Total of All Transactions with this Payee/Payer for This Schedule$9,000
Name and Address
(A)
Slicktext

301 E. Second St. Suite 308
Jamestown
NY
14701
Type or Classification
(B)
Communications
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$7,438
Total of All Transactions with this Payee/Payer for This Schedule$7,438
Name and Address
(A)
Time Warner Cable
PO Box 223085

Pittsburgh
PA
15251
Type or Classification
(B)
Internet Service Provider
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$10,468
Total of All Transactions with this Payee/Payer for This Schedule$10,468
Name and Address
(A)
Verizon
PO Box 25505

Lehigh Valley
PA
18002
Type or Classification
(B)
Telecommunications
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$8,254
Total of All Transactions with this Payee/Payer for This Schedule$8,254
Name and Address
(A)
Wayne McDearmon

3497 Binborok Road North
Columbus
OH
43227
Type or Classification
(B)
Janitor
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$24,488
Total of All Transactions with this Payee/Payer for This Schedule$24,488
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 19 - UNION ADMINISTRATION FILE NUMBER: 040-094

Name and Address
(A)
James Mills
PO Box 714086

Cincinnati
OH
45271
Type or Classification
(B)
Video Production
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$15,880
Total Non-Itemized Transactions with this Payee/Payer$1,113
Total of All Transactions with this Payee/Payer for This Schedule$16,993
Video Production04/22/2021$15,880
Name and Address
(A)
Survey Monkey

32330 Collections Center Dr
Chicago
IL
60693
Type or Classification
(B)
Continuing Education
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$10,965
Total Non-Itemized Transactions with this Payee/Payer$968
Total of All Transactions with this Payee/Payer for This Schedule$11,933
Continuing Education - Survey09/17/2020$10,965
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 20 - BENEFITS FILE NUMBER: 040-094

Description
(A) 		To Whom Paid
(B) 		Amount
(C)
Total of all lines above (Total will be automatically entered in Item 55.)$838,932
401k Profit Sharing PlanAEGON USA$286,572
Employee Insurance Principal Insurance Group$39,074
Employee InsuranceTASC$21,052
Employee InsuranceUnited Healthcare$361,239
Employee InsuranceVision Service Plan$4,982
Employee InsuranceAvidia Bank$126,013
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL INFORMATION SUMMARY FILE NUMBER: 040-094


Question 10: Ohio Nurses Foundation (ONF) 3760 Ridge Mill Drive, Hilliard, Ohio 43026

Question 11(a):

Question 11(a): Ohio Nurses Association Political Contributing Entity (ONA PCE) 3760 Ridge Mill Drive Hilliard, Ohio 43026

Question 12: Blue & Co., LLC Westerville, Ohio

Schedule 13, Row1:

Schedule 13, Row1:Members Full Rate 100%

Schedule 13, Row1:

Schedule 13, Row1:

Schedule 13, Row2:

Schedule 13, Row2:Members Full Rate 50%

Schedule 13, Row2:

Schedule 13, Row2:

Schedule 13, Row3:

Schedule 13, Row3:Members Full Rate 25%

Schedule 13, Row3:

Schedule 13, Row3:
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)