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SEIU LOCAL 2015 LONG TERM CARE WORKERS HEALTH TRUST FUND: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
SEIU LOCAL 2015 LONG TERM CARE WORKERS HEALTH TRUST FUND (EIN 20-4570305)
Tax period
2021-06-01 to 2022-05-31
Filed
2023-04-12
IRS object ID
202341029349300314
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-04-12T09:03:20-05:00ReturnTs
Tax Period End2022-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN470900880PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CALIBRE CPA GROUP PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line17501 WISCONSIN AVENUE SUITE 1200AddressLine1Txt
Address Line2WESTAddressLine2Txt
CityBETHESDACityNm
State AbbreviationMDStateAbbreviationCd
ZIP20814ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN204570305EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SEIU LOCAL 2015 LONG-TERM CARE WORKERSBusinessNameLine1Txt
Business Name Line2HEALTH TRUSTBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlSEIUBusinessNameControlTxt
Phone8776985829PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12910 BEVERLY BOULEVARDAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90057ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID WERLINPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone8776985829PhoneNum
Signature2023-04-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDAVIDPersonFirstNm
Person LastWERLINPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonERIN CRANMERPreparerPersonNm
PTINP01712644PTIN
Phone2023319880PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDAVID WERLINPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12910 BEVERLY BOULEVARDAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90057ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$22,641,756GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation2006FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTHE TRUST WAS ESTABLISHED TO MAINTAIN THE LONG TERM CARE WORKERS HEALTH PLAN. THE PLAN WAS CREATED FOR THE EXCLUSIVE BENEFIT OF ELIGIBLE LONG TERM CARE WORKERS. THE PLAN PROVIDES HEALTH BENEFITS (MEDICAL, DENTAL, AND VISION) TO PARTICIPATING EMPLOYEES IN THE IN-HOME SUPPORTIVE SERVICES INDUSTRY OF CALIFORNIA, WHOSE EMPLOYERS ARE REQUIRED, BY CONTRACT, TO PAY CONTRIBUTIONS TO THE TRUST.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$9,120,267PYProgramServiceRevenueAmt
CY Program Service Revenue$9,533,091CYProgramServiceRevenueAmt
PY Investment Income$395,809PYInvestmentIncomeAmt
CY Investment Income$886,265CYInvestmentIncomeAmt
PY Other Revenue$30,115PYOtherRevenueAmt
CY Other Revenue$30,084CYOtherRevenueAmt
PY Total Revenue$9,546,191PYTotalRevenueAmt
CY Total Revenue$10,449,440CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$8,915,092PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$9,301,323CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$208,063PYOtherExpensesAmt
CY Other Expenses$210,417CYOtherExpensesAmt
PY Total Expenses$9,123,155PYTotalExpensesAmt
CY Total Expenses$9,511,740CYTotalExpensesAmt
PY Revenues Less Expenses$423,036PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$937,700CYRevenuesLessExpensesAmt
Total Assets BOY$14,114,996TotalAssetsBOYAmt
Total Assets EOY$13,464,655TotalAssetsEOYAmt
Total Liabilities BOY$16,724TotalLiabilitiesBOYAmt
Total Liabilities EOY$20,783TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$14,098,272NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$13,443,872NetAssetsOrFundBalancesEOYAmt
MissionSEE SCHEDULE O FOR DETAILS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTHE PLAN PROVIDES HEALTH BENEFITS SUCH AS MEDICAL, DENTAL, AND VISION TO PARTICIPATING EMPLOYEES IN THE IN-HOME SUPPORTIVE SERVICES INDUSTRY OF CALIFORNIA.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DELTA FUND ADMINISTRATORS LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2099405100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11234 WEST OAK STREETAddressLine1Txt
CitySTOCKTONCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95203ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
CSEKEY TOM
TRUSTEE1.0040.00Yes (X)$0$153,018$43,136
WERLIN DAVID
CHAIR1.0040.00Yes (X)$0$176,905$50,798
CULBREATH FAITH
TRUSTEE1.0040.00Yes (X)$0$187,894$43,182
TEMPLETON PAMELA
TRUSTEE THROUGH 10/5/20211.0040.00Yes (X)$0$182$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$517,999TotReportableCompRltdOrgAmt
Total Other Compensation$137,116TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYEE CONTRIBUTIONS900099$9,360,467$9,360,467
EMPLOYER CONTRIBUTIONS900099$172,624$172,624
FieldValueIRS element (for citing)
Total Program Service Revenue$9,533,091TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$313,315TotalRevenueColumnAmt
Exclusion$313,315ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$12,765,266SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$12,192,316SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$572,950SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$572,950TotalRevenueColumnAmt
