UFCW UNIONS & PARTCIPATING EMPLOYERS HEALTH AND WELFARE FUND: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- UFCW UNIONS & PARTCIPATING EMPLOYERS HEALTH AND WELFARE FUND (EIN 01-0749311)
- Tax period
- 2012-11-01 to 2013-10-31
- Filed
- 2014-09-15
- IRS object ID
- 201402589349300230
- Schema version
- 2012v2.3
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-09-15T13:06:37-05:00 | Timestamp |
| Tax Period End Date | 2013-10-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BARATZ & ASSOCIATES PA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7 EVES DRIVE SUITE 100 | AddressLine1 |
| City | MARLTON | City |
| State | NJ | State |
| ZIP Code | 080533196 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-11-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010749311 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UFCW UNIONS & PARTICIPATING | BusinessNameLine1 |
| Business Name Line2 | EMPLOYERS HEALTH & WELFARE FUND | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | UFCW | NameControl |
| Phone | 8567932500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27 ROLAND AVENUE | AddressLine1 |
| City | MT LAUREL | City |
| State | NJ | State |
| ZIP Code | 08054 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SAM FERRAINO | Name |
| Title | CHAIRMAN | Title |
| Phone | 8567932500 | Phone |
| Date Signed | 2014-09-10 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN FEKETE CPA | Name |
| Phone | 8569855688 | Phone |
| Date Prepared | 2014-09-15 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | VINCE CARROLL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27 ROLAND AVE | AddressLine1 |
| City | MT LAUREL | City |
| State | NJ | State |
| ZIP Code | 08054 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 41625868 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Type Of Organization Other | X | TypeOfOrganizationOther |
| Type Of Org Other Description | BENEFIT FUND | TypeOfOrgOtherDescription |
| Year Formation | 2002 | YearFormation |
| State Legal Domicile | NJ | StateLegalDomicile |
| Activity Or Mission Description | TO PAY HEALTH, LIFE AND LIMITED LEGAL BENEFITS FOR PARTICIPANTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 37847865 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 41597745 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 20509 | InvestmentIncomePriorYear |
| Investment Income Current Year | 10419 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 5112 | OtherRevenuePriorYear |
| Other Revenue Current Year | 17704 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 37873486 | TotalRevenuePriorYear |
| Total Revenue Current Year | 41625868 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 38592466 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 39217968 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3532599 | OtherExpensePriorYear |
| Other Expenses Current Year | 3751888 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 42125065 | TotalExpensesPriorYear |
| Total Expenses Current Year | 42969856 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -4251579 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1343988 | RevenuesLessExpensesCY |
| Total Assets BOY | 13030768 | TotalAssetsBOY |
| Total Assets EOY | 8654075 | TotalAssetsEOY |
