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:
01-31-2025
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
031-827
2.
PERIOD COVERED
From
01/01/2021
Through
12/31/2021
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
TEAMSTERS
5. DESIGNATION (Local, Lodge, etc.)
LOCAL UNION
6. DESIGNATION NBR
401
7. UNIT NAME (if any)
8. MAILING ADDRESS (Type or print in capital
letters)
First Name
SCOTT
Last Name
KUCHARSKI
P.O Box - Building and Room Number
PO BOX 1420
Number and Street
260 SOUTH WASHINGTON STREET
City
WILKES-BARRE
State
PA
ZIP Code + 4
187031420
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:
Mark Dimirco
PRESIDENT
71. SIGNED:
Scott Kucharski
TREASURER
Date:
Mar 29, 2022
Telephone
Number:
570-823-5131
Date:
Mar 29, 2022
Telephone
Number:
570-823-3121
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21
FILE NUMBER:
031-827
10. During the reporting period did the labor
organization create or participate in the administration of
a trust or a fund or organization, as defined in the
instructions, which provides benefits for members or
beneficiaries?
Yes
11(a). During the reporting period did the
labor organization have a political action committee (PAC)
fund?
No
11(b). During the reporting period did the
labor organization have a subsidiary organization as
defined in Section X of these Instructions?
No
12. During the reporting period did the labor
organization have an audit or review of its books and
records by an outside accountant or by a parent body
auditor/representative?
Yes
13. During the reporting period did the labor
organization discover any loss or shortage of funds or
other assets? (Answer "Yes" even if there has
been repayment or recovery.)
No
14. What is the maximum amount recoverable
under the labor organization's fidelity bond for a
loss caused by any officer, employee or agent of the labor
organization who handled union funds?
$250,000
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?
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?
10/2023
20. How many members did the labor organization
have at the end of the reporting period?
1,323
21. What are the labor organization's rates of dues
and fees?
Rates of Dues and Fees
Dues/Fees
Amount
Unit
Minimum
Maximum
(a) Regular Dues/Fees
20 to 107
per
N/A
20
107
(b) Working Dues/Fees
N/A
per
N/A
N/A
N/A
(c) Initiation Fees
50 to 150
per
N/A
50
150
(d) Transfer Fees
.50
per
N/A
.50
.50
(e) Work Permits
N/A
per
N/A
N/A
N/A
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS
AND LIABILITIES
FILE NUMBER:
031-827
ASSETS
ASSETS
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
22. Cash
$227,625
$136,816
23. Accounts Receivable
1
$0
$0
24. Loans Receivable
2
$0
$0
25. U.S. Treasury
Securities
$0
$0
26. Investments
5
$1,334,948
$1,793,273
27. Fixed Assets
6
$87,452
$105,066
28. Other Assets
7
$0
$0
29.
TOTAL ASSETS
$1,650,025
$2,035,155
LIABILITIES
LIABILITIES
Schedule
Number
Start of Reporting Period
(A)
End of Reporting Period
(B)
30. Accounts Payable
8
$0
$0
31. Loans Payable
9
$0
$125,732
32. Mortgages Payable
$0
$0
33. Other Liabilities
10
$0
$0
34. TOTAL
LIABILITIES
$0
$125,732
35. NET
ASSETS
$1,650,025
$1,909,423
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B -
RECEIPTS AND DISBURSEMENTS
FILE NUMBER:
031-827
CASH
RECEIPTS
SCH
AMOUNT
36. Dues and Agency Fees
$910,304
37. Per Capita Tax
$0
38. Fees, Fines,
Assessments, Work Permits
$22,025
39. Sale of Supplies
$1,554
40. Interest
$0
41. Dividends
$0
42. Rents
$12,000
43. Sale of Investments
and Fixed Assets
3
$0
44. Loans Obtained
9
$130,175
45. Repayments of Loans
Made
2
$0
46. On Behalf of
Affiliates for Transmittal to Them
$0
47. From Members for
Disbursement on Their Behalf
$262
48. Other Receipts
14
$1,998
49. TOTAL RECEIPTS
$1,078,318
CASH DISBURSEMENTS
SCH
AMOUNT
50.
Representational Activities
15
$265,831
51.
Political Activities and Lobbying
16
$125
52.
Contributions, Gifts, and Grants
17
$2,369
53. General
Overhead
18
$137,846
54. Union
Administration
19
$26,223
55. Benefits
20
$231,245
56. Per
Capita Tax
$226,995
57. Strike
Benefits
$0
58. Fees,
Fines, Assessments, etc.
