LM-2 Form LM-2 Labor Organization Annual Report

U.S. Department of Labor
Employment Standards Administration
Office of Labor-Management Standards
Washington, DC 20210

FORM LM-2 LABOR ORGANIZATION ANNUAL REPORT
MUST BE USED BY LABOR ORGANIZATIONS WITH $250,000 OR MORE IN
TOTAL ANNUAL RECEIPTS AND LABOR ORGANIZATIONS IN TRUSTEESHIP

Form Approved
Office of Management and Budget
No. 1215-0188
Expires: 11-30-2006

This report is mandatory under P.L. 86-257, as amended. Failure to comply may result in criminal prosecution, fines, or civil penalties as provided by 29 U.S.C. 439 or 440.
READ THE INSTRUCTIONS CAREFULLY BEFORE PREPARING THIS REPORT.
For Official Use Only

1. FILE NUMBER

2. PERIOD COVERED
DAY
MO

-

YEAR

From
Through

4. AFFILIATION OR ORGANIZATION NAME

3.

(a) AMENDED - If this is an amended report, check
here:
(b) HARDSHIP - If filing under the hardship
procedures, check here:
(c) TERMINAL - If this is a terminal report, check here:

8. MAILING ADDRESS (Type or print in capital letters)
First Name

5. DESIGNATION (Local, Lodge, etc.)

Last Name

6. DESIGNATION NUMBER
P.O. Box - Building and Room Number

7. UNIT NAME (if any)
Number and Street

9. Are your organization's records kept at its mailing address? (If "No,"
provide address in Item 69.)
Yes

No

City
State

ZIP Code + 4

69. ADDITIONAL INFORMATION (Text entered will appear on last page of form. To enter comments, press the "General Additional Information" button.)

Each of the undersigned, duly authorized officers of the above labor organization, declares, under penalty of perjury and other applicable penalties of law, that all of the information submitted in
this report (including the information contained in any accompanying documents) has been examined by the signatory and is, to the best of the undersigned's knowledge and belief, true, correct,
and complete. (See Section VI on penalties in the instructions.)
70. SIGNED:

71. SIGNED:

Date
Form LM-2 (Revised 2003)

Telephone Number

(If other title, see
instructions.)

Date

(If other title, see
instructions.)
Telephone Number

COMPLETE ITEMS 10 THROUGH 21

FILE NUMBER:

10. During the reporting period did the labor organization create or
participate in the administration of a trust or other fund or organization, as
defined in the instructions, which provides benefits for members or their
beneficiaries?
Yes
No
11. During the reporting period did the labor organization have a political
action committee (PAC) fund?
Yes
No
12. During the reporting period did the labor organization have an audit or
review of its books and records by an outside accountant or by a parent body
auditor/representative?
Yes
No
13. During the reporting period did the labor organization discover any loss
or shortage of funds or other assets? (Answer "Yes" even if there has been
repayment or recovery.)
Yes
No
14. What is the maximum amount recoverable under the labor organization's
fidelity bond for a loss caused by any officer, employee or agent of the labor
organization who handled union funds?
15. During the reporting period did the labor organization acquire or dispose
of any assets in any manner other than by purchase or sale? Yes
No

20. How many members did the labor organization have at
the end of the reporting period? (Total from Line 8 of Schedule 13)
21. What are the labor organization's rates of dues and fees? (Enter a
minimum and maximum if more than one rate applies for any line.)

Rates of Dues and Fees
Dues/Fees

Amount

(a) Regular Dues/Fees

$

(b) Working Dues/Fees

$

(c) Initiation Fees

$

(d) Transfer Fees

$

(e) Work Permits

$

Unit

Minimum

Maximum

per
per
per
per
per

16. Were any of the labor organization's assets pledged as security or
encumbered in any other way at the end of the reporting period?
Yes

No

17. Did the labor organization have any contingent liabilities at the end of
the reporting period?
Yes
No
18. During the reporting period did the labor organization have any changes
in its constitution and bylaws, other than rates of dues and fees, or in
practices/procedures listed in the instructions?
Yes
No
19. What is the date of the labor organization's next regular
election of officers?
If the answer to any of the above questions is "Yes," provide details in Item 69 (Additional Information) as explained in the instructions for each item.
Form LM-2 (Revised 2003)

STATEMENT A - ASSETS AND LIABILITIES

FILE NUMBER:

Complete Schedules 1 Through 20 Before Completing Statement A

ASSETS

Schedule
Number

Start of Reporting Period
(A)

End of Reporting Period
(B)

Start of Reporting Period
(C)

End of Reporting Period
(D)

