FURP.ORG / PUBLIC DATA EXPLORER

ROBERT F KENNEDY FARM WORKERS MEDICAL PLAN: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ROBERT F KENNEDY FARM WORKERS MEDICAL PLAN (EIN 94-6186170)
Tax period
2012-09-01 to 2013-08-31
Filed
2014-07-15
IRS object ID
201431969349301043
Schema version
2012v2.0
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)
Timestamp2014-07-15T11:57:37-07:00Timestamp
Tax Period End Date2013-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MENDEZ PETTY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11400 EASTON DRIVE SUITE 139-AAddressLine1
CityBAKERSFIELDCity
StateCAState
ZIP Code93309ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN946186170EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ROBERT F KENNEDY FARM WORKERSBusinessNameLine1
Business Name Line2MEDICAL PLANBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlROBENameControl
Phone6618236900Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 47AddressLine1
CityKEENECity
StateCAState
ZIP Code93531ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePATRICK PINEName
TitleADMINISTRATORTitle
Date Signed2014-07-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAbel Moreno CPAName
PTINP01292146PTIN
Phone6618647880Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts15067883GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionPROVIDE HEALTH AND WELFARE BENEFITS TO FARMWORKERS AND FARMWORKER AFFILIATED ORGANIZATIONS.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees7TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14280078ProgramServiceRevenuePriorYear
Program Service Revenue CY14589987ProgramServiceRevenueCY
Investment Income Prior Year249554InvestmentIncomePriorYear
Investment Income Current Year-51110InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year14529632TotalRevenuePriorYear
Total Revenue Current Year14538877TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year13537450BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY15523407BenefitsPaidToMembersCY
Salaries Etc Prior Year215798SalariesEtcPriorYear
Salaries Etc Current Year196126SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year420547OtherExpensePriorYear
Other Expenses Current Year690162OtherExpensesCurrentYear
Total Expenses Prior Year14173795TotalExpensesPriorYear
Total Expenses Current Year16409695TotalExpensesCurrentYear
Revenues Less Expenses Prior Year355837RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1870818RevenuesLessExpensesCY
Total Assets BOY6127514TotalAssetsBOY
Total Assets EOY5284058TotalAssetsEOY
Total Liabilities BOY3450762TotalLiabilitiesBOY
Total Liabilities EOY4478124TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2676752NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY805934NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDE HEALTH AND WELFARE BENEFITS TO FARMWORKERS AND FARMWORKER AFFILIATED ORGANIZATIONS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
DescriptionTHE ORGANIZATION PROVIDED HEALTH AND WELFARE BENEFITS TO AN ESTIMATED 2,722 PARTICIPANTS. MOST PARTICIPANTS WERE LOW PAID FARM WORKERS.Description
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees7NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonsfalseAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementfalseRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonPATRICK PINENamePerson
Telephone Number6618236900TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1P O BOX 47AddressLine1
CityKEENECity
StateCAState
ZIP Code93531ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
DANIEL URBANO
Trustee1.000.00X000
SHAH KAZEMI
TRUSTEE1.000.00X000
TANIS YBARRA
TRUSTEE1.000.00X000
EFREN BARAJAS
TRUSTEE1.000.00X000
ARTURO RODRIGUEZ
TRUSTEE1.000.00X000
RICHARD VERA
ADMINISTRATOR15.000.00000X
MERCEDES MARTINEZ FARMER
ASST ADMINISTRA15.000.00000X
FieldValueIRS element (for citing)
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServices
VISION SERVICE PLAN
PO BOX 45210SAN FRANCISCOCA941455210VISION SERVICES
UNITED HEALTHCARE INSURANCE COMPANY
22561 NETWORKK PLACECHICAGOIL606731225DENTAL SERVICES
EXPRESS SCRIPTS
21653 NETWORK PLACECHICAGOIL606731216PRESCRIPTIONS
ANTHEM BLUE CROSS
DEPT 5812LOS ANGELESCA900745812MEDICAL BENEFITS
FieldValueIRS element (for citing)
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MISC. INCOME68126812
LEGAL RECOVERIES
EMPLOYER CONTRIBUTIONS1438639114386391
EMPLOYEE CONTRIBUTIONS196784196784
FieldValueIRS element (for citing)
Total Program Service Revenue14589987TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column-95835TotalRevenueColumn
Related Or Exempt Function Income-95835RelatedOrExemptFunctionIncome