| Total Liabilities BOY | 9391609 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 6358904 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3639159 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2295171 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PAY HEALTH, LIFE AND LIMITED LEGAL BENEFITS FOR PARTICIPANTS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Description | TO PROVIDE HEALTH, LIFE, LEGAL, AND OTHER BENEFITS TO PARTICIPANTS. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | TO PROVIDE HEALTH, LIFE, LEGAL, AND OTHER BENEFITS TO PARTICIPANTS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Described In501 C3 | false | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 511 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicy |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ADMINISTRATIVE COMMITTEE | NamePerson |
| Telephone Number | 8567932500 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27 ROLAND AVENUE | AddressLine1 |
| City | MT LAUREL | City |
| State | NJ | State |
| ZIP Code | 08054 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (8 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|
| DEWEY CANNELLA | |||||
| TRUSTEE/SECR | 1.00 | X | 0 | 0 | 0 |
| PATRICK J DURNING | |||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 |
| CRAIG HOFFMAN | |||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 |
| DAVID B GILLIS | |||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 |
| SAM FERRAINO | |||||
| CHAIR/TRUSTE | 1.00 | X | 0 | 0 | 0 |
| BRIAN STRING | |||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 |
| DANIEL KONCZYK | |||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 |
| GREGORY QUAGLIATO | |||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Business Name Line2NameOfContractor/NameBusiness/BusinessNameLine2 | Address Line1AddressOfContractor/AddressUS/AddressLine1 | Address Line2AddressOfContractor/AddressUS/AddressLine2 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|---|---|
| TRI-STATE ADMINISTRATORS | |||||||
| TRI-STATE ADMINISTRATORS | 27 ROLAND AVE | 27 ROLAND AVE | MT LAUREL | NJ | 08054 | ADMINISTRATION | 3445661 |
| SPEAR WILDERMAN PC | |||||||
| SPEAR WILDERMAN PC | 230 S BROAD ST | 230 S BROAD ST | PHILADELPHIA | PA | 19102 | LEGAL | 388114 |
| O'BRIEN BELLAND & BUSHINSKY LLC | |||||||
| O'BRIEN BELLAND & BUSHINSKY LLC | 1526 BERLIN RD | 1526 BERLIN RD | CHERRY HILL | NJ | 08003 | LEGAL | 202056 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| EMPLOYER CONTRIBUTIONS | 41411374 | 41411374 |
| EMPLOYEE CONTRIBUTIONS | 186371 | 186371 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 41597745 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10419 | TotalRevenueColumn |
| Exclusion | $10,419 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER INCOME | Description |
| Total Revenue Column | 17704 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17704 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 17704 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 41625868 | TotalRevenueColumn |
| Related Or Exempt Function Income | 41615449 | RelatedOrExemptFunctionIncome |
| Exclusion | $10,419 | ExclusionAmount |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39217968 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34370 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20500 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3908 | Total |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal |
|---|---|
| ADMINISTRATOR FEES | 3405041 |
| DATA PROCESSING | 124610 |
| DEPRECIATION | 54892 |
| ADMINISTRATION-PROJECTS | 41089 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67478 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42969856 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2872238 | BOY |
