STRATEGY STUDIO / PUBLIC DATA EXPLORER

HOTEL AND RESTAURANT EMPLOYEES HEALTH & WELFARE TRUST FUND: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
HOTEL AND RESTAURANT EMPLOYEES HEALTH & WELFARE TRUST FUND (EIN 94-1229312)
Tax period
2019-01-01 to 2019-12-31
Filed
2021-06-22
IRS object ID
202141739349301604
Schema version
2019v5.2
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)
Return2021-06-22T17:31:26-05:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13130 CROW CANYON PL STE 300AddressLine1Txt
CitySAN RAMONCityNm
State AbbreviationCAStateAbbreviationCd
ZIP945831386ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN941229312EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOTEL AND RESTAURANT EMPLOYEESBusinessNameLine1Txt
Business Name Line2HEALTH AND WELFARE TRUSTBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlHOTEBusinessNameControlTxt
Phone2063294900PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12323 EASTLAKE AVE EAddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98102ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSENIOR DIRECTOR LABORPersonNm
Person TitleSENIOR DIRECTOR, LABORPersonTitleTxt
Phone2063294900PhoneNum
Signature2021-06-22SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTHERESA MONTGOMERY CPAPreparerPersonNm
PTINP00232100PTIN
Phone9254804000PhoneNum
Preparation2021-06-06PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Amended ReturnYes (X)AmendedReturnInd
Principal OfficerKEVIN GLEASONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12323 EASTLAKE AVE EAddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98102ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$34,471,408GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1963FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTSActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers6TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$23,505,747PYProgramServiceRevenueAmt
CY Program Service Revenue$24,302,040CYProgramServiceRevenueAmt
PY Investment Income$497,561PYInvestmentIncomeAmt
CY Investment Income$844,225CYInvestmentIncomeAmt
PY Other Revenue$223,295PYOtherRevenueAmt
CY Other Revenue$73,960CYOtherRevenueAmt
PY Total Revenue$24,226,603PYTotalRevenueAmt
CY Total Revenue$25,220,225CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$21,091,213PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$24,108,989CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$497,860PYOtherExpensesAmt
CY Other Expenses$490,846CYOtherExpensesAmt
PY Total Expenses$21,589,073PYTotalExpensesAmt
CY Total Expenses$24,599,835CYTotalExpensesAmt
PY Revenues Less Expenses$2,637,530PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$620,390CYRevenuesLessExpensesAmt
Total Assets BOY$18,273,619TotalAssetsBOYAmt
Total Assets EOY$21,366,728TotalAssetsEOYAmt
Total Liabilities BOY$2,036,330TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,963,099TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$16,237,289NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,403,629NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTSMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTO PROVIDE HEALTH AND WELFARE BENEFITS TO APPROXIMATELY 1,400 ELIGIBLE PARTICIPANTS COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE UNIONS AND THE EMPLOYERS.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document6IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST ADMINISTRATORS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2067263271PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12323 EASTLAKE AVE EAddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98102ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
KEVIN GLEASON
SENIOR DIRECTOR, LABOR5.00Yes (X)Yes (X)$0$0$0
WEI-LING HUBER
CO-CHAIR5.00Yes (X)Yes (X)$0$0$0
DOUGLAS CORNFORD
TRUSTEE5.00Yes (X)$0$0$0
JOSE ZARATE
TRUSTEE5.00Yes (X)$0$0$0
LIAN ALAN
TRUSTEE5.00Yes (X)$0$0$0
YULISA ELENES
TRUSTEE5.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST ADMINISTRATORS INCBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line11182 MARKET ST STE 320AddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94102ZIPCd
FieldValueIRS element (for citing)
ServicesADMINISTRATIVE SERVICESServicesDesc
Compensation$201,971CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$24,274,859$24,274,859
PARTICIPANT CONTRIB900099$27,181$27,181
FieldValueIRS element (for citing)
Total Program Service Revenue$24,302,040TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$489,508TotalRevenueColumnAmt
Exclusion$489,508ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$9,605,900SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$9,251,183SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$354,717SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$354,717TotalRevenueColumnAmt
Related Or Exempt Func Income$354,717RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescLIQUIDATED DAMAGESDesc
Business900099BusinessCd
Total Revenue Column$73,960TotalRevenueColumnAmt
Related Or Exempt Func Income$73,960RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$73,960OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,220,225TotalRevenueColumnAmt
Related Or Exempt Func Income$24,730,717RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$489,508ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$24,108,989TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$201,971TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$27,299TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$79,928TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$32,750TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$117,988TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$8,486TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,171TotalAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmt
PRINTING, POSTAGE AND S$14,585
BANK CHARGES$1,620
AD HOC GROUP EXPENSES$48