$0
59. Supplies
for Resale
$2,609
60. Purchase
of Investments and Fixed Assets
4
$236,117
61. Loans
Made
2
$0
62.
Repayment of Loans Obtained
9
$4,443
63. To
Affiliates of Funds Collected on Their Behalf
$0
64. On
Behalf of Individual Members
$262
65. Direct
Taxes
$35,062
66. Subtotal
$1,169,127
67.
Withholding Taxes and Payroll Deductions
67a. Total
Withheld
$91,359
67b. Less Total
Disbursed
$91,359
67c.
Total Withheld But Not Disbursed
68.
TOTAL DISBURSEMENTS
$1,169,127
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS
RECEIVABLE AGING SCHEDULE
FILE NUMBER:
031-827
Entity or Individual Name
(A)
Total Account Receivable
(B)
90-180 Days
Past Due
(C)
180+ Days
Past Due
(D)
Liquidated Account
Receivable
(E)
Total of all itemized
accounts receivable
$0
$0
$0
$0
Totals from all other
accounts receivable
Totals
(Total of Column (B) will be automatically entered in Item
23, Column(B))
$0
$0
$0
$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 2 - LOANS
RECEIVABLE
FILE NUMBER:
031-827
List below loans to officers, employees, or members which
at any time during the reporting period exceeded $250 and
list all loans to business enterprises regardless of amount.
(A)
Loans
Outstanding at
Start of Period
(B)
Loans Made
During Period
(C)
Repayments Received During Period
Cash
(D)(1)
Other Than Cash
(D)(2)
Loans
Outstanding at
End of Period
(E)
Total of loans not
listed above
Total of all lines
above
$0
$0
$0
$0
$0
Totals will be
automatically entered in...
Item 24
Column (A)
Item 61
Item 45
Item 69
with Explanation
Item 24
Column (B)
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 3 - SALE OF
INVESTMENTS AND FIXED ASSETS
FILE NUMBER:
031-827
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:
031-827
Description (if land or buildings, give location)
(A)
Cost
(B)
Book Value
(C)
Cash Paid
(D)
Total
of all lines above
$236,117
$236,117
$236,117
Jeep Grand Cherokee - 2021
$36,117
$36,117
$36,117
Transfers to Investment Accounts
$200,000
$200,000
$200,000
Less Reinvestments
$0
(The
total from Net Purchases Line will be automatically
entered in Item 60.)
Net Purchases
$236,117
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 -
INVESTMENTS
FILE NUMBER:
031-827
Description
(A)
Amount
(B)
Marketable Securities
A. Total Cost
$1,388,877
B. Total Book Value
$1,793,273
C. List each
marketable security which has a book value over $5,000
and exceeds 5% of Line B.
UNITED PARCEL SERVICE - B UPS
$321,510
JPM LKD TO SPX - 10% MINIMUM RETURN
$118,136
AMERICAN BALANCED FUND
$108,323
COLUMBIA SELIGMAN TECHNOLOGY & INFORMATION FUND
$164,128
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))
$1,793,273
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 6 - FIXED
ASSETS
FILE NUMBER:
031-827
Description
(A)
Cost or Other Basis
(B)
Total Depreciation or
Amount Expensed
(C)
Book Value
(D)
Value
(E)
A.
Land (give location)
Land
1
:
260 South Washington Street, Wilkes Barre, PA
$6,867
$6,867
$6,867
B.
Buildings (give location)
Building
1
:
260 South Washington Street, Wilkes Barre, PA
$318,715
$265,431
$53,284
$53,284
C. Automobiles
and
Other Vehicles
$68,617
$24,675
$43,942
$43,942
D. Office
Furniture
and Equipment
$29,129
$29,129
$0
$0
E.
Other Fixed Assets
$24,360
$23,387
$973
$973
F. Totals of Lines A through E
(Column(D) Total will be automatically entered in Item
27, Column(B))
$447,688
$342,622
$105,066
$105,066
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER
ASSETS
FILE NUMBER:
031-827
Description
(A)
Book Value
(B)
Total
(Total will be automatically entered in Item 28, Column(B))
$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS
PAYABLE AGING SCHEDULE
FILE NUMBER:
031-827
Entity or Individual Name
(A)
Total Account
Payable
(B)
90-180 Days
Past Due
(C)
180+ Days Past
Due
(D)
Liquidated Account
Payable
(E)
Total for all itemized accounts payable
$0
$0
$0
$0
Total from all other accounts payable
$0
$0
$0
$0
Totals
(Total for Column(B) will be automatically entered in Item
30, Column(D))
$0
$0
$0
$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 9 - LOANS
PAYABLE
FILE NUMBER:
031-827
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
$130,175
$4,443
$0
$125,732
Totals will be automatically entered in...
