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THE TILE INDUSTRY HEALTH & WELFARE FUND: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
THE TILE INDUSTRY HEALTH & WELFARE FUND (EIN 95-1734798)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-08
IRS object ID
201213139349301836
Schema version
2011v1.3
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)
Timestamp2012-11-08T18:55:57-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MILLER KAPLAN ARASE LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14123 LANKERSHIM BLVDAddressLine1
CityNORTH HOLLYWOODCity
StateCAState
ZIP Code916022828ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN951734798EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE TILE INDUSTRY HEALTH & WELFARE FUNDBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JIM PRATER BENESYSInCareOfName
Name ControlTILENameControl
Phone6266461075Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11050 LAKES DRAddressLine1
CityWEST COVINACity
StateCAState
ZIP Code917902910ZIPCode

Officer Officer

FieldValueIRS element (for citing)
Namechad boggioName
TitletrusteeTitle
Date Signed2012-11-08DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMiller Kaplan Arase LLPName
Phone8187692010Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCHAD BOGGIONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11050 LAKES DR STE 225AddressLine1
CityWEST COVINACity
StateCAState
ZIP Code917902910ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6124856GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1960YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionSEE SCHEDULE OActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees20TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6431935ProgramServiceRevenuePriorYear
Program Service Revenue CY4434001ProgramServiceRevenueCY
Investment Income Prior Year497616InvestmentIncomePriorYear
Investment Income Current Year404358InvestmentIncomeCurrentYear
Other Revenue Prior Year15OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year6929566TotalRevenuePriorYear
Total Revenue Current Year4838359TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year5661050BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY4651461BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year506460OtherExpensePriorYear
Other Expenses Current Year392122OtherExpensesCurrentYear
Total Expenses Prior Year6167510TotalExpensesPriorYear
Total Expenses Current Year5043583TotalExpensesCurrentYear
Revenues Less Expenses Prior Year762056RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-205224RevenuesLessExpensesCY
Total Assets BOY16559727TotalAssetsBOY
Total Assets EOY15772602TotalAssetsEOY
Total Liabilities BOY3770809TotalLiabilitiesBOY
Total Liabilities EOY3140864TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY12788918NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY12631738NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
DescriptionSEE SCHEDULE ODescription
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096290NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees20NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJIM PRATER BENESYSNamePerson
Telephone Number6266461075TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11050 LAKES DR STE 225AddressLine1
CityWEST COVINACity
StateCAState
ZIP Code917902910ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
VIVIAN GALLUP
EMPLOYER TRUSTEE1.0X000
RANDALL NUNNELLY
EMPLOYER TRUSTEE1.0X000
LOREN RUCKER
EMPLOYER TRUSTEE1.0X000
JOHN WILSON
EMPLOYER TRUSTEE1.0X000
CHAD BOGGIO
UNION TRUSTEE1.0X000
PETE GERBER
UNION TRUSTEE1.0X000
STEPHEN PERSON
UNION TRUSTEE1.0X000
REFUGIO PINEDO
UNION TRUSTEE1.0X000
joel rehome
union trustee1.0X000
CHRIS SCHRADER
UNION TRUSTEE1.0X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonBENESYS INCNamePerson

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11050 LAKES DR STE 225AddressLine1
CityWEST COVINACity
StateCAState
ZIP Code917902910ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesCONTRACT ADMIN.DescriptionOfServices
Compensation108000Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYERS CONTRIBUTIONS90009941528204152820
EMPLOYEES SELF-PAYMENTS900099105783105783
CONTRACTORS COVERAGE900099115196115196
COBRA SUBSIDY9000996020260202
FieldValueIRS element (for citing)
Total Program Service Revenue4434001TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column388207TotalRevenueColumn
Exclusion$388,207ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1302648Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1286497Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities16151Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column16151TotalRevenueColumn
Exclusion$16,151ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4838359TotalRevenueColumn
Related Or Exempt Function Income4434001RelatedOrExemptFunctionIncome
Exclusion$404,358ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total4651461Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total108000Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total78583Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total58743Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total22740Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total66575Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total33039Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total372Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total24070Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5043583Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY-30223BOY
EOY-24362EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3352536BOY
EOY3684701EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1196345BOY
EOY345399EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY15887BOY
EOY24278EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY12025182BOY
EOY11742586EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY16559727BOY
EOY15772602EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY52051BOY
EOY67625EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3718758BOY
EOY3073239EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3770809BOY
EOY3140864EOY
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)
BOY12788918BOY
EOY12631738EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12788918BOY
EOY12631738EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16559727BOY
EOY15772602EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-205224ReconcilationRevenueExpenses
Reconcilation Other Changes48044ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
BENEFITS OBLIGATIONS$2,760,600
EMPLOYER REMITTANCE DIFFERENCE$117,556
DUE TO AFFILIATES$195,083
FieldValueIRS element (for citing)
Total Of Amounts3073239TotalOfAmounts
Total Revenue4838359TotalRevenue
Total Expenses5043583TotalExpenses
Excess Or Deficit For Year-205224ExcessOrDeficitForYear
Net Unrealized GL On Investments4851NetUnrealizedGLOnInvestments
Total Adjustments4851TotalAdjustments
Excess Or Deficit Per FS-200373ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt4843210TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments4851NetUnrealizedGainsInvestments
Revenue Not Rptd F9904851RevenueNotRptdF990
Revenue Subtotal4838359RevenueSubtotal
Total Revenue Per Form9904838359TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5043583TotExpensesEtcAuditedFinclStmt
Expenses Subtotal5043583ExpensesSubtotal
Total Expenses Per Form9905043583TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
Identifierpart x, line 2:Identifier
Return ReferenceThe Organization has adopted guidance on accounting for uncertainty inReturnReference
Explanationincome taxes issued by the Financial Accounting Standards Board. Management believes that the Organization has taken no uncertain tax positions that require adjustment to the financial statements to comply with the provisions of this guidance. Certain prior years information returns filed by the Plan are subject to examination by authorities.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation

FieldValueIRS element (for citing)
IdentifierPART I, LINE 1; PART III, LINES 1 AND 4:Identifier
Return ReferenceTHE TILE INDUSTRY HEALTH AND WELFARE FUND IS A MULTIEMPLOYER, DEFINEDReturnReference
ExplanationBENEFIT WELFARE PLAN PROVIDING MEDICAL-HOSPITAL, DENTAL, PRESCRIPTION, VISION, DEATH AND ACCIDENTAL DEATH AND DISMEMBERMENT, AND DISABILITY BENEFITS TO PARTICIPANTS. PART I, LINE 5; PART V LINES 2A AND 2B: THE ORGANIZATION HAS NO STATUTORY EMPLOYEES, HOWEVER, FORMS W-2/W-3 WERE FILED FOR PLAN PARTICIPANTS PAID SELF-FUNDED DISABILITY BENEFITS. PART VI, LINE 11b: THE BOARD OF TRUSTEES REVIEWS THE FORM 990 AND UPON APPROVAL, DESIGNATES AND AUTHORIZES AN INDIVIDUAL TO SIGN THE RETURN. PART VI, LINES 15A AND 15B: MEMBERS OF THE BOARD OF TRUSTEES RECEIVE NO COMPENSATION. THE ORGANIZATION DOES NOT HAVE OTHER OFFICERS OR KEY EMPLOYEES. PART VI, LINE 19: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. PART VI, LINE 12C: The Board of Trustees has adopted a set of policies and procedures to monitor and comply with the conflict of interest policy. part xi, line 5: TRANSFER OF NET ASSETS FROM TERMINATED TILE LAYERS AND TILE FINISHERS VACATION TRUST FUND (THE "VACATION FUND") (E.I.N. 95-6142282). THE FOLLOWING ASSETS, LIABILITIES AND NET ASSETS OF THE VACATION FUND WERE TRANSFERRED TO THE PLAN IN DECEMBER 2011: ASSETS CASH $52,161 LIABILITIES ACCRUED EXPENSES 8,968 NET ASSETS $43,193 UNREALIZED APPRECIATION OF INVESTMENTS 4,851 TOTAL $48,044Explanation

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
TILE INDUSTRY RETIREMENT SAVINGS TR FD
1050 LAKES DR STE 225WEST COVINACA917902910956118656EMP. BEN. PL.CA501(A)N/ANAfalse
TILE LAYERS & TILE FINISHERS VACATION PL
1050 LAKES DR STE 225WEST COVINACA917902910956142282EMP. BEN. PL.CA501(C)(9)N/ANAfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
tile industry retirement savings trust fund
d215000CASH
tile industry retirement savings trust fund
r1222281CASH
TILE LAYERS AND TILE FINISHERS VAC TF
R52161CASH

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierTHE INSTRUCTIONS FOR PREPARING 990 SCHEDULE R ARE UNCLEAR AS TO WHETHERIdentifier
Return ReferenceINFORMATION ABOUT CONTRIBUTING EMPLOYERS, INCLUDING MONTHLY CONTRIBUTIONSReturnReference
Explanationpaid to a multiemployer defined benefit, health and welfare plan, are required to be reported in applicable sections of Schedule R. The Tax Exempt and Government Entities division of the Internal Revenue Service was unable to provide any clarification of this issue. The plan has 110 contributing employers and much of the information required to complete Schedule R is currently not available at the administrative office. The plan would incur significant administrative costs to accumulate this additional information and the prudency of using plan assets to compile this questionable information has not been determined. Therefore, pending clear direction from the Internal Revenue Service, information on contributing employers has not been reported on Schedule R (Form 990).Explanation