UFCW UNIONS & PARTCIPATING EMPLOYERS HEALTH AND WELFARE FUND: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- UFCW UNIONS & PARTCIPATING EMPLOYERS HEALTH AND WELFARE FUND (EIN 01-0749311)
- Tax period
- 2010-11-01 to 2011-10-31
- Filed
- 2012-09-06
- IRS object ID
- 201232509349300633
- Schema version
- 2010v3.7
- 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 | 2012-09-06T15:22:11-05:00 | Timestamp |
| Tax Period End Date | 2011-10-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHULMAN KURTZ TURER & TOPAZ LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 N LAKEVIEW DRIVE | AddressLine1 |
| City | GIBBSBORO | City |
| State | NJ | State |
| ZIP Code | 080261046 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-11-01 | 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 | 2012-08-23 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RICHARD L BAITZEL CPA | Name |
| Phone | 8566277444 | Phone |
| Date Prepared | 2012-08-23 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | 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 | 35650399 | 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 | 33567609 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 35602805 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 40209 | InvestmentIncomePriorYear |
| Investment Income Current Year | 35657 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 23518 | OtherRevenuePriorYear |
| Other Revenue Current Year | 11937 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 33631336 | TotalRevenuePriorYear |
| Total Revenue Current Year | 35650399 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 27907728 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 31407117 | 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 | 3193410 | OtherExpensePriorYear |
| Other Expenses Current Year | 3288301 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 31101138 | TotalExpensesPriorYear |
| Total Expenses Current Year | 34695418 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2530198 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 954981 | RevenuesLessExpensesCY |
| Total Assets BOY | 14364919 | TotalAssetsBOY |
| Total Assets EOY | 14165673 | TotalAssetsEOY |
| Total Liabilities BOY | 7429162 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 6274935 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6935757 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7890738 | 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 | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 327 | 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 |
| PAUL TRUNCELLITO | |||||
| 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
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-STATE ADMINISTRATORS | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| 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) |
|---|---|---|
| Description Of Services | ADMINISTRATION | DescriptionOfServices |
| Compensation | 3062793 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| EMPLOYER CONTRIBUTIONS | 35474817 | 35474817 |
| EMPLOYEE CONTRIBUTIONS | 127988 | 127988 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 35602805 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 35657 | TotalRevenueColumn |
| Exclusion | $35,657 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER INCOME | Description |
| Total Revenue Column | 11937 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11937 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 11937 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 35650399 | TotalRevenueColumn |
| Related Or Exempt Function Income | 35614742 | RelatedOrExemptFunctionIncome |
| Exclusion | $35,657 | ExclusionAmount |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31407117 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33741 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18000 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2282 | Total |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal |
|---|---|
| ADMINISTRATOR FEES | 3034680 |
| DATA PROCESSING | 88587 |
| OFFICE EXPENSES | 50231 |
| NEWSLETTER | 18597 |
| ACTUARY | 15478 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26705 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34695418 | 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 | 2064820 | BOY |
| EOY | 2867450 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6927349 | BOY |
| EOY | 6240286 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3052705 | BOY |
| EOY | 3221466 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5267 | BOY |
| EOY | 5574 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 236398 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 18872 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 227319 | BOY |
| EOY | 217526 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2087459 | BOY |
| EOY | 1613371 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14364919 | BOY |
| EOY | 14165673 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7429162 | BOY |
| EOY | 6274935 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7429162 | BOY |
| EOY | 6274935 | 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 | 6935757 | BOY |
| EOY | 7890738 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6935757 | BOY |
| EOY | 7890738 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14364919 | BOY |
| EOY | 14165673 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 954981 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 236398 | OtherCostOrOtherBasis |
| Depreciation | 18872 | Depreciation |
| Book Value | 217526 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 217526 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| BLUE CROSS DEPOSIT/RESERVE | 1281175 |
| DEPOSITS & DRUG REBATE RECEIVABLE | 332196 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1613371 | TotalBookValueOtherAssets |
| Total Revenue | 35650399 | TotalRevenue |
| Total Expenses | 34695418 | TotalExpenses |
| Excess Or Deficit For Year | 954981 | ExcessOrDeficitForYear |
| Other | -$1,255,086 | OtherAmount |
| Total Adjustments | -1255086 | TotalAdjustments |
| Excess Or Deficit Per FS | -300105 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 35650399 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 35650399 | RevenueSubtotal |
| Total Revenue Per Form990 | 35650399 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 35950504 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 35950504 | ExpensesSubtotal |
| Other Expenses Not Included | -1255086 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | -1255086 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 34695418 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RECONCILIATION OF CHANGES - OTHER | SCHEDULE D, PAGE 4, PART XI, LINE 8 | BENEFIT PAYABLE ADJUSTMENT -1,255,086 |
| EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER | SCHEDULE D, PAGE 4, PART XIII, LINE 4B | BENEFIT PAYABLE ADJUSTMENT -1,255,086 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ALL OTHER ACHIEVEMENTS 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. |
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