UNITE HERE NORTHWEST HEALTH TRUST FUND: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: UNITE HERE NORTHWEST HEALTH TRUST FUND (EIN 91-0590441)
Tax period: 2011-06-01 to 2012-05-31
Filed: 2013-03-27
IRS object ID: 201320869349300737
Schema version: 2011v1.5
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
Form 990
Schedule D
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-03-27T17:50:19-05:00	Timestamp
Tax Period End Date	2012-05-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	522385296	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LINDQUIST LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	5000 EXECUTIVE PARKWAY SUITE 400	AddressLine1
City	SAN RAMON	City
State	CA	State
ZIP Code	94583	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-06-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	910590441	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	HOTEL EMPLOYEES RESTAURANT EMPLOYEES	BusinessNameLine1
Business Name Line2	HEALTH TRUST PLAN	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	HOTE	NameControl
Phone	2064417574	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2815 SECOND AVENUE NO 300	AddressLine1
City	SEATTLE	City
State	WA	State
ZIP Code	98121	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	RICHARD SAWYER	Name
Title	TRUSTEE	Title
Phone	2064417574	Phone
Date Signed	2013-03-27	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	LORI L SCOTT	Name
PTIN	P01452038	PTIN
Phone	9252779100	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	RICHARD SAWYER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	2815 SECOND AVE STE 300	AddressLine1
City	SEATTLE	City
State	WA	State
ZIP Code	98121	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	34799677	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	N/A	WebSite
Type Of Organization Trust	X	TypeOfOrganizationTrust
Year Formation	1976	YearFormation
State Legal Domicile	WA	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS	ActivityOrMissionDescription
Nbr Voting Members Governing Body	10	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	4	NbrIndependentVotingMembers
Total Nbr Employees	134	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	0	ContributionsGrantsPriorYear
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	24953552	ProgramServiceRevenuePriorYear
Program Service Revenue CY	25542077	ProgramServiceRevenueCY
Investment Income Prior Year	1602884	InvestmentIncomePriorYear
Investment Income Current Year	1394205	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1371	OtherRevenuePriorYear
Other Revenue Current Year	3820	OtherRevenueCurrentYear
Total Revenue Prior Year	26557807	TotalRevenuePriorYear
Total Revenue Current Year	26940102	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	20644132	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	20101207	BenefitsPaidToMembersCY
Salaries Etc Prior Year	0	SalariesEtcPriorYear
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1551218	OtherExpensePriorYear
Other Expenses Current Year	1621603	OtherExpensesCurrentYear
Total Expenses Prior Year	22195350	TotalExpensesPriorYear
Total Expenses Current Year	21722810	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	4362457	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	5217292	RevenuesLessExpensesCY
Total Assets BOY	38665842	TotalAssetsBOY
Total Assets EOY	43403617	TotalAssetsEOY
Total Liabilities BOY	7121440	TotalLiabilitiesBOY
Total Liabilities EOY	5855012	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	31544402	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	37548605	NetAssetsOrFundBalancesEOY
Mission Description	TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Description	PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS.	Description
Described In501 C3	0	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	0	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	0	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Info In Schedule O Part V	X	InfoInScheduleOPartV
Number Forms Transmitted With1096	1167	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	134	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	10	NbrVotingGoverningBodyMembers
Number Independent Voting Members	4	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	1	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	0	CompensationProcessCEO
Compensation Process Other	0	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	WELFARE AND PENSION ADMIN SERVICE	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	2064417574	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2815 SECOND AVENUE SUITE 300	AddressLine1
City	SEATTLE	City
State	WA	State
ZIP Code	98121	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
RICHARD SAWYER
TRUSTEE	0.50	X	0	0	0
ERIK VAN ROSSUM
TRUSTEE	0.50	X	0	0	0
HOWARD COHEN
TRUSTEE	0.50	X	0	0	0
SARAH WARREN
TRUSTEE	0.50	X	0	0	0
LEE KAUFMAN
TRUSTEE	0.50	X	0	0	0
DOUG RIGONI
TRUSTEE	0.50	X	0	0	0
ENRIQUE FERNANDEZ
TRUSTEE	0.50	X	0	0	0
STEFAN MORITZ
TRUSTEE	0.50	X	0	0	0
JEANNE CAMERON
TRUSTEE	0.50	X	0	0	0
BRENDAN COFFEY
TRUSTEE	0.50	X	0	0	0
KARLY EDWARDS
TRUSTEE - PAST	0.50	X	0	0	0
ELIZABETH SLAUGHTER
TRUSTEE - PAST	0.50	X	0	0	0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	0	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	0	TotalOtherCompensation
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	0	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
WELFARE & PENSION ADMINISTRATION SERVICE
2815 2ND AVE STE 300	SEATTLE	WA	98121	ADMINISTRATION	977391
FIRST CHOICE HEALTH NETWORK INC
600 UNIVERISTY ST STE 1400	SEATTLE	WA	98101	ADMINISTRATION	241069

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	2	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS	900099	25179040	25179040
PARTICIPANT CONTRIBUTI	900099	130207	130207
FORMULARY REBATE	900099	130074	130074
STOP LOSS INCOME	900099	99668	99668
ARRA COBRA REIMURSEMEN	900099	3088	3088