Assets

22. Cash
23. Accounts Receivable

1

24. Loans Receivable

2

25. U.S. Treasury Securities
26. Investments

5

27. Fixed Assets

6

28. Other Assets

7

Liabilities

29. TOTAL ASSETS

LIABILITIES
30. Accounts Payable

8

31. Loans Payable

9

32. Mortgages Payable
33. Other Liabilities
34. TOTAL LIABILITIES

35. NET ASSETS (Item 29 Less Item 34)
Form LM-2 (Revised 2003)

Schedule
Number

10

STATEMENT B - RECEIPTS AND DISBURSEMENTS

FILE NUMBER:

Complete Schedules 1 Through 20 Before Completing Statement B

Item

CASH RECEIPTS

SCH #

AMOUNT

Item

CASH DISBURSEMENTS

SCH #

36. Dues and Agency Fees

50. Representational Activities

15

37. Per Capita Tax

51. Political Activities and Lobbying

16

38. Fees, Fines, Assessments, Work Permits

52. Contributions, Gifts, and Grants

17

39. Sale of Supplies

53. General Overhead

18

40. Interest

54. Union Administration

19

41. Dividends

55. Benefits

20

42. Rents

56. Per Capita Tax

43. Sale of Investments and Fixed Assets

3

57. Strike Benefits

44. Loans Obtained

9

58. Fees, Fines, Assessments, etc.

45. Repayments of Loans Made

2

59. Supplies for Resale

46. On Behalf of Affiliates for Transmittal to Them

60. Purchase of Investments and Fixed Assets

4

47. From Members for Disbursement on Their Behalf

61. Loans Made

2

62. Repayment of Loans Obtained

9

48. Other Receipts
49. TOTAL RECEIPTS

14

63. To Affiliates of Funds Collected on Their Behalf
64. On Behalf of Individual Members
65. Direct Taxes

66. Subtotal
67. Withholding Taxes and Payroll Deductions
67a. Total Withheld
67b. Less Total Disbursed
67c. Total Withheld But Not Disbursed

68. TOTAL DISBURSEMENTS (Line 66-Line 67c)
Form LM-2 (Revised 2003)

AMOUNT

SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE

Entity or Individual Name
(A)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25. Totals from Continuation pages (if any)
26. Totals of Lines 1 through 25
27. Totals from all other accounts receivable
28. Totals of Lines 26 and 27 (Total from Line 28, Column(B) will be automatically entered in Item 23, Column(B).)
Form LM-2 (Revised 2003)

FILE NUMBER:

Total Account
Receivable
(B)

90-180 Days
Past Due
(C)

180+ Days
Past Due
(D)

Liquidated Account
Receivable
(E)

SCHEDULE 2 - LOANS RECEIVABLE

List below loans to officers, employees, or
members which at any time during the reporting
period exceeded $250 and list all loans to
business enterprises regardless of amount.
(A)

FILE NUMBER:

Loans
Outstanding at
Start of Period
(B)

Repayments Received During Period
Loans Made
During Period
(C)

Cash
(D)(1)

Other Than Cash
(D)(2)

Item 61

Item 45

Item 69
with Explanation

Loans
Outstanding at
End of Period
(E)

1. Name:
Purpose:
Security:
Terms of Repayment:
2. Name:
Purpose:
Security:
Terms of Repayment:
3. Name:
Purpose:
Security:
Terms of Repayment:
4. Totals from Continuation pages (if any)
5. Totals of loans not listed above
6. Totals of Lines 1 through 5
The Totals from Line 6 will be
automatically entered in

Form LM-2 (Revised 2003)

Item 24
Column (A)

Item 24
Column (B)

SCHEDULE 3 - SALE OF INVESTMENTS AND FIXED ASSETS

Description (if land or buildings, give location)
(A)

FILE NUMBER:

Cost
(B)

Book Value
(C)

Gross Sales Price
(D)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12. Totals from Continuation pages (if any)
13. Totals of Lines 1 through 12
14. Less Reinvestments
(The total from Line 15
15. Net Sales
will be automatically
entered in Item 43.)
Form LM-2 (Revised 2003)

Amount Received
(E)

SCHEDULE 4 - PURCHASE OF INVESTMENTS AND FIXED ASSETS

Description (if land or buildings, give location)
(A)

FILE NUMBER:

Cost
(B)

Book Value
(C)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12. Totals from Continuation pages (if any)
13. Totals of Lines 1 through 12
14. Less Reinvestments
(The Total from Line 15
15. Net Purchases
will be automatically
entered in Item 60.)
Form LM-2 (Revised 2003)

Cash Paid
(D)

SCHEDULE 5 - INVESTMENTS

FILE NUMBER:

Description
(A)

Marketable Securities
1. Total Cost
2. Total Book Value
3. List each marketable security which has a book value over $5,000 and exceeds 5% of Line 2.
(a)
(b)
(c)
(d) Total from Continuation pages (if any)

