ROBERT F KENNEDY FARM WORKERS MEDICAL PLAN: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: ROBERT F KENNEDY FARM WORKERS MEDICAL PLAN (EIN 94-6186170)
Tax period: 2011-09-01 to 2012-08-31
Filed: 2013-07-15
IRS object ID: 201341969349300134
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	2013-07-15T09:12:36-07:00	Timestamp
Tax Period End Date	2012-08-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	1400 EASTON DRIVE SUITE 139-A	AddressLine1
City	BAKERSFIELD	City
State	CA	State
ZIP Code	93309	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-09-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	946186170	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ROBERT F KENNEDY FARM WORKERS	BusinessNameLine1
Business Name Line2	MEDICAL PLAN	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	ROBE	NameControl
Phone	6618236900	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 47	AddressLine1
City	KEENE	City
State	CA	State
ZIP Code	93531	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	PATRICK PINE	Name
Title	ADMINISTRATOR	Title
Date Signed	2013-07-15	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Donald R Mendez CPA	Name
Phone	6613342779	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Gross Receipts	14529632	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	false	AllAffiliatesIncluded
Organization501c	X	Organization501c
Web Site	N/A	WebSite
Type Of Organization Trust	X	TypeOfOrganizationTrust
State Legal Domicile	CA	StateLegalDomicile
Activity Or Mission Description	PROVIDE HEALTH AND WELFARE BENEFITS TO FARMWORKERS AND FARMWORKER AFFILIATED ORGANIZATIONS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	5	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	5	NbrIndependentVotingMembers
Total Nbr Employees	7	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	15069936	ProgramServiceRevenuePriorYear
Program Service Revenue CY	14280078	ProgramServiceRevenueCY
Investment Income Prior Year	106109	InvestmentIncomePriorYear
Investment Income Current Year	249554	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	15176045	TotalRevenuePriorYear
Total Revenue Current Year	14529632	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	14488552	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	13537450	BenefitsPaidToMembersCY
Salaries Etc Prior Year	218756	SalariesEtcPriorYear
Salaries Etc Current Year	215798	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	425383	OtherExpensePriorYear
Other Expenses Current Year	420547	OtherExpensesCurrentYear
Total Expenses Prior Year	15132691	TotalExpensesPriorYear
Total Expenses Current Year	14173795	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	43354	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	355837	RevenuesLessExpensesCY
Total Assets BOY	5711751	TotalAssetsBOY
Total Assets EOY	6127514	TotalAssetsEOY
Total Liabilities BOY	3412612	TotalLiabilitiesBOY
Total Liabilities EOY	3450762	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	2299139	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	2676752	NetAssetsOrFundBalancesEOY
Mission Description	PROVIDE HEALTH AND WELFARE BENEFITS TO FARMWORKERS AND FARMWORKER AFFILIATED ORGANIZATIONS.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	14173795	Expense
Revenue	14529632	Revenue
Description	THE ORGANIZATION PROVIDED HEALTH AND WELFARE BENEFITS TO AN ESTIMATED 2,722 PARTICIPANTS. MOST PARTICIPANTS WERE LOW PAID FARM WORKERS.	Description
Total Program Service Expense	14173795	TotalProgramServiceExpense
Described In501 C3	false	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	false	ComplianceWithBackupWitholding
Number Of Employees	7	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Form990-T Filed	false	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Form8886 T Filed	false	Form8886TFiled
Non Deductible Contributions	false	NonDeductibleContributions
Non Deductible Disclosure	false	NonDeductibleDisclosure
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Filed Lieu1041	false	FiledLieu1041
Licensed More Than One State	false	LicensedMoreThanOneState
Indoor Tanning Services	false	IndoorTanningServices
Form720 Filed	false	Form720Filed
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	5	NbrVotingGoverningBodyMembers
Number Independent Voting Members	5	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Policies Reference Chapters	false	PoliciesReferenceChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	false	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	false	RegularMonitoringEnforcement
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Written Policy Or Procedure	false	WrittenPolicyOrProcedure
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	PATRICK PINE	NamePerson
Telephone Number	6618236900	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	P O BOX 47	AddressLine1
City	KEENE	City
State	CA	State
ZIP Code	93531	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer
DANIEL URBANO
Trustee	1.00	X	0	0	0
SHAH KAZEMI
TRUSTEE	1.00	X	0	0	0
TANIS YBARRA
TRUSTEE	1.00	X	0	46168	0
EFREN BARAJAS
TRUSTEE	1.00	X	0	44205	0
ARTURO RODRIGUEZ
TRUSTEE	1.00	X	0	77657	0
RICHARD VERA
ADMINISTRATOR	15.00		0	0	0	X
MERCEDES MARTINEZ FARMER
ASST ADMINISTRA	15.00		0	0	0	X

Field	Value	IRS element (for citing)
Total Reportable Comp Frm Rltd Orgs	168030	TotalReportableCompFrmRltdOrgs
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
VISION SERVICE PLAN
PO BOX 45210	SAN FRANCISCO	CA	941455210	VISION SERVICES	333837
UNITED HEALTHCARE INSURANCE COMPANY
22561 NETWORKK PLACE	CHICAGO	IL	606731225	DENTAL SERVICES	1195472
EXPRESS SCRIPTS
21653 NETWORK PLACE	CHICAGO	IL	606731216	PRESCRIPTIONS	1895369
ANTHEM BLUE CROSS
DEPT 5812	LOS ANGELES	CA	900745812	MEDICAL BENEFITS	10093695