Exclusion$572,950ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$30,084TotalRevenueColumnAmt
Related Or Exempt Func Income$30,084RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$30,084OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,449,440TotalRevenueColumnAmt
Related Or Exempt Func Income$9,563,175RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$886,265ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$9,301,323TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$21,423TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$20,000TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$40,395TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$31,724TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$23,069TotalAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescADMINISTRATOR FEESDesc
Total$73,746TotalAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$60TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$9,511,740TotalAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$312,354BOYAmt
EOY$269,902EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$76,729BOYAmt
EOY$91,081EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$5,485BOYAmt
EOY$5,434EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$12,969,920BOYAmt
EOY$12,271,054EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$750,508BOYAmt
EOY$827,184EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$14,114,996BOYAmt
EOY$13,464,655EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$16,724BOYAmt
EOY$20,783EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,724BOYAmt
EOY$20,783EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,098,272BOYAmt
EOY$13,443,872EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,098,272BOYAmt
EOY$13,443,872EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,114,996BOYAmt
EOY$13,464,655EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$937,700ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,592,100NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM SEIU LOCAL 2015Desc
Book Value$827,184BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$827,184TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$8,850,798TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$1,592,100NetUnrealizedGainsInvstAmt
Revenue Not Reported-$1,592,100RevenueNotReportedAmt
Revenue Subtotal$10,442,898RevenueSubtotalAmt
Investment Expenses Not Incld$6,542InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$6,542RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$10,449,440TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$9,505,198TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$9,505,198ExpensesSubtotalAmt
Investment Expenses Not Incld2$6,542InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$6,542ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$9,511,740TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE PLAN IS INTENDED TO QUALIFY UNDER SECTION 501(C) (9) OF THE INTERNAL REVENUE CODE AND,THEREFORE, IS NOT SUBJECT TO INCOME TAX. THE PLAN OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE ON JANUARY 4, 2008, STATING THAT THE PLAN, AS THEN DESIGNED,WAS IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THE PLAN HAS ALSO RECEIVED A FAVORABLE TAX DETERMINATION LETTER FROM THE STATE OF CALIFORNIA. THE PLAN HAS BEEN AMENDED SINCE RECEIVING THE DETERMINATION LETTERS. THE PLAN SPONSOR BELIEVES THAT THE PLAN, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION FOR FEDERAL OR CALIFORNIA INCOME TAXES HAS BEEN INCLUDED IN THE PLANS FINANCIAL STATEMENTS. AS OF MAY 31, 2022, THE STATUTE OF LIMITATIONS FOR TAX YEARS 2018 THROUGH 2020 REMAINS OPEN WITH THE U. S. FEDERAL JURISDICTION AND THE VARIOUS STATES AND LOCAL JURISDICTIONS IN WHICH THE PLAN FILES RETURNS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CULBREATH FAITH
TRUSTEE$0$181,778$0$6,116$0$0$0$35,921$0$7,261$0$231,076$0$0
WERLIN DAVID
CHAIR$0$163,442$0$5,663$0$7,800$0$30,265$0$20,533$0$227,703$0$0
CSEKEY TOM
TRUSTEE$0$153,018$0$0$0$0$0$28,632$0$14,504$0$196,154$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE TRUSTEES REVIEW THE FORM 990 BEFORE FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CINTERNAL PROCEDURES INCLUDE THE CONTINUOUS REVIEW OF PROCEDURES TO ENSURE COMPLIANCE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES THESE DOCUMENTS AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C:DAVID LLOYD IS THE CHAIMAN OF THE AUDIT COMMITTEE, WHICH HAS RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtControlled OrganizationControlledOrganizationInd
SEIU LOCAL 2015
2910 BEVERLY BLVDLOS ANGELESCA90057474164197UNITE MEMBERS INTO ONE ORG. FOR THE PURPOSE OF IMPROVING WORKING CONDITIONSCA501(C)(5)0
COUNTY OF SAN BENITO - STATE OF CALIFORNIA
SEIU UNITED LONG-TERM CARE WORKERS LOCAL UNION NO 6434
2910 BEVERLY BLVDLOS ANGELESCA90057260718017UNITE MEMBERS INTO ONE ORG. FOR THE PURPOSE OF IMPROVING WORKING CONDITIONSCA501(C)(5)0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

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