2012-11-14T12:34:02-06:00 2011-12-31 910189318 MOSS ADAMS LLP 805 SW BROADWAY 1200 PORTLAND OR 97205 990 2011-01-01 943067499 DAIMLER TRUCKS NA LLC EMPLOYEE BENEFIT BASIC TRUST DAIM 5037456179 2701 NW VAUGHN ST NO 900 PORTLAND OR 97210 MICHAEL KURUC 5037456179 2012-11-12 1 WENDY CAMPOS P00448102 5032421447 2011 2016-02-24 21:20:13Z MICHAEL KURUC 2701 NW VAUGHN ST NO 900 PORTLAND OR 97210 35310270 0 X N/A X 1981 OR VEBA TRUST FOR THE PAYMENT OF BENEFITS FOR MEMBERS. 7 7 0 15 0 0 0 0 36761764 35305876 17786 4394 0 0 36779550 35310270 0 0 29658911 33836846 0 0 0 0 0 6510339 1852522 36169250 35689368 610300 -379098 14351036 14003357 1075 32494 14349961 13970863 VEBA TRUST FOR THE PAYMENT OF BENEFITS FOR MEMBERS. 0 0 PROVIDED MEDICAL AND SICK PAY COVERAGE FOR ACTIVE EMPLOYEES. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 X 7 7 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X ERIK LINVOG 5037458479 2701 NW VAUGHN ST SUITE 900 PORTLAND OR 97210 X JUERGEN KRITSCHGAU 0.50 X X 0 0 0 BRIAN BURTON 0.50 X 0 0 0 JOHN O'LEARY 0.50 X 0 0 0 DAVID SWAINSON 0.50 X 0 0 0 ROGER NIELSEN 0.50 X 0 0 0 KELLEY PLATT 0.50 X 0 0 0 BOB ROBERTSON 0.50 X 0 0 0 PAUL HURD 0.50 X 0 0 0 0 0 0 0 0 0 0 BLUE CROSS BLUE SHIELD 600 E LAFAYETTE BLVD DETROIT MI 48226 CONTRACT ADMINISTRATOR 1357761 ADP 2835 S DECKER LAKE DR SALT LAKE CITY UT 84119 CONTRACT ADMINISTRATOR 321509 2 CONTRIBUTIONS 525100 35305876 35305876 35305876 3521 3521 873 0 873 873 873 35310270 35305876 0 4394 33836846 18295 1834227 35689368 14350100 14003352 936 5 14351036 14003357 1075 32494 1075 32494 X 14349961 13970863 0 0 0 0 14349961 13970863 14351036 14003357 -379098 0 X 0 1 1 X 0 0 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE PLAN IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. THE PLAN EVALUATES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC 450-10-05 - ACCOUNTING FOR CONTINGENCIES, WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2011 AND 2010, THE PLAN HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. FORM 990, PART VI, SECTION A, LINE 2 JUERGEN KRITSCHGAU IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. BRIAN BURTON IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. JOHN O'LEARY IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. DAVID SWAINSON IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. ROGER NIELSEN IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. KELLEY PLATT IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. BOB ROBERTSON IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. PAUL HURD IS RELATED TO ALL OTHER MEMBERS OF THE INVESTMENT COMMITTEE THROUGH A BUSINESS RELATIONSHIP. ALL INVESTMENT COMMITTEE MEMBERS ARE EMPLOYED BY DAIMLER TRUCKS NORTH AMERICA, THE SPONSOR OF THE BENEFIT PLAN AND TRUST. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE CORPORATE TAX DIRECTOR AND THE PLAN ADMINISTRATOR PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 15A & LINE 15B: THE ORGANIZATION DOES NOT COMPENSATE INTERESTED PERSONS. THEREFORE, THE ORGANIZATION DOES NOT HAVE A PROCESS IN PLACE FOR DETERMINING AND REVIEWING COMPENSATION. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION RELIES ON THE SARBANES-OXLEY ACT, INTERNAL CONTROLS, AND OUTSIDE AUDITS TO ENSURE THAT THE CONFLICT OF INTEREST POLICY IS ENFORCED. 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OR 501 (C) (9) DAIMLER TRUCKS NORTH AMERICA 0 DTNA PORTLAND SHOP EMPLOYEE BENEFIT TRUST 2701 NW VAUGHN ST SUITE 900 PORTLAND OR 97210 931207916 VEBA TRUST FOR THE PAYMENT OF BENEFITS FOR MEMBERS. OR 501 (C) (9) DAIMLER TRUCKS NORTH AMERICA 0 MT HOLLY SHOP UAW RETIREE MEDICAL PREMIUM TRUST 2701 NW VAUGHN ST SUITE 900 PORTLAND OR 97210 931207918 VEBA TRUST FOR THE PAYMENT OF BENEFITS FOR MEMBERS. OR 501 (C) (9) DAIMLER TRUCKS NORTH AMERICA 0 DAIMLER TRUCKS NORTH AMERICA LLC 2701 NW VAUGHN ST SUITE 900 PORTLAND OR 97210 930790608 VEHICLE MANUFACTURER OR N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 DAIMLER TRUCKS NORTH AMERICA LLC R 26017260 EMPLOYER CONTRIBUTIONS - FMV