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BAY AREA AUTOMOTIVE GROUP WELFARE FUND: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BAY AREA AUTOMOTIVE GROUP WELFARE FUND (EIN 94-6072964)
Tax period
2012-12-01 to 2013-11-30
Filed
2014-09-30
IRS object ID
201442739349300639
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)
Timestamp2014-09-30T16:35:17-05:00Timestamp
Tax Period End Date2013-11-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN522385296EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LINDQUIST LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15000 EXECUTIVE PARKWAY SUITE 400AddressLine1
CitySAN RAMONCity
StateCAState
ZIP Code94583ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-12-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN946072964EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BAY AREA AUTOMOTIVE GROUP WELFARE FUNDBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBAYANameControl
Phone5105287100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14160 DUBLIN BOULEVARD NO 400AddressLine1
CityDUBLINCity
StateCAState
ZIP Code945687756ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK GLEASONName
TitleTRUSTEETitle
Phone5105287100Phone
Date Signed2014-09-30DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDENNIS J QUICHOCHOName
PTINP01451585PTIN
Phone9252779100Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK GLEASONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14160 DUBLIN BOULEVARD NO 400AddressLine1
CityDUBLINCity
StateCAState
ZIP Code945687756ZIPCode
FieldValueIRS element (for citing)
Gross Receipts32877002GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1954YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND DEPENDENTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees29TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year32193263ProgramServiceRevenuePriorYear
Program Service Revenue CY28759158ProgramServiceRevenueCY
Investment Income Prior Year403182InvestmentIncomePriorYear
Investment Income Current Year267020InvestmentIncomeCurrentYear
Other Revenue Prior Year745OtherRevenuePriorYear
Other Revenue Current Year513OtherRevenueCurrentYear
Total Revenue Prior Year32597190TotalRevenuePriorYear
Total Revenue Current Year29026691TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year34175155BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY26862272BenefitsPaidToMembersCY
Salaries Etc Prior Year36382SalariesEtcPriorYear
Salaries Etc Current Year27672SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1545017OtherExpensePriorYear
Other Expenses Current Year1527066OtherExpensesCurrentYear
Total Expenses Prior Year35756554TotalExpensesPriorYear
Total Expenses Current Year28417010TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-3159364RevenuesLessExpensesPriorYear
Revenues Less Expenses CY609681RevenuesLessExpensesCY
Total Assets BOY16359178TotalAssetsBOY
Total Assets EOY16511199TotalAssetsEOY
Total Liabilities BOY5021884TotalLiabilitiesBOY
Total Liabilities EOY4478417TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY11337294NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY12032782NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND DEPENDENTS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionPROVIDED HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND DEPENDENTSDescription
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 Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
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 Required0ScheduleJRequired
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 With1096588NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees29NumberOfEmployees
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 Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
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 Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1HEALTH SERVICES & BENEFIT ADMINISTRBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9254497070TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14160 DUBLIN BOULEVARD SUITE 400AddressLine1
CityDUBLINCity
StateCAState
ZIP Code98568ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
JOHN HORTON
TRUSTEE1.00X000
LAWRENCE ROSE
TRUSTEE1.00X000
MARK GLEASON
TRUSTEE1.00X000
ERNIE YATES
TRUSTEE1.00X000
CHUCK ANDREW
TRUSTEE1.00X000
DAVID PANSINI
TRUSTEE1.00X000
SEE SCHEDULE O FOR COMPENSATION
PAID BY RELATED ORGANIZATIONS0.00X010
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HEALTH SERVICES & BENEFIT ADMIN
4160 DUBLIN BOULEVARD SUITE 400DUBLINCA945687756ADMINISTRATOR FEE830619
BEESON TAYER & BODINE
ROSS HOUSE SECOND FLOOR 483 NINTHOAKLANDCA94607LEGAL FEE154115
LINDQUIST LLP
5000 EXECUTIVE PARKWAY SUITE 400SAN RAMONCA945834346ACCOUNTING FEE151553
BLUE CROSS OF CALIFORNIA
DEPARTMENT 5812LOS ANGELESCA900745812PPO NETWORK FEE133755
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS9000992798938027989380
PARTICIPANT CONTRIBUTIONS900099401309401309
STOP LOSS INCOME900099368469368469
FieldValueIRS element (for citing)
Total Program Service Revenue28759158TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column217721TotalRevenueColumn
