UNITED FOOD & COMM WORKERS INTL UNION & EMP INSURANCE FUND: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
UNITED FOOD & COMM WORKERS INTL UNION & EMP INSURANCE FUND (EIN 35-1065816)
Tax period
2017-12-01 to 2018-11-30
Filed
2019-10-02
IRS object ID
201942759349300329
Schema version
2017v2.3
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)
Return2019-10-02T11:12:14-05:00ReturnTs
Tax Period End2018-11-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN320043599PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LEGACY PROFESSIONALS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14 WESTBROOK CORPORATE CTR 700AddressLine1Txt
CityWESTCHESTERCityNm
State AbbreviationILStateAbbreviationCd
ZIP60154ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-12-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351065816EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UNITED FOOD & COMM WORKERSBusinessNameLine1Txt
Business Name Line2CALUMET REGION INSURANCE FUNDBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlUNITBusinessNameControlTxt
Phone8006215133PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line118861 90TH AVENUE NO AAddressLine1Txt
CityMOKENACityNm
State AbbreviationILStateAbbreviationCd
ZIP60448ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEVE POWELLPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone8006215133PhoneNum
Signature2019-10-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRUCE A PAVLIKPreparerPersonNm
PTINP00748405PTIN
Phone3123680500PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address12.235.239.120IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-10-02IPDt
IP Tm11:12:50IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id93A4F84426990A9A61EBC632D98786EB8E4F1B1DAtSubmissionCreationDeviceId
At Submission Filing Device IdDBF743AF1216C3B70D6C9C598EE47CA4DBC4F1E6AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerSTEVE POWELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line118861 90TH AVENUE NO AAddressLine1Txt
CityMOKENACityNm
State AbbreviationILStateAbbreviationCd
ZIP60448ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$6,548,635GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1960FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionPROVIDE HEALTH BENEFITSActivityOrMissionDesc
Voting Members Governing Body4VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
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$6,813,661PYProgramServiceRevenueAmt
CY Program Service Revenue$4,209,792CYProgramServiceRevenueAmt
PY Investment Income$158,817PYInvestmentIncomeAmt
CY Investment Income$107,066CYInvestmentIncomeAmt
PY Other Revenue$91PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$6,972,569PYTotalRevenueAmt
CY Total Revenue$4,316,858CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$8,173,353PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$5,382,819CYBenefitsPaidToMembersAmt
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$439,253PYOtherExpensesAmt
CY Other Expenses$401,785CYOtherExpensesAmt
PY Total Expenses$8,612,606PYTotalExpensesAmt
CY Total Expenses$5,784,604CYTotalExpensesAmt
PY Revenues Less Expenses-$1,640,037PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,467,746CYRevenuesLessExpensesAmt
Total Assets BOY$5,303,173TotalAssetsBOYAmt
Total Assets EOY$3,907,115TotalAssetsEOYAmt
Total Liabilities BOY$26,048TotalLiabilitiesBOYAmt
Total Liabilities EOY$27,448TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$5,277,125NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,879,667NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE HEALTH BENEFITSMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTO PROVIDE HEALTH AND WELFARE, DEATH, AND LOSS OF TIME BENEFITS TO ELIGIBLE PARTICIPANTS AND/OR THEIR DEPENDENTS.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
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 Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
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 Document33IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
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 Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ZENITH AMERICAN SOLUTIONSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8006215133PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line118861 90TH AVENUE SUITE AAddressLine1Txt
CityMOKENACityNm
State AbbreviationILStateAbbreviationCd
ZIP60448ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
STEVEN POWELL
TRUSTEE1.00Yes (X)$0$0$0
SAMUEL VAN TIL
TRUSTEE1.00Yes (X)$0$0$0
LISA CATANZARO
TRUSTEE1.00Yes (X)$0$0$0
JEFFREY STRACK
TRUSTEE1.00Yes (X)$0$0$0
HARRY GROW
TRUSTEE - ALTERNATE1.00Yes (X)$0$0$0
DEREK KINNEY
TRUSTEE - ALTERNATE1.00Yes (X)$0$0$0
RICHARD BUGAJSKI
TRUSTEE - ALTERNATE1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$4,136,720$4,136,720
PARTICIPANT CONTRIBUTIONS900099$59,401$59,401
STOP LOSS REFUNDS900099$13,671$13,671
FieldValueIRS element (for citing)
Total Program Service Revenue$4,209,792TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$103,292TotalRevenueColumnAmt
Exclusion$103,292ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,235,551SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,231,777SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$3,774SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,774TotalRevenueColumnAmt
Exclusion$3,774ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,316,858TotalRevenueColumnAmt
Related Or Exempt Func Income$4,209,792RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$107,066ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$5,382,819TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$178,516TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$34,470TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$31,230TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$28,550TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$86,908TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$14,163TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,608TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$12,713TotalAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmt
WEB CLAIMS SERVICE FEE$9,878
FEES MANDATED BY ACA$2,749