Field	Value	IRS element (for citing)
Total Program Service Revenue	25542077	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1293780	TotalRevenueColumn
Exclusion	$1,293,780	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	7960000	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	7859575	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	100425	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	100425	TotalRevenueColumn
Exclusion	$100,425	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	MISCELLANEOUS INCOME	Description
Business Code	900099	BusinessCode
Total Revenue Column	3820	TotalRevenueColumn
Related Or Exempt Function Income	3820	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	3820	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	26940102	TotalRevenueColumn
Related Or Exempt Function Income	25545897	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$1,394,205	ExclusionAmount

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	20101207	Total

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	919379	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	25200	Total

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	47547	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	29273	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	412785	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	136752	Total

Travel Travel

Field	Value	IRS element (for citing)
Total	28663	Total

Insurance Insurance

Field	Value	IRS element (for citing)
Total	22004	Total

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	21722810	Total

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	249464	BOY
EOY	1236711	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	5864118	BOY
EOY	4908144	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2324975	BOY
EOY	2279588	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	3982	BOY
EOY	3715	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	30223303	BOY
EOY	34975459	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	38665842	BOY
EOY	43403617	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	35440	BOY
EOY	96705	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	7086000	BOY
EOY	5758307	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	7121440	BOY
EOY	5855012	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	31544402	BOY
EOY	37548605	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	31544402	BOY
EOY	37548605	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	38665842	BOY
EOY	43403617	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	5217292	ReconcilationRevenueExpenses
Reconcilation Other Changes	786911	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	0	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
ACCUMULATED ELIGIBILITY CREDITS	$3,704,000
CLAIMS PAYABLE AND INCURRED BUT NOT REPORTED	$2,054,307

Field	Value	IRS element (for citing)
Total Of Amounts	5758307	TotalOfAmounts
Total Revenue	26940102	TotalRevenue
Total Expenses	21722810	TotalExpenses
Excess Or Deficit For Year	5217292	ExcessOrDeficitForYear
Net Unrealized GL On Investments	786911	NetUnrealizedGLOnInvestments
Other	-$1,327,693	OtherAmount
Total Adjustments	-540782	TotalAdjustments
Excess Or Deficit Per FS	4676510	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	27697740	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	786911	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	786911	RevenueNotRptdF990
Revenue Subtotal	26910829	RevenueSubtotal
Investment Expenses Not Included	29273	InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt	29273	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	26940102	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	23021230	TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	23021230	ExpensesSubtotal
Investment Expenses Not Included2	29273	InvestmentExpensesNotIncluded2
Other Expenses Not Included	-1327693	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	-1298420	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	21722810	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	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. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF MAY 31, 2012, 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. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO 2009.
PART XI, LINE 8 - OTHER ADJUSTMENTS:		CHANGE IN BENEFIT OBLIGATIONS
PART XIII, LINE 4B - OTHER ADJUSTMENTS:		CHANGE IN BENEFIT OBLIGATIONS

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART V, LINE 2A:	THE TRUST DOES NOT HAVE EMPLOYEES. HOWEVER, THE TRUST ISSUED FORMS W-2 TO PARTICIPANTS THAT RECEIVED TAXABLE DISABILITY BENEFITS.
FORM 990, PART VI, SECTION A, LINE 3	THE PLAN HAS CONTRACTED WITH WELFARE AND PENION ADMINISTRATION SERVICE, INC. TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11	A TRUSTEE REVIEWED THE FORM 990 FOR ACCURACY AND COMPLETENESS PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	IF AND WHEN A POTENTIAL CONFLICT OF INTEREST IS DISCLOSED, THE BOARD OF TRUSTEES WILL INVOLVE THE TRUST'S ATTORNEY TO EVALUATE IF THE MATTER WOULD LIKELY PREVENT AN UNBIASED OR OBJECTIVE DECISION BY A TRUSTEE, AND AS APPROPRIATE, DISCIPLINARY OR CORRECTIVE ACTION WILL BE TAKEN.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 786,911.	CHANGES IN NET ASSETS OR FUND BALANCES:
	FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF INDEPENDENT AUDITORS. THIS PROCESS HAS NOT CHANGED.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg
HOTEL EMPLOYEES RESTAURANT EMPLOYEES PENSION PLAN
PO BOX 34203	SEATTLE	WA	981241203	916145131	PROVIDE PENSION BENEFITS FOR ELIGIBLE EMPLOYEES	WA	501(A)	N/A	N/A	0
UNITE HERE LOCAL 8
2800 FIRST AVENUE ROOM 3	SEATTLE	WA	98121	910968179	LABOR ORGANIZATION	WA	501(C)(5)	N/A	N/A	0

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Explanation	SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF MAY 31, 2012, THERE ARE 37 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. HOWEVER, CERTAIN INFORMATION THAT IS REQUIRED TO BE REPORTED ON SCHEDULE R SUCH AS EMPLOYER IDENTIFICATION NUMBERS AND LEGAL STRUCTURE (CORPORATION, PARTNERSHIP, ETC.) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE CONTRIBUTING EMPLOYERS HAVE NOT BEEN INCLUDED ON SCHEDULE R.	Explanation