Exclusion$217,721ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3899610Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3850311Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities49299Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column49299TotalRevenueColumn
Exclusion$49,299ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER INCOMEDescription
Business Code900099BusinessCode
Total Revenue Column513TotalRevenueColumn
Related Or Exempt Function Income513RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue513TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column29026691TotalRevenueColumn
Related Or Exempt Function Income28759671RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$267,020ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total26862272Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total27672Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total819302Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total106998Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total134697Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total26803Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total337098Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total72005Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2045Total

Insurance Insurance

FieldValueIRS element (for citing)
Total28118Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total28417010Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2732061BOY
EOY3492026EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY546490BOY
EOY1143919EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3908767BOY
EOY2933688EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY23000BOY
EOY20039EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY9113768BOY
EOY8858910EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY35092BOY
EOY62617EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY16359178BOY
EOY16511199EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2108884BOY
EOY1720160EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2913000BOY
EOY2758257EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5021884BOY
EOY4478417EOY
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)
BOY11337294BOY
EOY12032782EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11337294BOY
EOY12032782EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16359178BOY
EOY16511199EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses609681ReconcilationRevenueExpenses
Reconciliation Unrealized Invest85807ReconciliationUnrealizedInvest
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

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ACCUMULATED ELIGIBILITY CREDITS$2,750,000
CASH OVERDRAFT$8,257
FieldValueIRS element (for citing)
Total Of Amounts2758257TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt29085695TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments85807NetUnrealizedGainsInvestments
Revenue Not Rptd F99085807RevenueNotRptdF990
Revenue Subtotal28999888RevenueSubtotal
Investment Expenses Not Included26803InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt26803RevenueNotRptdOnFinStmt
Total Revenue Per Form99029026691TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt29078363TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal29078363ExpensesSubtotal
Investment Expenses Not Included226803InvestmentExpensesNotIncluded2
Other Expenses Not Included-688156OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-661353ExpensesNotRptdOnFinStmt
Total Expenses Per Form99028417010TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN BY THE PLAN AND TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT, AS OF NOVEMBER 30, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2010.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN BENEFIT OBLIGATIONS

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 3THE TRUST HAS CONTRACTED WITH HEALTH SERVICES & BENEFIT ADMINISTRATORS, INC., TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 8BTHERE IS NO COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. REVIEW OF THE FORM 990 WAS CONDUCTED BY THE BOARD PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CAT LEAST ONCE A YEAR, TRUSTEES AND OTHER INDIVIDUALS WHO ARE SUBJECT TO THE CONFLICT ON INTEREST POLICY WILL BE ASKED TO DISCLOSE IN WRITING ANY RELATIONSHIP OR INTERESTS THAT COULD GIVE RISE TO A CONFLICT. SHOULD ANY INDIVIDUAL COVERED BY THE POLICY DETERMINE OR SUSPECT THAT HE OR SHE POSSESSES AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, SUCH INDIVIDUAL MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST OR RELATIONSHIP GIVING RISE TO THE CONFLICT AND DISCLOSE ALL RELEVANT FACTS PRIOR TO PARTICIPATING IN ANY DECISION TO ENTER INTO ANY PROPOSED TRANSACTION OR ARRANGEMENT OR, IF LATER, AS SOON AS THE ACTUAL OR POTENTIAL CONFLICT IS RECOGNIZED.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. UPON REQUEST, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION AVAILABLE TO THE PARTICIPANTS.
FORM 990, PART XII, LINE 2C:THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED.