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$24,599,835TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,133,510BOYAmt
EOY$3,466,929EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$836,199BOYAmt
EOY$4,830,946EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,675,386BOYAmt
EOY$2,736,089EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,304,142BOYAmt
EOY$2,931EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$8,324,382BOYAmt
EOY$10,329,833EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$18,273,619BOYAmt
EOY$21,366,728EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$30,520BOYAmt
EOY$21,328EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,005,810BOYAmt
EOY$4,941,771EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,036,330BOYAmt
EOY$4,963,099EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

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

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

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

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$16,237,289BOYAmt
EOY$16,403,629EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,237,289BOYAmt
EOY$16,403,629EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,273,619BOYAmt
EOY$21,366,728EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$620,390ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$949,367NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$1,403,417PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
INSURANCE PREMIUMS PAYABLE$4,102,272
DUE TO OTHER TRUSTS$101,604
DUE TO BROKER$737,895
FieldValueIRS element (for citing)
Total Liability$4,941,771TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$26,136,842TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$949,367NetUnrealizedGainsInvstAmt
Revenue Not Reported$949,367RevenueNotReportedAmt
Revenue Subtotal$25,187,475RevenueSubtotalAmt
Investment Expenses Not Incld$32,750InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$32,750RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$25,220,225TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$23,184,487TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$1,395,984OtherExpensesIncludedAmt
Expenses Not Reported-$1,395,984ExpensesNotReportedAmt
Expenses Subtotal$24,580,471ExpensesSubtotalAmt
Investment Expenses Not Incld2$19,364InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$19,364ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$24,599,835TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE PLAN HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. THE PLAN BELIEVES THAT THE PLAN HAS NOT TAKEN UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AS A TAX LIABILITY. INFORMATIONAL TAX RETURNS, FOR TAX YEARS FOR WHICH THE APPLICABLE STATUTES OF LIMITATIONS HAVE NOT EXPIRED, ARE SUBJECT TO EXAMINATION BY AUTHORITIES.
PART XII, LINE 2D - OTHER ADJUSTMENTS:NET CHANGE IN BENEFIT OBLIGATIONS -1,395,984.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 1, LINE BAMENDED RETURN - FINANCIAL STATEMENTS WERE AMENDED FOR RECEIVABLES, AMOUNTS DUE TO BROKERS, EMPLOYER CONTRIBUTIONS AND MEMBER BENEFITS. PRIOR YEAR AMOUNTS WERE RESTATED TO PROVIDE COMPARATIVE INFORMATION
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION DELEGATES CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISON OF OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES TO THE CONTRACT ADMINISTRATOR, NORTHWEST ADMINISTRATORS, INC.
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11BTRUSTEES ARE MAILED THE FORM AND ASKED TO REMARK IF THEY HAVE CHANGES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC, UPON REQUEST.
FORM 990, PART XI LINE 2CTHE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSEEING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR SELECTING THE INDEPENDENT AUDITOR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1EAST BAY RESTAURANT AND TAVERN RETIREMENT PLANBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11182 MARKET STREETAddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94120ZIPCd
FieldValueIRS element (for citing)
EIN946076428EIN
Primary ActivitiesTO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTSPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Exempt Code Section401AExemptCodeSectionTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePARTS II, III, AND IV - IDENTIFICATION OF RELATED TAX ORGANIZATIONSFormAndLineReferenceDesc
ExplanationIN A MULTIEMPLOYER PLAN, A CONTRIBUTING EMPLOYER IS CONSIDERED A RELATED ORGANIZATION BECAUSE THEY ARE OBLIGATED TO CONTRIBUTE TO THE PLAN PURSUANT TO THE TERMS IN THE COLLECTIVE BARGAINING OR PARTICIPATION AGREEMENT. THE ADMINISTRATIVE OFFICE ONLY MAINTAINS THE DATA NECESSARY TO FULFILL THE OBLIGATION TO CONTRIBUTE, IT DOES NOT MAINTAIN SPECIFIC BUSINESS DATA REGARDING THE EMPLOYERS, SUCH AS ENTITY TYPE OR TAX INFORMATION.ExplanationTxt