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	4	NumberOfContractorsGT100K
Total Contributions	0	TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescription	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MISC. INCOME	5261	5261
LEGAL RECOVERIES
EMPLOYER CONTRIBUTIONS	14059615	14059615
EMPLOYEE CONTRIBUTIONS	215202	215202

Field	Value	IRS element (for citing)
Total Program Service Revenue	14280078	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	249554	TotalRevenueColumn
Related Or Exempt Function Income	249554	RelatedOrExemptFunctionIncome

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Total Other Revenue	0	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	14529632	TotalRevenueColumn
Related Or Exempt Function Income	14529632	RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	13537450	Total
Program Services	13537450	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	0	Total

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	164095	Total
Program Services	164095	ProgramServices

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	0	Total

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	35750	Total
Program Services	35750	ProgramServices

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	15953	Total
Program Services	15953	ProgramServices

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	23920	Total
Program Services	23920	ProgramServices

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	11495	Total
Program Services	11495	ProgramServices

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	0	Total

Advertising Advertising

Field	Value	IRS element (for citing)
Total	0	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	73162	Total
Program Services	73162	ProgramServices

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	0	Total

Travel Travel

Field	Value	IRS element (for citing)
Total	9202	Total
Program Services	9202	ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	0	Total

Interest Interest

Field	Value	IRS element (for citing)
Total	0	Total

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	0	Total

Insurance Insurance

Field	Value	IRS element (for citing)
Total	18230	Total
Program Services	18230	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
EQUIPMENT	35016	35016
AUDIT	48820	48820
FIELD OFFICE SERVICES	59928	59928
MEDICAL BENEFITS CONSULTING	71292	71292

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	69482	Total
Program Services	69482	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	14173795	Total
Program Services	14173795	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1574830	BOY
EOY	1555843	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
EOY	0	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	1633362	BOY
EOY	1407119	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
EOY	0	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	4778	BOY
EOY	6815	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	213996	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	190234	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	14338	BOY
EOY	23762	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	2484441	BOY
EOY	3126452	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	2	BOY
EOY	7523	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	5711751	BOY
EOY	6127514	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	3412611	BOY
EOY	3450762	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1	BOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	3412612	BOY
EOY	3450762	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2299139	BOY
EOY	2676752	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	2299139	BOY
EOY	2676752	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	5711751	BOY
EOY	6127514	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	355837	ReconcilationRevenueExpenses
Reconcilation Other Changes	21776	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	false	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired
Federal Grant Audit Performed	false	FederalGrantAuditPerformed

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	1627	InvestmentCostOrOtherBasis
Depreciation	1627	Depreciation

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	152382	InvestmentCostOrOtherBasis
Depreciation	144195	Depreciation
Book Value	8187	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	59987	InvestmentCostOrOtherBasis
Depreciation	44412	Depreciation
Book Value	15575	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	23762	TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Identifier	Part XI, Line 8	Identifier
Return Reference	Part XI, Line 8: Other Changes in Net Assets or Fund Balances	ReturnReference
Explanation	Decrease in accumulated liability $21776	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	The Plan has always maintained a policy of providing governing documents, policies and financial statement information to those requesting such information.
Form 990, Part VI, Line 11	Form 990, Part VI, Line 11: Form 990 Review Process	A electronic copy of the Form 990 was sent to all trustees and the administrator for review and comment before filing with the IRS. The administrator of the Plan performed a detailed review of the Form 990 including reconciliation with the audited financial statements, before filing it with the IRS. The Plan management expects to formally present the Form 990 to the Board of Trustees at their next regularly schedule board meeting for their approval.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 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
CESAR CHAVEZ FOUNDATION
PO BOX 62	KEENE	CA	93531	952466747	PROVIDES SERVICES TO FARMWORKER	CA	501(C)(3)	PUBLIC CHARITY	N/A	false
UNITED FARM WORKERS OF AMERICA
P O BOX 62	KEENE	CA	93531	941448579	LABOR UNION / PLAN SPONSOR	CA	501(C)(5)		N/A	false
JUAN DE LA CRUZ FARMWORKERS PENSION PLAN
P O BOX 36	KEENE	CA	93531	956454441	MULTIEEMPLOYER RETIREMENT PLAN PROVIDING PENSIONS	CA	501(C)(9)		N/A	false
NATIONAL CHAVEZ CENTER
P O BOX 62	KEENE	CA	93531	770159465	PERFORM CHARITABLE ACTIVIES THAT SUPPORT FARM WORKERS	CA	501(C) (3)	PUBLIC CHARITY	N/A	false

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	LAW OFFICE OF MARCOS CAMACHO	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1227 CALIFORNIA AVE	AddressLine1
City	BAKERSFIELD	City
State	CA	State
ZIP Code	93304	ZIPCode

Field	Value	IRS element (for citing)
EIN	931020541	EIN
Primary Activity	LAW FIRM	PrimaryActivity
Legal Domicile State	CA	LegalDomicileState
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Type Of Entity	S CORP	TypeOfEntity

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

Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
LAW OFFICE OF MARCOS CAMACHO
l	21713	CASH
LAW OFFICE OF MARCOS CAMACHO
k	7500	CASH
CESAR CHAVEZ FOUNDATION
l	1026157	CASH
CESAR CHAVEZ FOUNDATION
k	6051	CASH
UNITED FARM WORKERS OF AMERICA
l	427722	CASH
UNITED FARM WORKERS OF AMERICA
k	92901	CASH
JUAN DE LA CRUZ FARMWORKERS PENSION PLAN
l	46532	CASH
JUAN DE LA CRUZ FARMWORKERS PENSION PLAN
k	1640	CASH
NATIONAL CHAVEZ CENTER
l	57205	CASH
NATIONAL CHAVEZ CENTER
k	20652	CASH