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LM-2 Labor Organization Annual Report
ICR 201907-1245-001 · OMB 1245-0003 · Object 93295001.
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U.S. Department of Labor Office of Labor-Management Standards Washington, DC 20210 FORM LM-2 LABOR ORGANIZATION ANNUAL REPORT MUST BE USED BY LABOR ORGANIZATIONS WITH $250,000 OR MORE IN TOTAL ANNUAL RECEIPTS AND LABOR ORGANIZATIONS IN TRUSTEESHIP Form Approved Office of Management and Budget No. 1245-0003 Expires 07-31-2019 This report is mandatory under P.L. 86-257, as amended. Failure to comply may result in criminal prosecution, fines, or civil penalties as provided by 29 U.S.C. 439 or 440. READ THE INSTRUCTIONS CAREFULLY BEFORE PREPARING THIS REPORT. For Official Use Only 1. FILE NUMBER 2. PERIOD COVERED MO DAY 3. (a) AMENDED — If this is an amended report, check here: YEAR From (b) HARDSHIP — If filing under hardship procedures check here: Through (c) TERMINAL — If this is a terminal report, check here: 8. MAILING ADDRESS (Type or print in capital letters.) 4. AFFILIATION OR ORGANIZATION NAME First Name 5. DESIGNATION (Local, Lodge, etc.) 6. DESIGNATION NUMBER Last Name P.O. Box - Building and Room Number Number and Street 7. UNIT NAME (if any) City 9. Are your organization’s records kept at its mailing address? Yes No State ZIP Code + 4 (If “No,” provide address in Item 69.) 69. ADDITIONAL INFORMATION (Text entered will appear on last page of form. To enter comments, press the “General Additional Information” button.) Each of the undersigned, duly authorized officers of the above labor organization, declares, under penalty of perjury and other applicable penalties of law, that all of the information submitted in this report (including the information contained in any accompanying documents) has been examined by the signatory and is, to the best of the undersigned's knowledge and belief, true, correct, and complete. (See Section VI on penalties in the instructions.) 70. SIGNED: __________________________________________________________ PRESIDENT (If other title, / / ( ) — see instructions.) Date Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Telephone Number 71. SIGNED: ____________________________________________________ TREASURER (If other title, / / ( ) — see instructions.) Date Telephone Number Page 1 of 26 COMPLETE ITEMS 10 THROUGH 21 FILE NUMBER: 10. During the reporting period did the labor organization create or participate in the administration of a trust or other fund or organization, as defined in the instructions, which provides benefits for members or their beneficiaries? Yes No 18. During the reporting period did the labor organization have any changes in its constitution and bylaws, other than rates of dues and fees, or in practices/procedures listed in the instructions? Yes No 11(a). During the reporting period did the labor organization have a political action committee (PAC) fund? Yes No 19. What is the date of the labor organization’s next regular election of officers? 11(b). During the reporting period did the labor organization have a subsidiary organization as defined in Section X of these Instructions? Yes No 20. How many members did the labor organization have at the end of the reporting period? (Total from the Members Line of Schedule 13) 12. During the reporting period did the labor organization have an audit or review of its books and records by an outside accountant or by a parent body Yes No auditor/representative? 21. What are the labor organization’s rates of dues and fees? (Enter a minimum and maximum if more than one rate applies for any line.) Rates of Dues and Fees 13. During the reporting period did the labor organization discover any loss or shortage of funds or other assets? (Answer “Yes” even if there has been repayment or recovery.) Yes No 14. What is the maximum amount recoverable under the labor organization’s fidelity bond for a loss caused by any officer, employee or agent of the labor organization who handled union funds? 