| EOY | 1470505 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4747938 | BOY |
| EOY | 1952254 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3470601 | BOY |
| EOY | 3830933 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67503 | BOY |
| EOY | 94936 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 276971 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 116729 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 215134 | BOY |
| EOY | 160242 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1657354 | BOY |
| EOY | 1145205 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13030768 | BOY |
| EOY | 8654075 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9391609 | BOY |
| EOY | 6358904 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9391609 | BOY |
| EOY | 6358904 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3639159 | BOY |
| EOY | 2295171 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3639159 | BOY |
| EOY | 2295171 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13030768 | BOY |
| EOY | 8654075 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -1343988 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 276971 | OtherCostOrOtherBasis |
| Depreciation | 116729 | Depreciation |
| Book Value | 160242 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 160242 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| BLUE CROSS DEPOSIT/RESERVE | 782000 |
| DEPOSITS & DRUG REBATE RECEIVABLE | 303502 |
| OTHER RECEIVABLE | 59703 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1145205 | TotalBookValueOtherAssets |
| Tot Revenue Etc Audited Fincl Stmt | 41625868 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 41625868 | RevenueSubtotal |
| Total Revenue Per Form990 | 41625868 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 46002923 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 46002923 | ExpensesSubtotal |
| Other Expenses Not Included | -3033067 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | -3033067 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 42969856 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER | Identifier |
| Return Reference | SCHEDULE D, PAGE 4, PART XII, LINE 4B | ReturnReference |
| Explanation | BENEFIT PAYABLE ADJUSTMENT -3,033,067 | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ALL OTHER ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4D | TO PROVIDE HEALTH, LIFE, LEGAL, AND OTHER BENEFITS TO PARTICIPANTS. |
| MANAGEMENT DELEGATED | FORM 990, PAGE 6, PART VI, LINE 3 | DAILY OPERATIONS ARE PERFORMED BY A THIRD-PARTY ADMINISTRATOR (TRI-STATE ADMINISTRATORS). |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 WAS REVIEWED BY THE FUND'S BOOKKEEPER, BEFORE BEING SENT TO THE TRUSTEES FOR FINAL REVIEW AND SIGNATURE. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNMENT FORMS ARE AVAILABLE FOR REVIEW UPON REQUEST. PARTICIPANTS ARE ABLE TO COME TO THE ADMINISTRATIVE OFFICE AND REQUEST AN OPPORTUNITY TO REIVEW THE FORMS. |
| RECONCILIATION OF CHANGES - OTHER | FORM 990, PART XI, LINE 9 | BENEFIT PAYABLE ADJUSTMENT -3,033,067 |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 9 | BENEFIT PAYABLE ADJUSTMENT -3,033,067 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)
| Business Name Line2NameOfDisregardedEntity/BusinessNameLine2 | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| UNITED FOOD & COMMERCIAL WORKERS | ||||||||||
| UNION LOCAL 152 | 701 RT 50 | MAYS LANDING | NJ | 08330 | 203953178 | UNION | NJ | 501C5 | N/A | false |