Item 31
Column (C)
Item 44
Item 62
Item 69
with Explanation
Item 31
Column (D)
ALLY
$0
$26,117
$4,443
$0
$21,674
PPP - SBA Loan/Grant
$0
$104,058
$0
$0
$104,058
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 10 - OTHER
LIABILITIES
FILE NUMBER:
031-827
Description
(A)
Amount at End of Period
(B)
Total Other Liabilities
(Total will be automatically entered in Item 33, Column(D))
$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL
OFFICERS AND DISBURSEMENTS TO OFFICERS
FILE NUMBER:
031-827
(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
Kucharski
,
Scott
Secretary-Treasurer / BA C
$123,564
$9,815
$0
$0
$133,379
I
Schedule 15
Representational Activities
90
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
3
%
Schedule 19
Administration
7
%
A
B
C
Dimirco
,
Mark
President / BA C
$71,078
$3,152
$0
$0
$74,230
I
Schedule 15
Representational Activities
93
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
2
%
Schedule 19
Administration
5
%
A
B
C
Sissick
,
Thomas
A Vice President C
$2,460
$0
$0
$0
$2,460
I
Schedule 15
Representational Activities
9
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
91
%
A
B
C
Martinchek
,
Neil
E Recording Secretary C
$2,760
$0
$0
$0
$2,760
I
Schedule 15
Representational Activities
9
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
91
%
A
B
C
Colwell
,
John
Trustee C
$2,460
$0
$0
$0
$2,460
I
Schedule 15
Representational Activities
9
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
91
%
A
B
C
Keller
,
Dale
Trustee C
$2,460
$0
$0
$0
$2,460
I
Schedule 15
Representational Activities
9
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
91
%
A
B
C
Binner
,
Martin
Trustee C
$3,023
$0
$0
$0
$3,023
I
Schedule 15
Representational Activities
9
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
0
%
Schedule 19
Administration
91
%
Total Officer
Disbursements
$207,805
$12,967
$0
$0
$220,772
Less Deductions
$72,343
Net
Disbursements
$148,429
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 -
DISBURSEMENTS TO EMPLOYEES
FILE NUMBER:
031-827
(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
Musto
,
Lisa
M Book Keeper / Admin None
$37,117
$0
$0
$0
$37,117
I
Schedule 15
Representational Activities
10
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
90
%
Schedule 19
Administration
0
%
A
B
C
Wroblewski
,
Jennifer
Administrative Assisstant None
$14,576
$0
$0
$0
$14,576
I
Schedule 15
Representational Activities
10
%
Schedule 16
Political Activities and Lobbying
0
%
Schedule 17
Contributions
0
%
Schedule 18
General Overhead
90
%
Schedule 19
Administration
0
%
TOTALS RECEIVED
BY EMPLOYEES MAKING $10,000 OR LESS
$896
$0
$0
$0
$896
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
%
Total
Employee Disbursements
$52,589
$0
$0
$0
$52,589
Less
Deductions
$19,016
Net Disbursements
$33,573
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 -
MEMBERSHIP STATUS
FILE NUMBER:
031-827
Category of Membership
(A)
Number
(B)
Voting Eligibility
(C)
Members
(Total of all lines above)
1,323
Agency Fee Payers*
4
Total Members/Fee Payers
1,327
*Agency Fee Payers are
not considered members of the labor organization.