15. During the reporting period did the labor organization acquire or dispose of any assets in any manner other than by purchase or sale? Yes No 16. Were any of the labor organization’s assets pledged as security or encumbered in any other way at the end of the reporting period? Yes No 17. Did the labor organization have any contingent liabilities at the end of the reporting period? Yes No Dues/Fees Amount Unit (a) Regular Dues/Fees per (b) Working Dues/Fees per (c) Initiation Fees per (d) Transfer Fees per (e) Work Permits per Minimum Maximum If the answer to any of the above questions is “Yes,” provide details in Item 69 (Additional Information) as explained in the instructions for each item. Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 2 of 26 STATEMENT A – ASSETS AND LIABLITIES FILE NUMBER: Complete Schedules 1 Through 20 Before Completing Statement A ASSETS ASSETS Schedule Number Start of Reporting Period (A) End of Reporting Period (B) Start of Reporting Period (C) End of Reporting Period (D) 22. Cash 23. Accounts Receivable 1 24. Loans Receivable 2 25. U.S. Treasury Securities 26. Investments 5 27. Fixed Assets 6 28. Other Assets 7 29. TOTAL ASSETS LIABILITIES LIABILITIES Schedule Number 30. Accounts Payable 8 31. Loans Payable 9 32. Mortgages Payable 33. Other Liabilities 10 34. TOTAL LIABILITIES 35. NET ASSETS (Item 29 Less Item 34) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 3 of 26 STATEMENT B – RECEIPTS AND DISBURSEMENTS FILE NUMBER: Complete Schedules 1 Through 20 Before Completing Statement B Item CASH RECEIPTS SCH # AMOUNT Item CASH DISBURSEMENTS SCH # 36. Dues and Agency Fees 50. Representational Activities 15 37. Per Capita Tax 51. Political Activities and Lobbying 16 38. Fees, Fines, Assessments, Work Permits 52. Contributions, Gifts, and Grants 17 39. Sale of Supplies 53. General Overhead 18 40. Interest 54. Union Administration 19 41. Dividends 55. Benefits 20 42. Rents 56. Per Capita Tax 43. Sale of Investments and Fixed Assets 3 57. Strike Benefits 44. Loans Obtained 9 58. Fees, Fines, Assessments, etc. 45. Repayments of Loans Made 2 59. Supplies for Resale 46. On Behalf of Affiliates for Transmittal to Them 60. Purchase of Investments and Fixed Assets 4 47. From Members for Disbursement on Their Behalf 61. Loans Made 2 62. Repayment of Loans Obtained 9 48. Other Receipts 49. TOTAL RECEIPTS 14 AMOUNT 63. To Affiliates of Funds Collected on Their Behalf 64. On Behalf of Individual Members 65. Direct Taxes 66. Subtotal 67. Withholding Tax and Payroll Deductions 67a. Total Withheld 67b. Less Total Disbursed 67c. Total Withheld But Not Disbursed 68. TOTAL DISBURSEMENTS (Line 66 – Line 67c) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 4 of 26 SCHEDULE 1 – ACCOUNTS RECEIVABLE AGING SCHEDULE Entity or Individual Name (A) FILE NUMBER: Total Account Receivable (B) 90 - 180 Days Past Due (C) 180+ Days Past Due (D) Liquidated Account Receivable (E) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. Total of all itemized accounts receivable Totals from all other accounts receivable Totals (Total of Column (B) will be automatically entered in Item 23, Column (B)) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 5 of 26 SCHEDULE 2 – LOANS RECEIVABLE List below loans to officers, employees, or members which at any time during the reporting period exceeded $250 and list all loans to business enterprises regardless of amount. (A) FILE NUMBER: Loans Outstanding at Start of Period (B) Repayments Received During Period Loans Made During Period (C) Cash (D)(1) Other Than Cash (D)(2) Loans Outstanding at End of Period (E) 1. Name: _______________________________ Purpose: _______________________________ Security: _______________________________ Terms of Repayment: _____________________ 2. Name: _______________________________ Purpose: _______________________________ Security: _______________________________ Terms of Repayment: _____________________ 3. Name: _______________________________ Purpose: _______________________________ Security: _______________________________ Terms of Repayment: _____________________ 4. Name: _______________________________ Purpose: _______________________________ Security: _______________________________ Terms of Repayment: _____________________ Total of loans not listed above Totals of all lines above Totals will be automatically entered In Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) …………………Item 24.