2018-01-26T11:50:22-06:00 2017-04-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2016-05-01 200005676 ABHE & SVOBODA INC HEALTH AND WELFARE TRUST ABHE 9524476025 18100 DAIRY LANE JORDAN MN 55352 ROXANE SVOBODA TRUSTEE 9524476025 2018-01-19 1 STACY MEYER P00970265 6123764500 67.137.57.251 2018-01-19 11:26:37 CS P D49977F1ED05145F9BC0FB6803A02A420AB7E82B 90ACB623DB35E5AA69B5C19C10ADF2FE4D4ACF6D 2016 2021-01-29 14:40:06Z ROXANE SVOBODA 18100 DAIRY LANE JORDAN MN 55352 3021712 0 X N/A X 2003 MN FUNDS GROUP INSURANCE COVERAGE FOR EMPLOYEES OF ABHE & SVOBODA, INC., & THEIR DEPENDENTS. 2 0 0 0 0 0 0 0 2441346 3021712 0 0 0 0 2441346 3021712 0 0 1802900 2487784 0 0 0 0 0 192215 211680 1995115 2699464 446231 322248 1246240 1565328 3546 386 1242694 1564942 ABHE & SVOBODA, INC. HEALTH AND WELFARE TRUST PROVIDES FUNDING FOR GROUP INSURANCE COVERAGE FOR EMPLOYEES OF ABHE & SVOBODA, INC., AND THEIR DEPENDENTS 0 0 FUNDING FOR GROUP INSURANCE COVERAGE FOR EMPLOYEES OF ABHE & SVOBODA, INC., AND THEIR DEPENDENTS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2 0 0 0 0 0 0 0 0 X 2 0 1 0 0 0 0 1 1 1 0 0 0 1 0 0 0 0 0 0 X ABHE & SVOBODA INC 9524476025 18100 DAIRY LANE JORDAN MN 55352 X X ROXANE SVOBODA TRUSTEE 1.00 40.00 X 0 0 0 GAIL SVOBODA TRUSTEE 1.00 40.00 X 0 0 0 0 0 0 0 0 0 0 0 EMPLOYER CONTRIBUTIONS 900001 2495767 2495767 EMPLOYEE CONTRIBUTIONS 900001 525945 525945 3021712 3021712 3021712 0 0 2487784 27355 184325 2699464 1214424 1363317 31816 202011 1246240 1565328 3546 386 3546 386 X 0 0 0 0 1242694 1564942 1242694 1564942 1246240 1565328 322248 0 X 0 1 X 0 0 0 X 3021712 0 3021712 0 3021712 2699464 0 2699464 0 2699464 PART X, LINE 2: THE VEBA TRUST FUNDING CERTAIN BENEFITS OF THE PLAN RECEIVED AN EXEMPTION LETTER FROM THE IRS DATED DECEMBER 16, 2010, STATING THAT THE TRUST IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE IRC. HOWEVER, AS A RESULT OF THE PLAN'S FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED IN THE 2017 PLAN YEAR FOR UNRELATED BUSINESS TAXABLE INCOME. IN ADDITION, THE PLAN AND THE TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART VI, SECTION A, LINE 2 GAIL SVOBODA AND ROXANE SVOBODA - FAMILY RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS IS FAMILY RUN AND OFFICERS ARE SELECTED BY THE FAMILY MEMBERS BASED ON WHO THEY BELIEVE SHOULD HAVE THE RESPONSIBILITY. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS MAKE ALL GOVERNANCE DECISIONS FOR THE PLAN. FORM 990, PART VI, SECTION A, LINE 8B THE PLAN DID NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED AND IT IS REVIEWED IN CONJUNCTION WITH THE REVIEW OF THE RELATED PLAN'S ANNUAL AUDIT. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FORM 990 ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE TRUST IS IN THE PROCESS OF DRAFTING A CONFLICT OF INTEREST POLICY. FORM 990, PART VII, LINE 1A: COMPENSATION FROM A RELATED ORGANIZATION FOR THE TRUSTEES LISTED IS EXCLUDED AS ALLOWED UNDER THE VOLUNTEER EXCEPTION IN THE FORM 990 INSTRUCTIONS. ABHE & SVOBODA 18100 DAIRY LANE JORDAN MN 55352 200005676 CONSTRUCTION MN N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1