| UNITED FOOD & COMMERCIAL WORKERS | ||||||||||
| UNION LOCAL 1360 | 400 COMMERCE LANE | WEST BERLIN | NJ | 08091 | 210546700 | UNION | NJ | 501C5 | N/A | false |
| CAMDEN COUNTY MUNICIPAL | ||||||||||
| UTILITIES AUTHORITY | 1645 FERRY AVE | CAMDEN | NJ | 08104 | 222003702 | UTILITIES | NJ | N/A | false | |
| ALLEGANY COUNTY HUMAN RESOURCES | ||||||||||
| DEVELOPMENT COMMISSION INC | 125 VIRGINIA AVE | CUMBERLAND | MD | 21502 | 526065754 | SOCIAL SVC | MD | 501C3 | N/A | false |
| NURSING HOME BOARD OF ALLEGANY | ||||||||||
| COUNTY | 901 SETON DR | CUMBERLAND | MD | 21502 | 520812302 | HEALTHCARE | MD | 501C3 | N/A | false |
| WEPCO FEDERAL CREDIT UNION | ||||||||||
| 204 N BRANCH AVE | BLOOMINGTON | MD | 21523 | 520627367 | FINANCIAL | MD | 501C14 | N/A | false | |
| CHESSIE FEDERAL CREDIT UNION | ||||||||||
| 141 BALTIMORE ST | CUMBERLAND | MD | 21502 | 520580973 | FINANCIAL | MD | 501C14 | N/A | false | |
| FIRST PEOPLES COMMUNITY FEDERAL | ||||||||||
| CREDIT UNION | 153 BALTIMORE ST | CUMBERLAND | MD | 21502 | 520905189 | FINANCIAL | MD | 501C14 | N/A | false |
Form990 Schedule R Part III Form990ScheduleRPartIII (21 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Business Name Line2NameOfRelatedOrg/BusinessNameLine2 | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Business Name Line2DirectControllingEntityName/BusinessNameLine2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FROSTBURG FACILITY OPERATIONS LLC | ||||||||||||
| ONE KAYLOR CIRCLE | FROSTBURG | MD | 21532 | 205111843 | HEALTHCARE | MD | N/A | false | false | |||
| AVC PICTURES LLC | ||||||||||||
| 58 S BROAD ST | WOODBURY | NJ | 08096 | 201580850 | MEDIA | NJ | N/A | false | false | |||
| SHOP RITE OF GLEN BURNIE LLC | ||||||||||||
| 5000 RIVERSIDE DR | KEASBY | NJ | 08832 | 272508458 | GROCERY ST | NJ | N/A | false | false | |||
| COLLINS MARKETS LLC | ||||||||||||
| 1568 CHESTER PIKE | EDDYSTONE | PA | 19022 | 201624507 | GROCERY ST | PA | N/A | false | false | SHOPRITE OF EDDYSTONE | ||
| AVISTA HEALTHCARE LLC | ||||||||||||
| 3025 CHAPEL AVE WEST | CHERRY HILL | NJ | 08002 | 205274822 | HEALTHCARE | NJ | N/A | false | false | |||
| KGJ ASSOCIATES LLC | ||||||||||||
| 1310 FAIRVIEW BLVD | DELRAN | NJ | 08075 | 432104622 | GROCERY ST | NJ | false | false | SHOPRITE OF CINNAMINSON | EICKHOFF'S | SUPERMARKETS | |
| EEE ASSOCIATES LLC | ||||||||||||
| 1310 FAIRVIEW RD | DELRAN | NJ | 08075 | 562669847 | GROCERY ST | NJ | false | false | SHOPRITE OF ARK RD & RT 38 | EICKHOFF'S | SUPERMARKETS | |
| FROSTBURG FACILITY OPERATIONS LLC | ||||||||||||
| ONE KAYLOR CIRCLE | FROSTBURG | MD | 21532 | 205111843 | HEALTHCARE | MD | N/A | false | false | |||
| AVC PICTURES LLC | ||||||||||||
| 58 S BROAD ST | WOODBURY | NJ | 08096 | 201580850 | MEDIA | NJ | N/A | false | false | |||
| SHOP RITE OF GLEN BURNIE LLC | ||||||||||||
| 5000 RIVERSIDE DR | KEASBY | NJ | 08832 | 272508458 | GROCERY ST | NJ | N/A | false | false | |||
| COLLINS MARKETS LLC | ||||||||||||
| 1568 CHESTER PIKE | EDDYSTONE | PA | 19022 | 201624507 | GROCERY ST | PA | N/A | false | false | SHOPRITE OF EDDYSTONE | ||
| AVISTA HEALTHCARE LLC | ||||||||||||
| 3025 CHAPEL AVE WEST | CHERRY HILL | NJ | 08002 | 205274822 | HEALTHCARE | NJ | N/A | false | false | |||
| KGJ ASSOCIATES LLC | ||||||||||||
| 1310 FAIRVIEW BLVD | DELRAN | NJ | 08075 | 432104622 | GROCERY ST | NJ | false | false | SHOPRITE OF CINNAMINSON | EICKHOFF'S | SUPERMARKETS | |
| EEE ASSOCIATES LLC | ||||||||||||
| 1310 FAIRVIEW RD | DELRAN | NJ | 08075 | 562669847 | GROCERY ST | NJ | false | false | SHOPRITE OF ARK RD & RT 38 | EICKHOFF'S | SUPERMARKETS | |
