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BAY AREA AUTOMOTIVE GROUP WELFARE FUND: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
BAY AREA AUTOMOTIVE GROUP WELFARE FUND (EIN 94-6072964)
Tax period
2011-12-01 to 2012-11-30
Filed
2013-10-08
IRS object ID
201322819349300802
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-10-08T11:15:21-05:00Timestamp
Tax Period End Date2012-11-30TaxPeriodEndDate

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 Date2011-12-01TaxPeriodBeginDate

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)
NameERNIE YATESName
TitleTRUSTEETitle
Phone5105287100Phone
Date Signed2013-10-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDEBBIE R DIMERYName
PTINP01065763PTIN
Phone9252779100Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonERNIE YATESNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14160 DUBLIN BOULEVARD NO 400AddressLine1
CityDUBLINCity
StateCAState
ZIP Code945687756ZIPCode
FieldValueIRS element (for citing)
Gross Receipts37375158GrossReceipts
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 Employees28TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year32289985ProgramServiceRevenuePriorYear
Program Service Revenue CY32193263ProgramServiceRevenueCY
Investment Income Prior Year654536InvestmentIncomePriorYear
Investment Income Current Year403182InvestmentIncomeCurrentYear
Other Revenue Prior Year28414OtherRevenuePriorYear
Other Revenue Current Year745OtherRevenueCurrentYear
Total Revenue Prior Year32972935TotalRevenuePriorYear
Total Revenue Current Year32597190TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year32949258BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY34175155BenefitsPaidToMembersCY
Salaries Etc Prior Year34735SalariesEtcPriorYear
Salaries Etc Current Year36382SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1542675OtherExpensePriorYear
Other Expenses Current Year1545017OtherExpensesCurrentYear
Total Expenses Prior Year34526668TotalExpensesPriorYear
Total Expenses Current Year35756554TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1553733RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3159364RevenuesLessExpensesCY
Total Assets BOY19779977TotalAssetsBOY
Total Assets EOY16359178TotalAssetsEOY
Total Liabilities BOY5521808TotalLiabilitiesBOY
Total Liabilities EOY5021884TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14258169NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY11337294NetAssetsOrFundBalancesEOY
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 Equip1ReportLandBldgEquip
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
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096953NumberFormsTransmittedWith1096
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 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
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (6 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
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
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 FEE881883
BLUE CROSS OF CALIFORNIA
DEPARTMENT 5812LOS ANGELESCA900745812PPO NETWORK FEE129947
LINDQUIST LLP
5000 EXECUTIVE PARKWAY SUITE 400SAN RAMONCA945834346ACCOUNTING FEE112124
BEESON TAYER & BODINE
ROSS HOUSE SECOND FLOOR 483 NINTHOAKLANDCA94607LEGAL FEE106469
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS9000992968579429685794
STOP LOSS INCOME90009920055672005567
PARTICIPANT CONTRIBUTI900099501902501902
FieldValueIRS element (for citing)
Total Program Service Revenue32193263TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column328487TotalRevenueColumn
Exclusion$328,487ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4852663Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities4777968Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities74695Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column74695TotalRevenueColumn
Exclusion$74,695ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER INCOMEDescription
Business Code900099BusinessCode
Total Revenue Column745TotalRevenueColumn
Related Or Exempt Function Income745RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue745TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column32597190TotalRevenueColumn
Related Or Exempt Function Income32194008RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$403,182ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total34175155Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total36382Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total808254Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total153294Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total151553Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total33639Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total300095Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total65463Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1291Total

Insurance Insurance

FieldValueIRS element (for citing)
Total31428Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total35756554Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2394257BOY
EOY2732061EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1006451BOY
EOY546490EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3920683BOY
EOY3908767EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY23412BOY
EOY23000EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY12417838BOY
EOY9113768EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY17336BOY
EOY35092EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY19779977BOY
EOY16359178EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1886808BOY
EOY2108884EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3635000BOY
EOY2913000EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5521808BOY
EOY5021884EOY
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)
BOY14258169BOY
EOY11337294EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14258169BOY
EOY11337294EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY19779977BOY
EOY16359178EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-3159364ReconcilationRevenueExpenses
Reconcilation Other Changes238489ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

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

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionACCUMULATED ELIGIBILITY CREDITSDescription
Amount$2,913,000Amount
FieldValueIRS element (for citing)
Total Of Amounts2913000TotalOfAmounts
Total Revenue32597190TotalRevenue
Total Expenses35756554TotalExpenses
Excess Or Deficit For Year-3159364ExcessOrDeficitForYear
Net Unrealized GL On Investments238489NetUnrealizedGLOnInvestments
Other-$502,082OtherAmount
Total Adjustments-263593TotalAdjustments
Excess Or Deficit Per FS-3422957ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt32802040TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments238489NetUnrealizedGainsInvestments
Revenue Not Rptd F990238489RevenueNotRptdF990
Revenue Subtotal32563551RevenueSubtotal
Investment Expenses Not Included33639InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt33639RevenueNotRptdOnFinStmt
Total Revenue Per Form99032597190TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt36224997TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal36224997ExpensesSubtotal
Investment Expenses Not Included233639InvestmentExpensesNotIncluded2
Other Expenses Not Included-502082OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-468443ExpensesNotRptdOnFinStmt
Total Expenses Per Form99035756554TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
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. THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT, AS OF NOVEMBER 30, 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. THE PLAN BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL 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 ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
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 XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 238,489.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHE 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.

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
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, 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, 2012, THERE ARE APPROXIMATELY 120 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