PART VII, SECTION A, LINE 1A:TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINISTRATOR, HEALTH SERVICES & BENEFIT ADMINISTRATORS, INC.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1TEAMSTERS AUTOMOTIVE & ALLIED WORKERS LOCAL UNION NO 665BusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11500 FRANKLIN STREET 3RD FLRAddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94109ZIPCode
FieldValueIRS element (for citing)
Primary ActivitiesLABOR UNIONPrimaryActivities
Legal Domicile StateCALegalDomicileState
Exempt Code Section501(C)(5)ExemptCodeSection
Public Charity StatusN/APublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
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 Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE R, PART VII, IDENTIFICATION OF RELATED ORGANIZATIONS:ReturnReference
ExplanationTHE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF NOVEMBER 30, 2013, THERE ARE APPROXIMATELY 102 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARDED ENTITY, TAX-EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE NAMES OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. 60 S. MARKET (LAZ PARKING) A & B PAINTING INC ABC PARKING ACE PARKING -AIRPORT AREA ACE PARKING MGMT ALLRIGHT AMERICAN PARKING MGMT. AMPCO (LE MERIDIEN S.F.) AMPCO (NETWORK PARKING SJ) AMPCO SJ DOWNTOWN PARKING AMPCO SYS PARKING 83779 AMPCO SYSTEM PARKING-SJIA AMPCO SYSTEM -SJIA (CASHIERS) AUTORETURN BABBITT BEARING COMPANY BRANNON EQUIPMENT CA PACIFIC MED CTR. CABLE CAR PARKING SERVICE CAPITOL EXPRESSWAY FORD CARRIE'S CHILDCARE CENTRAL PARKING SAN JOSE CENTRAL PARKING SYS. INC CITY OF SF PORT-S. PLAZA COOKS AUTOMOTIVE D & J GARAGE DOUGLAS PARKING ELLIS & OFARRELL (LAZ PARKING) ENCORE HOSPITALITY SERVICE FREGENE'S FRONTIER FORD GATES, VERELENE XXX-XX-XXXX GOOGLE - CITY PARK GOSSETT-RADERMAN, LINDA GUIDOTTI, SHARRON 83809 HERTZ BURLINGAME HERTZ RENT A CAR HERTZ RENT-A-CAR HERTZ S.F. (MECHANICS) HERTZ SAN JOSE HERTZ SF HERTZ SFO HS&BA HYATT BURLINGAME-CITY PARK IMPERIAL PARKING INC. JAPAN CENTER GARAGES JENNINGS TECH. CORP. JOCKEY CLUB LARRY HOPKINS HONDA LARRY HOPKINS HONDA/MACHI LOCAL 665 PL10KD LOCAL 665 PL34 LOOMIS ARMORED US INC. LUXOR CAB CO. MASCONE (LAZ PARKING) MICHELLE KROGH DAY CARE MISSION VALLEY FORD TRUCK MOORE BUICK CO. NEW SO PRKING/CTRAL PRKNG NEW SO. PRKNG-SFIA 83791 NORMANDIN CHRYSJEEP/MACHI NORMANDIN CHRYSLER JEEP NORTH BEACH (LAZ PARKING) P & S SALES PACIFIC PARK MANAGEMENT PALACE GARAGE-KYO-YA CO. PARKING CONCEPTS, INC PAULINA'S DAY CARE PCAM, LLC PCAM, LLC - SO.SAN FRANCISCO PEARSON AUTOMOBILE CO INC PEARSON AUTOMOBILE(MACHINISTS) POLK AND BUSH (LAZ PARKING) PROPARK AMERICA WEST (B) R & R PARKING RECTOR MOTOR CAR COMPANY REINEGGER FRAME & WHEEL INC. ROLLER, HAPGOOD & TINNEY ROSAS, KIMI XXX-XX-XXXX RYDER TRANS/SERV. 84258 RYDER TRANSPORT SERVICES SAN FRANCISCO TOYOTA SAN JOSE COMM PROPERTIES SANTA CLARA YMCA SAVOY CORPORATION SF GEN. HOSPITAL GARAGE SF PARKING/SFIA EMPLOYEE PARK SFO PARKING INC-CITY PARK SFO SHUTTLE BUS - CITY PARK SJ BRITISH MOTORS/MACHI STANDARD PARKING SJ STANDARD PRKNG CORP OF CA STANFORD-CITY PARK (PART OF SAN FRANCISCO PARKING INC.) STEVENS CREEK TOYOTA STEWART CHEVROLET SUNNYVALE V-SWAGEN/MACHI T M INDUSTRIES INC TOYOTA OF PALO ALTO UNION PACIFIC PARKING INC UNIPART/JAGUAR CARS INC VALLEJO (LAZ PARKING) WENDT, TERESA YELLOW CAB COOP INCExplanation