| FROSTBURG FACILITY OPERATIONS LLC | ||||||||||||
| ONE KAYLOR CIRCLE | FROSTBURG | MD | 21532 | 205111843 | HEALTHCARE | MD | N/A | false | false | |||
| AVC PICTURES LLC | ||||||||||||
| 58 S BROAD ST | WOODBURY | NJ | 08096 | 201580850 | MEDIA | NJ | N/A | false | false | |||
| SHOP RITE OF GLEN BURNIE LLC | ||||||||||||
| 5000 RIVERSIDE DR | KEASBY | NJ | 08832 | 272508458 | GROCERY ST | NJ | N/A | false | false | |||
| COLLINS MARKETS LLC | ||||||||||||
| 1568 CHESTER PIKE | EDDYSTONE | PA | 19022 | 201624507 | GROCERY ST | PA | N/A | false | false | SHOPRITE OF EDDYSTONE | ||
| AVISTA HEALTHCARE LLC | ||||||||||||
| 3025 CHAPEL AVE WEST | CHERRY HILL | NJ | 08002 | 205274822 | HEALTHCARE | NJ | N/A | false | false | |||
| KGJ ASSOCIATES LLC | ||||||||||||
| 1310 FAIRVIEW BLVD | DELRAN | NJ | 08075 | 432104622 | GROCERY ST | NJ | false | false | SHOPRITE OF CINNAMINSON | EICKHOFF'S | SUPERMARKETS | |
| EEE ASSOCIATES LLC | ||||||||||||
| 1310 FAIRVIEW RD | DELRAN | NJ | 08075 | 562669847 | GROCERY ST | NJ | false | false | SHOPRITE OF ARK RD & RT 38 | EICKHOFF'S | SUPERMARKETS | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (36 entries)
| Business Name Line2NameOfRelatedOrg/BusinessNameLine2 | Address Line1AddressUS/AddressLine1 | Address Line2AddressUS/AddressLine2 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Business Name Line2DirectControllingEntityName/BusinessNameLine2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLSE & ASSOCIATES INC | |||||||||||||
| WILLSE & ASSOCIATES INC | 1501 S CLINTON ST | 7TH FLOOR | BALTIMORE | MD | 21224 | 521187907 | INSURANCE | NJ | N/A | C CORP | false | ||
| KRE INC | |||||||||||||
| KRE INC | 1310 FAIRVIEW BLVD | DELRAN | NJ | 08075 | 300107628 | GROCERY ST | NJ | C CORP | false | EICKHOFF | SUPERMARKETS INC | ||
| HFE INC | |||||||||||||
| HFE INC | 1310 FAIRVIEW BLVD | DELRAN | NJ | 08075 | 221859016 | GROCERY ST | NJ | C CORP | false | EICKHOFF | SUPERMARKETS INC | ||
| AVON FOODS INC | |||||||||||||
| AVON FOODS INC | 1275 HORNBERGER AVE | ROEBLING | NJ | 08554 | 562628476 | GROCERY ST | NJ | N/A | C CORP | false | |||
| PERLMART INC | |||||||||||||
| 954 RT 166 | TOMS RIVER | NJ | 08753 | 222143674 | GROCERY ST | NJ | N/A | C CORP | false | ||||
| SAKER SHOPRITES INC | |||||||||||||
| 922 HIGHWAY 33 | BLDG 6 | FREEHOLD | NJ | 07728 | 221729304 | GROCERY ST | NJ | N/A | C CORP | false | |||
| SJF-CCRC INC | |||||||||||||
| SJF-CCRC INC | 1110 LAUREL OAK RD | VOORHEES | NJ | 08043 | 233701092 | HEALTHCARE | NJ | N/A | C CORP | false | |||
| ZALLIE SUPERMARKETS INC | |||||||||||||
| 1230 BLACKWOOD-CLEMENTON RD | CLEMENTON | NJ | 08021 | 222385129 | GROCERY ST | NJ | N/A | C CORP | false | ||||
| AHOLD USA INC | |||||||||||||
| AHOLD USA INC | 1149 HARRISBURG PIKE | CARLISLE | PA | 17013 | 530073545 | GROCERY ST | PA | N/A | C CORP | false | |||
| ASSITED LIVING AT FROSTBURG VILLIAG | |||||||||||||
| 100 VILLAGE PARKWAY | FROSTBURG | MD | 21532 | 205103941 | HEALTHCARE | MD | N/A | C CORP | false | ||||
| FRANK M VACCARRO & ASSOCIATES INC | |||||||||||||
| 27 ROLAND AVE | MT LAUREL | NJ | 08054 | 232148108 | BENEFITS | NJ | N/A | false | |||||
| TRI STATE ADMINISTRATORS | |||||||||||||
| 27 ROLAND AVE | MT LAUREL | NJ | 08054 | 223478819 | BENEFITS | NJ | N/A | false | |||||
| WILLSE & ASSOCIATES INC | |||||||||||||
| WILLSE & ASSOCIATES INC | 1501 S CLINTON ST | 7TH FLOOR | BALTIMORE | MD | 21224 | 521187907 | INSURANCE | NJ | N/A | C CORP | false | ||
| KRE INC | |||||||||||||
