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WELFARE TRUST FUND LOCAL 804: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
WELFARE TRUST FUND LOCAL 804 (EIN 11-1637886)
Tax period
2012-06-01 to 2013-05-31
Filed
2014-04-08
IRS object ID
201440989349300714
Schema version
2012v2.1
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)
Timestamp2014-04-08T14:29:04-05:00Timestamp
Tax Period End Date2013-05-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN131578842EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BUCHBINDER TUNICK & COMPANYBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE PENNSYLVANIA PLAZA SUITE 5335AddressLine1
CityNEW YORKCity
StateNYState
ZIP Code10119ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-06-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN111637886EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LOCAL 804 WELFARE TRUST FUNDBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLOCANameControl
Phone7187865410Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line134-21 REVIEW AVENUEAddressLine1
CityLONG ISLAND CITYCity
StateNYState
ZIP Code111013241ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTIMOTHY SYLVESTERName
TitleTRUSTEETitle
Phone7187865410Phone
Date Signed2014-04-03DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameGREG AUTERIName
PTINP01366109PTIN
Phone2126955003Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTIMOTHY SYLVESTERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line134-21 REVIEW AVENUEAddressLine1
CityLONG ISLAND CITYCity
StateNYState
ZIP Code111013241ZIPCode
FieldValueIRS element (for citing)
Gross Receipts81040027GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteHTTP://WWW.LOCAL804FUND.COMWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1950YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTH CARE BENEFITSActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees28TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year63993489ProgramServiceRevenuePriorYear
Program Service Revenue CY68031870ProgramServiceRevenueCY
Investment Income Prior Year623659InvestmentIncomePriorYear
Investment Income Current Year512605InvestmentIncomeCurrentYear
Other Revenue Prior Year119888OtherRevenuePriorYear
Other Revenue Current Year214822OtherRevenueCurrentYear
Total Revenue Prior Year64737036TotalRevenuePriorYear
Total Revenue Current Year68759297TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year53796347BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY52223722BenefitsPaidToMembersCY
Salaries Etc Prior Year1878647SalariesEtcPriorYear
Salaries Etc Current Year2025085SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1263887OtherExpensePriorYear
Other Expenses Current Year1507182OtherExpensesCurrentYear
Total Expenses Prior Year56938881TotalExpensesPriorYear
Total Expenses Current Year55755989TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7798155RevenuesLessExpensesPriorYear
Revenues Less Expenses CY13003308RevenuesLessExpensesCY
Total Assets BOY28564191TotalAssetsBOY
Total Assets EOY41200227TotalAssetsEOY
Total Liabilities BOY1406273TotalLiabilitiesBOY
Total Liabilities EOY1016572TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY27157918NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY40183655NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE LOCAL 804 WELFARE TRUST FUND WAS CREATED IN 1950, UNDER AN AGREEMENT AND DECLARATION OF TRUST, AS AMENDED, BETWEEN DELIVERY AND WAREHOUSE EMPLOYEES UNION, LOCAL 804 IBT (THE "UNION") AND VARIOUS EMPLOYERS. THE UNION AND THE EMPLOYERS HAVE ENTERED INTO COLLECTIVE BARGAINING AGREEMENTS REQUIRING PAYMENTS BY THE EMPLOYERS FOR THE PURPOSE OF ESTABLISHING A WELFARE PROGRAM FOR THE EMPLOYERS TO PROVIDE WELFARE BENEFITS FOR THEIR EMPLOYEES AND THE EMPLOYEES OF THE UNION, AND THE EMPLOYEES OF THE LOCAL 804 WELFARE TRUST FUND.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionPROVIDED HEALTH CARE BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. ESTIMATED NUMBER OF PARTICIPANTS BENEFITED DURING THE PAST YEAR WAS 4547.Description
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096613NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees28NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1THOMAS LAMONTANARO FUND MANAGERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7187865410TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line134-21 REVIEW AVENUEAddressLine1
CityLONG ISLAND CITYCity
StateNYState
ZIP Code11101ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
TIMOTHY SYLVESTER
UNION TRUSTEE0.6040.00X011608038334
JAMES REYNOLDS
UNION TRUSTEE0.6040.00X011536038334
PETE MASTRANDREA
UNION TRUSTEE0.6040.00X011542038334
CHRIS LANGAN
EMPLOYER TRUSTEE0.60X000
BJ DORFMAN
EMPLOYER TRUSTEE0.20X000
STEVE BRENNAN
EMPLOYER TRUSTEE0.60X000
BRIAN MCCABE
EMPLOYER TRUSTEE0.60X000
DAVE FENNELL
UNION TRUSTEE0.6040.00X011536038334
THOMAS LAMONTANARO
FUND OFFICE MANAGER28.805.0086840039209X
MARC PANTELEONE
BENEFIT CLAIMS ASSISTANT59.40115763021236X
JAMES PANTELEONE
IT AND BENEFIT CLAIMS ASSISTANT65.30124601021190X
MAGGIE WU
BOOKKEEPER29.1010.10104546021313X
FieldValueIRS element (for citing)
Total Reportable Comp From Org431750TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs462220TotalReportableCompFrmRltdOrgs
Total Other Compensation256284TotalOtherCompensation
Number Individuals GT100 K3NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
EMPIRE HEALTHCHOICE ASSURANCE INC
3350 PEACHTREE ROADATLANTAGA30326BENEFIT ADMINISTRATIVE SERVICE1525557
NEW YORK MEDICAL MANAGEMENT
ONE WOODBRIDGE CENTERWOODBRIDGENJ07095BENEFIT CONSULTING SERVICES309429
HEALTH PLAN SYSTEM
ONE WOODBRIDGE CENTERWOODBRIDGENJ07095BENEFIT INFORMATION TECHNOLOGY303551
COHEN WEISS AND SIMON LLP
330 WEST 42ND STREETNEW YORKNY10036LEGAL SERVICES191710
PROSKAUER ROSE LLP
ELEVEN TIMES SQUARENEW YORKNY10036LEGAL SERVICES134066
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CONTRIBUTIONS - EMPLOYERS9000996521371065213710
CONTRIBUTIONS - RETIRED PARTICIPA90009926261642626164
CONTRIBUTIONS - COBRA PARTICIPANT900099191996191996
FieldValueIRS element (for citing)
Total Program Service Revenue68031870TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column591846TotalRevenueColumn
Exclusion$591,846ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities12201489Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities12280730Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-79241Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-79241TotalRevenueColumn
Exclusion-$79,241ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS INCOMEDescription
Business Code900099BusinessCode
Total Revenue Column214822TotalRevenueColumn
Related Or Exempt Function Income214822RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue214822TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column68759297TotalRevenueColumn
Related Or Exempt Function Income68246692RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$512,605ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total52223722Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total127234Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1280208Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total127918Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total365224Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total124501Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total397110Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total49200Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total101207Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total193737Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total159148Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total471747Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total78990Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1222Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total186479Total