………………………..Item 61.…………………………Item 45……………………………..Item 69………………….….……Item 24 Column (A) with Explanation Column (B) Page 6 of 26 SCHEDULE 3 – SALE OF INVESTMENTS AND FIXED ASSETS Description (if land or buildings, give location) (A) FILE NUMBER: Cost (B) Book Value (C) Gross Sales Price (D) Amount Received (E) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Total of all lines above Less Reinvestments (The total from Net Sales Line will be automatically entered in Item 43.) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Net Sales Page 7 of 26 SCHEDULE 4 – PURCHASE OF INVESTMENTS AND FIXED ASSETS Description (if land or buildings, give location) (A) FILE NUMBER: Cost (B) Book Value (C) Cash Paid (D) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Total of all lines above Less Reinvestments (The total from Net Purchases Line will be automatically entered in Item 60.) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Net Purchases Page 8 of 26 SCHEDULE 5 – INVESTMENTS FILE NUMBER: Description (A) Amount (B) Marketable Securities A. Total Cost B. Total Book Value C. List each marketable security which has a book value over $5,000 and exceeds 5% of Line B. (1) (2) (3) (4) Other Investments D. Total Cost E. Total Book Value F. List each other investment which has a book value over $5,000 and exceeds 5% of Line E. Also, list each subsidiary for which separate reports are attached. (1) (2) (3) (4) (5) G. Total of Lines B and E (Total from Line G will be automatically entered in Item 26, Column (B)) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 9 of 26 SCHEDULE 6 – FIXED ASSETS Description (A) FILE NUMBER: Cost or Other Basis (B) Total Depreciation or Amount Expensed (C) Book Value (D) Value (E) A. Land (give location) 1. 2. 3. B. Buildings (give location) 1. 2. 3. C. Automobiles and Other Vehicles D. Office Furniture and Equipment E. Other Fixed Assets F. Totals of Lines A through E (Column (D) Total will be automatically entered in Item 27, Column (B)) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 10 of 26 SCHEDULE 7 – OTHER ASSETS FILE NUMBER: Description (A) Book Value (B) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. Total (Total will be automatically entered in Item 28, Column (B)) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 11 of 26 SCHEDULE 8 – ACCOUNTS PAYABLE AGING SCHEDULE Entity or Individual Name (A) FILE NUMBER: Total Account Payable (B) 90 - 180 Days Past Due (C) 180+ Days Past Due (D) Liquidated Account Payable (E) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. Total of all Itemized Accounts Payable Total from all other accounts payable Totals (Total for Column (B) will be automatically entered in Item 30, Column (D)) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 12 of 26 SCHEDULE 9 – LOANS PAYABLE FILE NUMBER: Repayment Made During Period Source of Loans Payable at Any Time During the Reporting Period (A) Loans Owed at Start of Period (B) Loans Obtained During Period (C) Cash (D)(1) Other Than Cash (D)(2) Loans Owed at End of Period (E) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Total Loans Payable Totals will be automatically entered in Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) ………………….……Item 31.………………………..Item 44 …………………….