2016-11-11T09:53:00-06:00 2015-12-31 910189318 Moss Adams LLP 805 SW Broadway Ste 1200 Portland OR 97205 990 2015-01-01 931092580 Daimler Trucks NA LLC UAW Employee Benefit Basic Trust DAIM 5037458460 4747 N Channel Avenue Portland OR 97217 Michael Kuruc DIRECTOR OF TAXES 5037458460 2016-11-02 1 Wendy Campos P00448102 5032421447 2016-10-26 2015 2017-02-10 21:41:12Z X X MICHAEL KURUC 4747 N Channel Avenue Portland OR 97217 70865148 0 X n/a X 1992 OR VEBA Trust for the payment of benefits for members. X 7 7 0 15 0 0 0 0 105996176 70862739 567 2409 0 0 105996743 70865148 0 0 101454947 76574767 0 0 0 0 0 4215458 3278967 105670405 79853734 326338 -8988586 9163182 0 174596 0 8988586 0 VEBA trust for the payment of benefits for members. 0 0 PROVIDE MEDICAL BENEFITS TO ACTIVE UNION EMPLOYEES. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 X 7 7 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X erik linvog 5037458479 4747 N Channel Avenue Portland OR 97217 X John O'Leary Chair, Member 0.50 X X 0 0 0 BRIAN BURTON MEMBER 0.50 X 0 0 0 Roger Nielsen Member 0.50 X 0 0 0 Kelley Platt Member 0.50 X 0 0 0 Bob Robertson Member 0.50 X 0 0 0 DAVID SWAINSON MEMBER 0.50 X 0 0 0 Jeffery Sather MEMBER 0.50 X 0 0 0 0 0 0 0 0 0 0 BLUE CROSS BLUE SHIELD 600 E LAFAYETTE BLVD DETRIOT MI 48226 CONTRACT ADMINISTRATOR 2644411 ADP 2835 S DECKER LAKE DR SALT LAKE CITY UT 84119 CONTRACT ADMINISTRATOR 378970 Moda health 601 SW Second ave Portland OR 97204 CONTRACT ADMINISTRATOR 317413 Medco 100 Parsons Pond Drive Franklin Lakes NJ 07417 CONTRACT ADMINISTRATOR 112219 4 Contributions 525100 70862739 70862739 70862739 2409 0 2409 2409 2409 70865148 70862739 0 2409 76574767 28 3278814 125 79853734 0 9163108 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 9163182 0 174596 174596 0 X 8988586 0 0 0 0 0 8988586 0 9163182 0 -8988586 0 X 0 1 X 1 0 0 X Part X, Line 2: IN ACCORDANCE WITH GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, THE PLAN ADMINISTRATOR EVALUATED THE PLAN'S TAX POSITIONS AND DOES NOT BELIEVE THE PLAN HAS ANY UNCERTAIN TAX POSITIONS THAT REQUIRE DISCLOSURE OR ADJUSTMENT TO THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2012. N/A 0 0 0 0 1 0 0 0 0 Form 990, Part VI, Section A, line 2 JOHN O'LEARY IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. BRIAN BURTON IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. ROGER NIELSEN IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. KELLEY PLATT IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. BOB ROBERTSON IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. DAVID SWAINSON IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. JEFFERY SATHER IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. Form 990, Part VI, Section B, line 11 The form 990 is reviewed by the Corporate Tax Director and the Plan Administrator prior to filing. Form 990, Part VI, Section B, line 12c THE ORGANIZATION RELIES ON THE SARBANES-OXLEY ACT, INTERNAL CONTROLS, AND OUTSIDE AUDITS TO ENSURE THAT THE CONFLICT OF INTEREST POLICY IS ENFORCED. Form 990, Part VI, Section B, line 15 THE ORGANIZATION DOES NOT COMPENSATE INTERESTED PERSONS. THEREFORE, THE ORGANIZATION DOES NOT HAVE A PROCESS IN PLACE FOR DETERMINING AND REVIEWING COMPENSATION. Form 990, Part VI, Section C, line 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FINANCIAL STATEMENTS ARE MADE AVAILABLE TO PARTICIPANTS UPON REQUEST. dtna employee benefit basic trust 4747 N Channel Avenue Portland OR 97217 943067499 veba trust for the payment of benefits for members OR 501(c)(9) daimler trucks north america 0 dtna employee benefit supplemental trust 4747 N Channel Avenue portland OR 97217 930886584 veba trust for the payment of benefits for members OR 501(c)(9) daimler trucks north america 0 dtna union employee benefit supplemental trust 4747 N Channel Avenue portland OR 97217 931092582 veba trust for the payment of benefits for members OR 501(c)(9) daimler trucks north america 0 dtna employee benefit supplemental trust 2 4747 N Channel Avenue portland OR 97217 931098095 veba trust for the payment of benefits for members OR 501(c)(9) daimler trucks north america 0 dtna portland shop employee benefit trust 4747 N Channel Avenue portland OR 97217 931207916 veba trust for the payment of benefits for members OR 501(c)(9) daimler trucks north america 0 mt holly shop uaw retiree medical premium trust 4747 N Channel Avenue portland OR 97217 931207918 veba trust for the payment of benefits for members OR 501(c)(9) daimler trucks north america 0 Daimler Trucks North America LLC 4747 N Channel Avenue Portland OR 97217 930790608 Vehicle Manufacturer OR N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 DAIMLER TRUCKS NORTH AMERICA LLC S 65156966 Employer Contributions - FMV