| KRE INC | 1310 FAIRVIEW BLVD | DELRAN | NJ | 08075 | 300107628 | GROCERY ST | NJ | C CORP | false | EICKHOFF | SUPERMARKETS INC | ||
| HFE INC | |||||||||||||
| HFE INC | 1310 FAIRVIEW BLVD | DELRAN | NJ | 08075 | 221859016 | GROCERY ST | NJ | C CORP | false | EICKHOFF | SUPERMARKETS INC | ||
| AVON FOODS INC | |||||||||||||
| AVON FOODS INC | 1275 HORNBERGER AVE | ROEBLING | NJ | 08554 | 562628476 | GROCERY ST | NJ | N/A | C CORP | false | |||
| PERLMART INC | |||||||||||||
| 954 RT 166 | TOMS RIVER | NJ | 08753 | 222143674 | GROCERY ST | NJ | N/A | C CORP | false | ||||
| SAKER SHOPRITES INC | |||||||||||||
| 922 HIGHWAY 33 | BLDG 6 | FREEHOLD | NJ | 07728 | 221729304 | GROCERY ST | NJ | N/A | C CORP | false | |||
| SJF-CCRC INC | |||||||||||||
| SJF-CCRC INC | 1110 LAUREL OAK RD | VOORHEES | NJ | 08043 | 233701092 | HEALTHCARE | NJ | N/A | C CORP | false | |||
| ZALLIE SUPERMARKETS INC | |||||||||||||
| 1230 BLACKWOOD-CLEMENTON RD | CLEMENTON | NJ | 08021 | 222385129 | GROCERY ST | NJ | N/A | C CORP | false | ||||
| AHOLD USA INC | |||||||||||||
| AHOLD USA INC | 1149 HARRISBURG PIKE | CARLISLE | PA | 17013 | 530073545 | GROCERY ST | PA | N/A | C CORP | false | |||
| ASSITED LIVING AT FROSTBURG VILLIAG | |||||||||||||
| 100 VILLAGE PARKWAY | FROSTBURG | MD | 21532 | 205103941 | HEALTHCARE | MD | N/A | C CORP | false | ||||
| FRANK M VACCARRO & ASSOCIATES INC | |||||||||||||
| 27 ROLAND AVE | MT LAUREL | NJ | 08054 | 232148108 | BENEFITS | NJ | N/A | false | |||||
| TRI STATE ADMINISTRATORS | |||||||||||||
| 27 ROLAND AVE | MT LAUREL | NJ | 08054 | 223478819 | BENEFITS | NJ | N/A | false | |||||
| WILLSE & ASSOCIATES INC | |||||||||||||
| WILLSE & ASSOCIATES INC | 1501 S CLINTON ST | 7TH FLOOR | BALTIMORE | MD | 21224 | 521187907 | INSURANCE | NJ | N/A | C CORP | false | ||
| KRE INC | |||||||||||||
| KRE INC | 1310 FAIRVIEW BLVD | DELRAN | NJ | 08075 | 300107628 | GROCERY ST | NJ | C CORP | false | EICKHOFF | SUPERMARKETS INC | ||
| HFE INC | |||||||||||||
| HFE INC | 1310 FAIRVIEW BLVD | DELRAN | NJ | 08075 | 221859016 | GROCERY ST | NJ | C CORP | false | EICKHOFF | SUPERMARKETS INC | ||
| AVON FOODS INC | |||||||||||||
| AVON FOODS INC | 1275 HORNBERGER AVE | ROEBLING | NJ | 08554 | 562628476 | GROCERY ST | NJ | N/A | C CORP | false | |||
| PERLMART INC | |||||||||||||
| 954 RT 166 | TOMS RIVER | NJ | 08753 | 222143674 | GROCERY ST | NJ | N/A | C CORP | false | ||||
| SAKER SHOPRITES INC | |||||||||||||
| 922 HIGHWAY 33 | BLDG 6 | FREEHOLD | NJ | 07728 | 221729304 | GROCERY ST | NJ | N/A | C CORP | false | |||
| SJF-CCRC INC | |||||||||||||
| SJF-CCRC INC | 1110 LAUREL OAK RD | VOORHEES | NJ | 08043 | 233701092 | HEALTHCARE | NJ | N/A | C CORP | false | |||
| ZALLIE SUPERMARKETS INC | |||||||||||||
| 1230 BLACKWOOD-CLEMENTON RD | CLEMENTON | NJ | 08021 | 222385129 | GROCERY ST | NJ | N/A | C CORP | false | ||||
| AHOLD USA INC | |||||||||||||
| AHOLD USA INC | 1149 HARRISBURG PIKE | CARLISLE | PA | 17013 | 530073545 | GROCERY ST | PA | N/A | C CORP | false | |||
| ASSITED LIVING AT FROSTBURG VILLIAG | |||||||||||||
| 100 VILLAGE PARKWAY | FROSTBURG | MD | 21532 | 205103941 | HEALTHCARE | MD | N/A | C CORP | false | ||||
| FRANK M VACCARRO & ASSOCIATES INC | |||||||||||||
| 27 ROLAND AVE | MT LAUREL | NJ | 08054 | 232148108 | BENEFITS | NJ | N/A | false | |||||
| TRI STATE ADMINISTRATORS | |||||||||||||
| 27 ROLAND AVE | MT LAUREL | NJ | 08054 | 223478819 | BENEFITS | NJ | N/A | false | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
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