Other Investments
4. Total Cost
5. Total Book Value
6. List each other investment which has a book value over $5,000 and exceeds 5% of Line 5. Also, list each Trust which is an investment.
(a)
(b)
(c)
(d)
(e) Total from Continuation pages (if any)
7. Total of Lines 2 and 5 (The total from Line 7 will be automatically entered in Item 26, Column(B).)
Form LM-2 (Revised 2003)

Amount
(B)

SCHEDULE 6 - FIXED ASSETS

Description
(A)

1. Land (give location)

2. Totals from Continuation pages (if any)

3. Buildings (give location)

4. Totals from Continuation pages (if any)

5. Automobiles and Other Vehicles

6. Office Furniture and Equipment

7. Other Fixed Assets

8. Totals of Lines 1 through 7 (The Total from Line 8, Column(D) will be automatically
entered in Item 27, Column(B).)

Form LM-2 (Revised 2003)

FILE NUMBER:

Cost or Other Basis
(B)

Total Depreciation or
Amount Expensed
(C)

Book Value
(D)

Value
(E)

SCHEDULE 7 - OTHER ASSETS

FILE NUMBER:

Description
(A)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14. Total from Continuation pages (if any)
15. Total of Lines 1 through 14 (The Total from Line 15 will be automatically entered in Item 28, Column(B).)

Form LM-2 (Revised 2003)

Book Value
(B)

SCHEDULE 8 - ACCOUNTS PAYABLE AGING SCHEDULE

Entity or Individual Name
(A)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25. Totals from Continuation pages (if any)
26. Totals of Lines 1 through 25
27. Totals from all other accounts payable
28. Totals of Lines 26 and 27 (Line 28, Column(B) will be automatically entered in Item 30, Column(D).)
Form LM-2 (Revised 2003)

FILE NUMBER:

Total Account
Payable
(B)

90-180 Days
Past Due
(C)

Liquidated
180+ Days Past
Account Payable
Due
(E)
(D)

SCHEDULE 9 - LOANS PAYABLE

Source of Loans Payable at Any
Time During the Reporting Period
(A)

FILE NUMBER:

Loans Owed at
Start of Period
(B)

Loans Obtained
During Period
(C)

Item 31
Column (C)

Item 44

Repayment Made During Period
Cash
(D)(1)

Other Than Cash
(D)(2)

Loans Owed at
End of Period
(E)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12. Totals from Continuation pages (if
any)
13. Totals of Lines 1 through 12
The Totals from Line 13 will be
automatically entered in
Form LM-2 (Revised 2003)

Item 62

Item 69
with Explanation

Item 31
Column (D)

SCHEDULE 10 - OTHER LIABILITIES

FILE NUMBER:

Description
(A)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13. Total from Continuation pages (if any)
14. Total of Lines 1 through 13 (The Total from Line 14 will be automatically entered in Item 33, Column (D).)

Form LM-2 (Revised 2003)

Amount at End of Period
(B)

SCHEDULE 11 — ALL OFFICERS AND DISBURSEMENTS TO OFFICERS

(A)
Name

(B)
Title

(C)
Status

(D)
Gross Salary
Disbursements (before
any deductions)

(E)
Allowances Disbursed

FILE NUMBER:
(F)
Disbursements
for Official Business

(G)
Other Disbursements
not reported in
(D) through (F)

(H)
TOTAL

1A
B
C

I

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbying

%

Schedule 17
Contributions

%

Schedule 18
General Overhead

%

Schedule 19
Administration

%

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbying

%

Schedule 17
Contributions

%

Schedule 18
General Overhead

%

Schedule 19
Administration

%

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbying

%

Schedule 17
Contributions

%

Schedule 18
General Overhead

%

Schedule 19
Administration

%

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbying

%

Schedule 17
Contributions

%

Schedule 18
General Overhead

%

Schedule 19
Administration

%

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbying

%

Schedule 17
Contributions

%

Schedule 18
General Overhead

%

Schedule 19
Administration

%

2A
B
C

I
3A
B
C

I
4A
B
C

I
5A
B
C

I

6. TOTALS FROM CONTINUATION PAGES (if any)
7. TOTAL OF LINES 1-6
8. LESS DEDUCTIONS
9. NET DISBURSEMENTS

Form LM-2 (Revised 2003)

SCHEDULE 12 — DISBURSEMENTS TO EMPLOYEES

(A)
Name

(B)
Title

(C)
Other Payer

FILE NUMBER:

(D)
Gross Salary
Disbursements (before
any deductions)

(E)
Allowances Disbursed

(F)
Disbursements
for Official Business

(G)
Other Disbursements
not reported in
(D) through (F)

