MISCELLANEOUS WAREHOUSEMENS LOCAL 781 HEALTH AND WELFARE FUND: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MISCELLANEOUS WAREHOUSEMENS LOCAL 781 HEALTH AND WELFARE FUND (EIN 36-6117757)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-04-15
- IRS object ID
- 201341059349300734
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-04-15T11:43:59-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364409576 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRONSWICK REICIN POLLACK LTD | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2150 E LAKE COOK ROAD SUITE 430 | AddressLine1 |
| City | BUFFALO GROVE | City |
| State | IL | State |
| ZIP Code | 600891862 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 366117757 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MISC WHSMENS LOCAL 781 H & W FUND | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MISC | NameControl |
| Phone | 8472989999 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 747 CHURCH ROAD BUILDING D NO 1 | AddressLine1 |
| City | ELMHURST | City |
| State | IL | State |
| ZIP Code | 60126 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PAUL J STRIPLING | Name |
| Title | TRUSTEE | Title |
| Phone | 8472989999 | Phone |
| Date Signed | 2013-04-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEFFREY D BRONSWICK | Name |
| PTIN | P00440208 | PTIN |
| Phone | 8478089800 | 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) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | PAUL J STRIPLING | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 747 CHURCH ROAD BUILDING D NO 1 | AddressLine1 |
| City | ELMHURST | City |
| State | IL | State |
| ZIP Code | 60126 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12066623 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | N/A | WebSite |
| Type Of Organization Trust | X | TypeOfOrganizationTrust |
| Year Formation | 1960 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HEALTH BENEFITS AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTS AND COVERED DEPENDENTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 4 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 4 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1 | 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 | 5158899 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5941963 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 598723 | InvestmentIncomePriorYear |
| Investment Income Current Year | 620987 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 9821 | OtherRevenuePriorYear |
| Other Revenue Current Year | -9025 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5767443 | TotalRevenuePriorYear |
| Total Revenue Current Year | 6553925 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 5411391 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 5357362 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 40241 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 1496 | 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 | 554931 | OtherExpensePriorYear |
| Other Expenses Current Year | 555466 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6006563 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5914324 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -239120 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 639601 | RevenuesLessExpensesCY |
| Total Assets BOY | 16998265 | TotalAssetsBOY |
| Total Assets EOY | 18077449 | TotalAssetsEOY |
| Total Liabilities BOY | 692238 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 713228 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 16306027 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 17364221 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE HEALTH BENEFITS AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTS AND COVERED DEPENDENTS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Description | THE PLAN IS MAINTAINED PURSUANT TO A NUMBER OF COLLECTIVE BARGAINING AGREEMENTS AND PROVIDES FOR EMPLOYEE DEATH, DISABILITY, MEDICAL, HOSPITALIZATION, SURGICAL, PRESCRIPTION, DENTAL AND VISION BENEFITS. | 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 | 1 | 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 | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | 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 | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 2 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1 | 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 | 4 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 4 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | 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 | PAUL J STRIPLING | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8472989999 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 747 CHURCH ROAD BUILDING D | AddressLine1 |
| City | ELMHURST | City |
| State | IL | State |
| ZIP Code | 60126 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (4 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|
| S JAMES PERLOW | |||||
| MANAGEMENT TRUSTEE | 1.00 | X | 0 | 0 | 0 |
| EARL ABRAMSON | |||||
| MANAGEMENT TRUSTEE | 1.00 | X | 0 | 0 | 0 |
| PAUL J STRIPLING | |||||
| LABOR TRUSTEE | 6.00 | X | 0 | 0 | 0 |
| TRACY L TREADWELL | |||||
| LABOR TRUSTEE | 2.00 | 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 (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ILLINOIS | |||||
| 300 EAST RANDOLPH STREET | CHICAGO | IL | 60601 | PPO NETWORK PROVIDER | 221014 |
| GROUP ADMINISTRATORS LTD | |||||
| 915 NATIONAL PARKWAY SUITE F | SCHAUMBURG | IL | 60173 | THIRD PARTY ADMINISTRATOR | 137550 |