……Item 62…………………………..Item 69………………………Item 31 Column (C) with Explanation Column (D) Page 13 of 26 SCHEDULE 10 – OTHER LIABILITIES FILE NUMBER: Description (A) Amount at End of Period (B) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Total Other Liabilities (Total will be automatically entered in Item 33, Column (D)) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 14 of 26 SCHEDULE 11 – ALL OFFICERS AND DISBURSEMENTS TO OFFICERS (A) Name (B) Title FILE NUMBER: (C) (D) (E) (F) (G) (H) Status Gross Salary Disbursements (before any deductions) Allowances Disbursed Disbursements for Official Business Other Disbursements not reported in (D) through (F) TOTAL Last, First, MI 1A B C I Schedule 15 Representational Activities % Schedule 16 Political Activities and Lobbying % Schedule 17 Contributions % Schedule 18 General Overhead % Schedule 19 Administration % Schedule 15 Representational Activities % Schedule 16 Political Activities and Lobbying % Schedule 17 Contributions % Schedule 18 General Overhead % Schedule 19 Administration % Schedule 15 Representational Activities % Schedule 16 Political Activities and Lobbying % Schedule 17 Contributions % Schedule 18 General Overhead % Schedule 19 Administration % Schedule 15 Representational Activities % Schedule 16 Political Activities and Lobbying % Schedule 17 Contributions % Schedule 18 General Overhead % Schedule 19 Administration % Schedule 15 Representational Activities % Schedule 16 Political Activities and Lobbying % Schedule 17 Contributions % Schedule 18 General Overhead % Schedule 19 Administration % 2A B C I 3A B C I 4A B C I 5A B C I TOTAL OFFICER DISBURSEMENTS LESS DEDUCTIONS NET DISBURSEMENTS Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 15 of 26 SCHEDULE 12 – DISBURSEMENTS TO EMPLOYEES (A) Name (B) Title FILE NUMBER: (C) (D) (E) (F) (G) (H) Other Payer Gross Salary Disbursements (before any deductions) Allowances Disbursed Disbursements for Official Business Other Disbursements not reported in (D) through (F) TOTAL Last, First, MI 1A B C I Schedule 15 Representational Activities % Schedule 16 Political Activities and Lobbying % Schedule 17 Contributions % Schedule 18 General Overhead % Schedule 19 Administration % Schedule 15 Representational Activities % Schedule 16 Political Activities and Lobbying % Schedule 17 Contributions % Schedule 18 General Overhead % Schedule 19 Administration % Schedule 15 Representational Activities % Schedule 16 Political Activities and Lobbying % Schedule 17 Contributions % Schedule 18 General Overhead % Schedule 19 Administration % Schedule 15 Representational Activities % Schedule 16 Political Activities and Lobbying % Schedule 17 Contributions % Schedule 18 General Overhead % Schedule 19 Administration % Schedule 15 Representational Activities % Schedule 16 Political Activities and Lobbying % Schedule 17 Contributions % Schedule 18 General Overhead % Schedule 19 Administration % % Schedule 17 Contributions % Schedule 18 General Overhead % Schedule 19 Administration % 2A B C I 3A B C I 4A B C I 5A B C I TOTAL RECEIVED BY ALL OTHER EMPLOYEES MAKING $10,000 OR LESS I Schedule 15 Representational Activities % Schedule 16 Political Activities and Lobbying TOTAL EMPLOYEE DISBURSEMENTS LESS DEDUCTIONS NET DISBURSEMENTS Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 16 of 26 SCHEDULE 13 – MEMBERSHIP STATUS Category of Membership (A) FILE NUMBER: Number (B) Voter Eligibility (C) 1. Yes 2. Yes 3. Yes 4. Yes 5. Yes 6. Yes 7. Yes Members (Total of all lines above) Agency Fee Payers* Total Members/Fee Payers (Total of Members and Fee Payers Lines) *Agency Fee Payers are not considered members of the labor organization Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 17 of 26 DETAILED SUMMARY PAGE – SCHEDULES 14 THROUGH 19 FILE NUMBER: Complete Itemization Pages BEFORE the Detailed Summary Page SCHEDULE 14 1. Named Payer Itemized Receipts 1. Named Payee Itemized Disbursements 2. Named Payer Non-Itemized Receipts 2. Named Payee Non-Itemized Disbursements SCHEDULE 17 3. All Other Receipts OTHER RECEIPTS 4. Total Receipts (add Lines 1 through 3) Item 48 CONTRIBUTIONS, GIFTS, AND GRANTS 3. To Officers 4. To Employees 5. All Other Disbursements 6. Total Disbursements (add Lines 1 through 5) SCHEDULE 15 REPRESENTATIONAL ACTIVITIES 1. Named Payee Itemized Disbursements 