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities573731Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities529006Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities44725Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column44725TotalRevenueColumn
Related Or Exempt Function Income44725RelatedOrExemptFunctionIncome

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14538877TotalRevenueColumn
Related Or Exempt Function Income14538877RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total15523407Total
Program Services15523407ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total150227Total
Program Services150227ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total31390Total
Program Services31390ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total14509Total
Program Services14509ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total12196Total
Program Services12196ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total16012Total
Program Services16012ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total24695Total
Program Services24695ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total17655Total
Program Services17655ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2253Total
Program Services2253ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total16375Total
Program Services16375ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
FIELD OFFICE SERVICES5860658606
MEDICAL BENEFITS CONSULTING6722167221
OUTSIDE SERVICES7145471454
BAD DEBT280000280000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total123695Total
Program Services123695ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total16409695Total
Program Services16409695ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1555843BOY
EOY1001310EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1407119BOY
EOY1676354EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY6815BOY
EOY4600EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis217182LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec198219LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY23762BOY
EOY18963EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY3126452BOY
EOY2582826EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY7523BOY
EOY5EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6127514BOY
EOY5284058EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3450762BOY
EOY4478124EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3450762BOY
EOY4478124EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2676752BOY
EOY805934EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2676752BOY
EOY805934EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6127514BOY
EOY5284058EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-1870818ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteefalseAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1627InvestmentCostOrOtherBasis
Depreciation1627Depreciation

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis152884InvestmentCostOrOtherBasis
Depreciation146301Depreciation
Book Value6583BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis62671InvestmentCostOrOtherBasis
Depreciation50291Depreciation
Book Value12380BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings18963TotalOfBookValueLandBuildings

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe Plan has always maintained a policy of providing governing documents, policies and financial statement information to those requesting such information.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessA electronic copy of the Form 990 was sent to all trustees and the administrator for review and comment before filing with the IRS. The administrator of the Plan performed a detailed review of the Form 990 including reconciliation with the audited financial statements, before filing it with the IRS. The Plan management expects to formally present the Form 990 to the Board of Trustees at their next regularly schedule board meeting for their approval.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
CESAR CHAVEZ FOUNDATION
PO BOX 62KEENECA93531952466747PROVIDES SERVICES TO FARMWORKERCA501(C)(3)PUBLIC CHARITYN/Afalse
UNITED FARM WORKERS OF AMERICA
P O BOX 62KEENECA93531941448579LABOR UNION / PLAN SPONSORCA501(C)(5)N/Afalse
JUAN DE LA CRUZ FARMWORKERS PENSION PLAN
P O BOX 36KEENECA93531956454441MULTIEEMPLOYER RETIREMENT PLAN PROVIDING PENSIONSCA501(C)(9)N/Afalse
NATIONAL CHAVEZ CENTER
P O BOX 62KEENECA93531770159465PERFORM CHARITABLE ACTIVIES THAT SUPPORT FARM WORKERSCA501(C) (3)PUBLIC CHARITYN/Afalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1LAW OFFICE OF MARCOS CAMACHOBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11227 CALIFORNIA AVEAddressLine1
CityBAKERSFIELDCity
StateCAState
ZIP Code93304ZIPCode
FieldValueIRS element (for citing)
EIN931020541EIN
Primary ActivityLAW FIRMPrimaryActivity
Legal Domicile StateCALegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityS CORPTypeOfEntity
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
LAW OFFICE OF MARCOS CAMACHO
l15247CASH
LAW OFFICE OF MARCOS CAMACHO
k7500CASH
CESAR CHAVEZ FOUNDATION
l1029989CASH
CESAR CHAVEZ FOUNDATION
k6051CASH
UNITED FARM WORKERS OF AMERICA
l480094CASH
UNITED FARM WORKERS OF AMERICA
k92901CASH
JUAN DE LA CRUZ FARMWORKERS PENSION PLAN
l47512CASH
JUAN DE LA CRUZ FARMWORKERS PENSION PLAN
k1640CASH
NATIONAL CHAVEZ CENTER
l44901CASH
NATIONAL CHAVEZ CENTER
k20653CASH