Insurance Insurance

FieldValueIRS element (for citing)
Total19369Total

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotal
MISC4250
DUES AND SUBSCRIPTIONS2019
ADM.EXPENSES REIMBURSED-157296

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total55755989Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY911103BOY
EOY995096EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2198036BOY
EOY8584830EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5821531BOY
EOY7098827EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY41261BOY
EOY44155EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2569048LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2098035LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY642842BOY
EOY471013EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY18747305BOY
EOY24006306EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY202113BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY28564191BOY
EOY41200227EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1036918BOY
EOY462860EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY203476BOY
EOY390335EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY165879BOY
EOY163377EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1406273BOY
EOY1016572EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY27157918BOY
EOY40183655EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27157918BOY
EOY40183655EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY28564191BOY
EOY41200227EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses13003308ReconcilationRevenueExpenses
Reconciliation Unrealized Invest22429ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis316336OtherCostOrOtherBasis
Depreciation316336Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis197183OtherCostOrOtherBasis
Depreciation195866Depreciation
Book Value1317BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2055529OtherCostOrOtherBasis
Depreciation1585833Depreciation
Book Value469696BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings471013TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionEST'D FUTURE RETIREMENT BENEFITDescription
Amount$163,377Amount
FieldValueIRS element (for citing)
Total Of Amounts163377TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt68680519TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments22429NetUnrealizedGainsInvestments
Revenue Not Rptd F99022429RevenueNotRptdF990
Revenue Subtotal68658090RevenueSubtotal
Investment Expenses Not Included101207InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt101207RevenueNotRptdOnFinStmt
Total Revenue Per Form99068759297TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt55654782TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal55654782ExpensesSubtotal
Investment Expenses Not Included2101207InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt101207ExpensesNotRptdOnFinStmt
Total Expenses Per Form99055755989TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
TIMOTHY SYLVESTER
UNION TRUSTEE01160800000022736015598015441400
JAMES REYNOLDS
UNION TRUSTEE01153600000022736015598015369400
PETE MASTRANDREA
UNION TRUSTEE01154200000022736015598015375400
DAVE FENNELL
UNION TRUSTEE01153600000022736015598015369400

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 8BTHE FUND DOES NOT HAVE ANY COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11THE FUND'S BOARD OF TRUSTEES REVIEWS THE FORM 990 PRIOR TO ITS FILING.
FORM 990, PART VI, SECTION B, LINE 15THE FUND'S BOARD OF TRUSTEES REVIEWS AND AUTHORIZES COMPENSATION FOR ALL EMPLOYEES, INCLUDING FOR THE TOP MANAGEMENT OFFICIAL. THE REVIEW PROCESS IS CONDUCTED AT THE BOARD MEETING AND DOCUMENTED ACCORDINGLY.
FORM 990, PART VI, SECTION C, LINE 19THE FUND MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON RECEIPT OF A PARTICIPANT'S WRITTEN REQUEST.
THE FUND'S PROCESS FOR OVERSEEING THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionControlled OrgControlledOrg
LOCAL 804 ANNUITY FUND
34-21 REVIEW AVENUELONG ISLAND CITYNY111013241112506358SHARED ADMINISTRATIVE COSTNY1.401-1(B)(3)0
LOCAL 804 IBT
34-21 REVIEW AVENUELONG ISLAND CITYNY111013241111603598CONTRIBUTING EMPLOYER & RENTAL EXPENSENY501(C)(5)0
LOCAL 804 FEDERAL CREDIT UNION
34-21 REVIEW AVENUELONG ISLAND CITYNY111013241112491081CONTRIBUTING EMPLOYERNY501(C)(1)0

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Primary ActivityPrimaryActivityControlled OrgControlledOrg
UNITED PARCEL SERVICE
CONTRIBUTING EMPLOYER0
EPPENDORF INC
CONTRIBUTING EMPLOYER0
OCS AMERICA INC
CONTRIBUTING EMPLOYER0
TRUMP VILLAGE INC
CONTRIBUTING EMPLOYER0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
LOCAL 804 ANNUITY FUND
N106836SHARED ADM. COST AGREEMENT
LOCAL 804 ANNUITY FUND
O68371SHARED ADM. COST AGREEMENT