1. Named Payee Itemized Disbursements 2. Named Payee Non-Itemized Disbursements 2. Named Payee Non-Itemized Disbursements SCHEDULE 18 3. To Officers GENERAL OVERHEAD 4. To Employees 5. All Other Disbursements 6. Total Disbursements (add Lines 1 through 5) SCHEDULE 16 POLITICAL ACTIVITIES AND LOBBYING 3. To Officers 4. To Employees 5. All Other Disbursements Item 50 6. Total Disbursements (add Lines 1 through 5) 1. Named Payee Itemized Disbursements 1. Named Payee Itemized Disbursements 2. Named Payee Non-Itemized Disbursements 2. Named Payee Non-Itemized Disbursements SCHEDULE 19 3. To Officers UNION ADMINISTRATION 4. To Employees 5. All Other Disbursements 6. Total Disbursements (add Lines 1 through 5) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Item 52 Item 53 3. To Officers 4. To Employees 5. All Other Disbursements Item 51 6. Total Disbursements (add Lines 1 through 5) Item 54 Page 18 of 26 SCHEDULE 14 – OTHER RECEIPTS FILE NUMBER: Complete Itemization Pages BEFORE the Detailed Summary Page Name and Address (A) Purpose (C) Date (D) Amount (E) (B) Type or Classification Total Itemized Transactions with this Payee/Payer Total Non-Itemized Transactions with this Payee/Payer Total of All Transactions with this Payee/Payer for This Schedule Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 19 of 26 SCHEDULE 15 – REPRESENTATIONAL ACTIVITIES FILE NUMBER: Complete Itemization Pages BEFORE the Detailed Summary Page Name and Address (A) Purpose (C) Date (D) Amount (E) (B) Type or Classification Total Itemized Transactions with this Payee/Payer Total Non-Itemized Transactions with this Payee/Payer Total of All Transactions with this Payee/Payer for This Schedule Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 20 of 26 SCHEDULE 16 – POLITICAL ACTIVITIES AND LOBBYING FILE NUMBER: Complete Itemization Pages BEFORE the Detailed Summary Page Name and Address (A) Purpose (C) Date (D) Amount (E) (B) Type or Classification Total Itemized Transactions with this Payee/Payer Total Non-Itemized Transactions with this Payee/Payer Total of All Transactions with this Payee/Payer for This Schedule Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 21 of 26 SCHEDULE 17 – CONTRIBUTIONS, GIFTS, AND GRANTS FILE NUMBER: Complete Itemization Pages BEFORE the Detailed Summary Page Name and Address (A) Purpose (C) Date (D) Amount (E) (B) Type or Classification Total Itemized Transactions with this Payee/Payer Total Non-Itemized Transactions with this Payee/Payer Total of All Transactions with this Payee/Payer for This Schedule Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 22 of 26 SCHEDULE 18 – GENERAL OVERHEAD FILE NUMBER: Complete Itemization Pages BEFORE the Detailed Summary Page Name and Address (A) Purpose (C) Date (D) Amount (E) (B) Type or Classification Total Itemized Transactions with this Payee/Payer Total Non-Itemized Transactions with this Payee/Payer Total of All Transactions with this Payee/Payer for This Schedule Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 23 of 26 SCHEDULE 19 – UNION ADMINISTRATION FILE NUMBER: Complete Itemization Pages BEFORE the Detailed Summary Page Name and Address (A) Purpose (C) Date (D) Amount (E) (B) Type or Classification Total Itemized Transactions with this Payee/Payer Total Non-Itemized Transactions with this Payee/Payer Total of All Transactions with this Payee/Payer for This Schedule Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 24 of 26 SCHEDULE 20 – BENEFITS FILE NUMBER: Description (A) To Whom Paid (B) Amount (C) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. Total of all lines above (Total will be automatically entered in Item 55.) Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) Page 25 of 26 69. ADDITIONAL INFORMATION SUMMARY Form LM-2 (Revised 2010); (Tech. Rev. 2/2013) FILE NUMBER: Page 26 of 26
| File Type | application/pdf |
| File Title | FORM LM-3 LABOR ORGANIZATION ANNUAL REPORT |
| Author | US Department of Labor |
| File Modified | 2016-08-22 |
| File Created | 2016-06-01 |