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,784,604TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$74,716BOYAmt
EOY$207,709EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$199,614BOYAmt
EOY$128,527EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$39,882BOYAmt
EOY$18,543EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$15,098BOYAmt
EOY$3,580EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,933,501BOYAmt
EOY$3,529,466EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$40,362BOYAmt
EOY$19,290EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,303,173BOYAmt
EOY$3,907,115EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$26,048BOYAmt
EOY$27,448EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$26,048BOYAmt
EOY$27,448EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$5,277,125BOYAmt
EOY$3,879,667EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,277,125BOYAmt
EOY$3,879,667EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,303,173BOYAmt
EOY$3,907,115EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,467,746ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$70,288NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$4,358,596TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$70,288NetUnrealizedGainsInvstAmt
Revenue Not Reported$70,288RevenueNotReportedAmt
Revenue Subtotal$4,288,308RevenueSubtotalAmt
Investment Expenses Not Incld$28,550InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$28,550RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$4,316,858TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$5,756,054TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$5,756,054ExpensesSubtotalAmt
Investment Expenses Not Incld2$28,550InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$28,550ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$5,784,604TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE ITS TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAX AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THROUGH JULY 1, 2018, THE PLAN WAS ADMINISTERED AND MANAGED BY THE UNITED FOOD AND COMMERCIAL WORKERS UNION AND EMPLOYERS (UFCW) MIDWEST HEALTH BENEFITS FUND. THE PLAN REIMBURSED THE UFCW MIDWEST HEALTH BENEFITS FUND FOR CERTAIN COMMON ADMINISTRATIVE EXPENSES BASED ON A PER MEMBER FEE AGREEMENT. EFFECTIVE AUGUST 1, 2018, THE TRUSTEES HAVE DELEGATED THE DAY TO DAY MANAGEMENT DUTIES TO ZENITH AMERICAN SOLUTIONS, A THIRD PARTY ADMINISTRATOR. THE TRUSTEES RETAIN THE ULTIMATE RESPONSIBILITY FOR THE ADMINISTRATION OF THE FUND.
FORM 990, PART VI, SECTION A, LINE 8BTHE PLAN HAS NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY (TRUSTEES).
FORM 990, PART VI, SECTION B, LINE 11BTHE COMPLETED FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES. ONCE THE FORM IS REVIEWED AND APPROVED, IT IS SIGNED AND FILED.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS,CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE FUND OFFICE.

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Primary ActivitiesPrimaryActivitiesTxtControlled OrganizationControlledOrganizationInd
INDIANA GROCERY GROUP
CONTRIBUTING EMPLOYER0
STRACK-ULTRA LLC
CONTRIBUTING EMPLOYER0
LAKE COUNTY NURSING INC
CONTRIBUTING EMPLOYER0
HAPPY FOODS INC
CONTRIBUTING EMPLOYER0
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 Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

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