Active
1,323
Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE
- SCHEDULES 14 THROUGH 19
FILE NUMBER:
031-827
SCHEDULE 14 OTHER RECEIPTS
1. Named Payer
Itemized Receipts
$0
2. Named Payer
Non-itemized Receipts
$0
3. All Other Receipts
$1,998
4. Total
Receipts
$1,998
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
$2,369
6. Total
Disbursements
$2,369
SCHEDULE 15 REPRESENTATIONAL
ACTIVITIES
1. Named Payee
Itemized Disbursements
$5,741
2. Named Payee
Non-itemized Disbursements
$54,984
3. To Officers
$190,258
4. To Employees
$6,066
5. All Other
Disbursements
$8,782
6. Total
Disbursements
$265,831
SCHEDULE 18 GENERAL OVERHEAD
1. Named Payee
Itemized Disbursements
$5,143
2. Named Payee
Non-itemized Disbursements
$33,932
3. To Officers
$5,486
4. To Employees
$46,523
5. All Other
Disbursements
$46,762
6. Total
Disbursements
$137,846
SCHEDULE 16 POLITICAL
ACTIVITIES AND LOBBYING
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$0
4. To Employees
$0
5. All Other
Disbursements
$125
6. Total
Disbursements
$125
SCHEDULE 19 UNION
ADMINISTRATION
1. Named Payee
Itemized Disbursements
$0
2. Named Payee
Non-itemized Disbursements
$0
3. To Officers
$25,029
4. To Employees
$0
5. All Other
Disbursements
$1,194
6. Total
Disbursements
$26,223
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER
RECEIPTS
FILE NUMBER:
031-827
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 15 -
REPRESENTATIONAL ACTIVITIES
FILE NUMBER:
031-827
Name and Address
(A)
A T & T 5019
CAROL STREAM IL 60197-5019
Type or Classification
(B)
Telephone Coverage
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$6,185
Total of All Transactions with this
Payee/Payer for This Schedule
$6,185
Name and Address
(A)
Hourigan, Kluger & Quinn
600 Third Avenue Kingston PA 18704
Type or Classification
(B)
Legal Fees
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$5,741
Total
Non-Itemized Transactions with this Payee/Payer
$15,345
Total of All Transactions with this
Payee/Payer for This Schedule
$21,086
Legal Fees
07/15/2021
$5,741
Name and Address
(A)
Teamsters Local 401
260 South Washington St Wilkes-Barre PA 18703-1420
Type or Classification
(B)
Steward Dues
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$33,454
Total of All Transactions with this
Payee/Payer for This Schedule
$33,454
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 -
POLITICAL ACTIVITIES AND LOBBYING
FILE NUMBER
031-827
Name and Address
(A)
-1
Type or Classification
(B)
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this
Payee/Payer for This Schedule
$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 17 -
CONTRIBUTIONS, GIFTS & GRANTS
FILE NUMBER:
031-827
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:
031-827
Name and Address
(A)
Kosmerl & Co., P.C.
535 North Fifth Street Reading PA 19601-3005
Type or Classification
(B)
Audit & Accounting Services
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$18,600
Total of All Transactions with this
Payee/Payer for This Schedule
$18,600
Name and Address
(A)
Labor Benefits, LLC
836 Ritchie Highway Serverna Park MD 21146
Type or Classification
(B)
Liability Insurance
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
$5,143
Total
Non-Itemized Transactions with this Payee/Payer
$0
Total of All Transactions with this
Payee/Payer for This Schedule
$5,143
Liability Insurance
03/08/2021
$5,143
Name and Address
(A)
Right Height Lawn Care
12 Long Leaf Lane Pittston PA 18640
Type or Classification
(B)
Lawn Care & Landscaping
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$6,301
Total of All Transactions with this
Payee/Payer for This Schedule
$6,301
Name and Address
(A)
Westfield Insurance 9001566
Louisville KY 40290-1566
Type or Classification
(B)
Insurance
Purpose
(C)
Date
(D)
Amount
(E)
Total
Itemized Transactions with this Payee/Payer
Total
Non-Itemized Transactions with this Payee/Payer
$9,031
Total of All Transactions with this
Payee/Payer for This Schedule
$9,031
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 19 - UNION
ADMINISTRATION
FILE NUMBER:
031-827
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 20 -
BENEFITS
FILE NUMBER:
031-827
Description
(A)
To Whom Paid
(B)
Amount
(C)
Total of all
lines above (Total will be automatically entered in Item
55.)
$231,245
Health & Welfare
Teamsters #401 H&W Fund
$80,088
Health & Welfare
Jt. Council #53 Retirees H&W
$21,386
Pension
Jt. Council #53 Pension Fund
$35,642
Pension
CPTPF
$94,129
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL
INFORMATION SUMMARY
FILE NUMBER:
031-827
Question 10: Teamsters Local 401 Health & Welfare Fund
260 S. Washington street
Wilkes-Barre, Pennsylvania 18701
Question 12: Kosmerl & Co.,P.C.
535 North Fifth Street
Reading, PA 19601
Question 16: Local 401 has an automobile loan. The automobile is pledged as security for the loan.