| BRONSWICK REICIN POLLACK | |||||
| 2150 E LAKE COOK ROAD SUITE 430 | BUFFALO GROVE | IL | 60089 | AUDITING | 115704 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| EMPLOYER PREMIUM CONTR | 525100 | 5883507 | 5883507 |
| EMPLOYEE COBRA CONTRIB | 525100 | 58456 | 58456 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5941963 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 566052 | TotalRevenueColumn |
| Exclusion | $566,052 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5567633 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5512698 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 54935 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 54935 | TotalRevenueColumn |
| Exclusion | $54,935 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INTEREST DELINQUENT CO | Description |
| Business Code | 525100 | BusinessCode |
| Total Revenue Column | -9025 | TotalRevenueColumn |
| Exclusion | -$9,025 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -9025 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6553925 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5941963 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $611,962 | ExclusionAmount |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5357362 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1496 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47036 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115704 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53599 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24678 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8814 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9857 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8360 | Total |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal |
|---|---|
| INSURANCE ADMINISTRATIO | 126701 |
| PROVISION FOR UNCOLLECT | 56000 |
| INSURANCE CONSULTANTS | 40037 |
| ADMINISTRATIVE EXPENSES | 38473 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26207 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5914324 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 205252 | BOY |
| EOY | 230241 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 470107 | BOY |
| EOY | 246198 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 345195 | BOY |
| EOY | 791149 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9059 | BOY |
| EOY | 2067 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7902 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7902 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15808653 | BOY |
| EOY | 16642695 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 159999 | BOY |
| EOY | 165099 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16998265 | BOY |
| EOY | 18077449 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24730 | BOY |
| EOY | 34340 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 667508 | BOY |
| EOY | 678888 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 692238 | BOY |
| EOY | 713228 | 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 | 16306027 | BOY |
| EOY | 17364221 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16306027 | BOY |
| EOY | 17364221 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16998265 | BOY |
| EOY | 18077449 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 639601 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 418593 | ReconcilationOtherChanges |
| 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
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1703 | OtherCostOrOtherBasis |
| Depreciation | 1703 | Depreciation |
| Book Value | 0 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6199 | OtherCostOrOtherBasis |
| Depreciation | 6199 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CLAIMS PAYABLE AND CLAIMS IBNR | $648,882 |
| DUE TO AFFILIATED ORGANIZATION | $2,473 |
| INSURANCE PREMIUM PAYABLE | $27,533 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 678888 | TotalOfAmounts |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PAGE 3, PART IV, ITEM 12 - AUDITED FINANCIAL STATEMENTS | THE FUND DID RECEIVE AN AUDITED FINANCIAL STATEMENT IN ACCORDANCE WITH GAAP. THE FUND'S AUDITED FINANCIAL STATEMENT IS NOT REQUIRED TO BE PREPARED IN ACCORDANCE WITH SFAS 117. THEREFORE, THE FUND ANSWERED "NO" TO THIS QUESTION AND IS NOT REQUIRED TO COMPLETE PARTS XI,XII AND XIII OF SCHEDULE D. NOTE THAT ON FORM 990, PAGE 12, PART XI, LINE 2B, THE FUND ANSWERED "YES" BECAUSE THE FUND'S FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT ACCOUNTANT IN ACCORDANCE WITH GAAP. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE PARTICIPANTS OF THE FUND ARE CONSIDERED THE MEMBERS. THE HEALTH AND DEATH BENEFITS PROVIDED TO THE PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS ARE PAID FROM THE FUND'S INCOME AND/OR ASSETS. | |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO COMMITTEES OTHER THAN THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE TWO LABOR TRUSTEES OF THE FUND REVIEWED THE FORM 990 IN DETAIL WITH THE PREPARER PRIOR TO ITS FILING. THE TWO MANAGEMENT TRUSTEES WERE PROVIDED COPIES OF THE FORM 990 PRIOR TO ITS FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE POLICY STATES THAT EACH TRUSTEE WILL BE REQUIRED TO STATE ANNUALLY THAT HE HAS REVIEWED THE POLICY AND DOES NOT HAVE ANY CONFLICTS OR, IF THERE IS A CONFLICT, THAT THE TRUSTEE IS REQUIRED TO INDICATE WHAT IT IS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FUND'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST FROM THE FUND'S OFFICE. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 418,593. | CHANGES IN NET ASSETS OR FUND BALANCES: |