(H)
TOTAL

1A
B
C

I

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbying

%

Schedule 17
Contributions

%

Schedule 18
General Overhead

%

Schedule 19
Administration

%

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbying

%

Schedule 17
Contributions

%

Schedule 18
General Overhead

%

Schedule 19
Administration

%

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbying

%

Schedule 17
Contributions

%

Schedule 18
General Overhead

%

Schedule 19
Administration

%

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbyings

%

Schedule 17
Contributions

%

Schedule 18
General Overhead

%

Schedule 19
Administration

%

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbying

%

Schedule 17
Contributions

%

Schedule 18
General Overhead

%

Schedule 19
Administration

%

%

Schedule 17
Contributions

%

Schedule 18
General Overhead

%

Schedule 19
Administration

%

2A
B
C

I
3A
B
C

I
4A
B
C

I
5A
B
C

I

6. TOTAL RECEIVED BY ALL OTHER EMPLOYEES MAKING $10,000 OR LESS
I

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbying

7. TOTALS FROM CONTINUATION PAGES (if any)
8. TOTAL OF LINES 1-7
9. LESS DEDUCTIONS
10. NET DISBURSEMENTS
Form LM-2 (Revised 2003)

SCHEDULE 13 - MEMBERSHIP STATUS

Category of Membership
(A)

FILE NUMBER:

Number
(B)

Voting Eligibility
(C)

1.

Yes

2.

Yes

3.

Yes

4.

Yes

5.

Yes

6.

Yes

7. Total from Continuation page(s)

8. Members (Total of Lines 1 through 7; Enter the Total from Line 8 in Item 20.)

9. Agency Fee Payers*

10. Total Members/Fee Payers (Total of Lines 8 and 9)
*Agency Fee Payers are not considered members of the labor organization.

Form LM-2 (Revised 2003)

DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19

FILE NUMBER:

Complete Itemization Pages BEFORE the Detailed Summary Page
1. Named Payer Itemized Receipts

1. Named Payee Itemized Disbursements

2. Named Payer Non-itemized Receipts

SCHEDULE 14
OTHER RECEIPTS

SCHEDULE 17

3. All Other Receipts
4. Total Receipts (add Lines 1 through 3)

Item
48

2. Named Payee Non-itemized Disbursements
3. To Officers

CONTRIBUTIONS, 4. To Employees
GIFTS, AND
5. All Other Disbursements
GRANTS
6.Total Disbursements (add Lines 1 through 5)

SCHEDULE 15
REPRESENTATIONAL
ACTIVITIES

1. Named Payee Itemized Disbursements

1. Named Payee Itemized Disbursements

2. Named Payee Non-itemized Disbursements

2. Named Payee Non-itemized Disbursements

3. To Officers
4. To Employees
5. All Other Disbursements
6. Total Disbursements (add Lines 1 through 5)

SCHEDULE 16
POLITICAL
ACTIVITIES AND
LOBBYING

SCHEDULE 18

3. To Officers

GENERAL
OVERHEAD

4. To Employees

Item
50

5. All Other Disbursements
6.Total Disbursements(add Lines 1 through 5)

1. Named Payee Itemized Disbursements

1. Named Payee Itemized Disbursements

2. Named Payee Non-itemized Disbursements

2. Named Payee Non-itemized Disbursements

3. To Officers

SCHEDULE 19

4. To Employees

4. To Employees
UNION
ADMINISTRATION 5. All Other Disbursements

5. All Other Disbursements
6.Total Disbursements (add Lines 1 through 5)

Form LM-2 (Revised 2003)

Item
51

Item
52

Item
53

3. To Officers

6.Total Disbursements (add Lines 1 through 5)

Item
54

FILE NUMBER:

SCHEDULE 14 - OTHER RECEIPTS

Complete Itemization Pages BEFORE the Detailed Summary Page
Name and Address
(A)

Purpose
(C)

Date
(D)

(B) Type or Classification

(F) Total of Transactions Listed Above
(G) Total of All Transactions from Continuation Pages with this Payee/Payer
(H) Total of All Itemized Transactions with this Payee/Payer (Sum of (F) and (G))
(I) Total of All Non-Itemized Transactions with this Payee/Payer
(J) Total of All Transactions with This Payee/Payer for This Schedule (Sum of (H) and (I))
Form LM-2 (Revised 2003)

Amount
(E)

SCHEDULE 15 – REPRESENTATIONAL ACTIVITIES

FILE NUMBER:
Schedule

Page Number

Total Number of Additional Pages

Complete Itemization Pages BEFORE the Detailed Summary Page
Name and Address
(A)

Purpose
(C)

Date
(D)

(B) Type or Classification

(F) Total of Transactions Listed Above
(G) Total of All Transactions from Continuation Pages with this Payee/Payer
(H) Total of All Itemized Transactions with this Payee/Payer (Sum of (F) and (G))
(I) Total of All Non-Itemized Transactions with this Payee/Payer
(J) Total of All Transactions with This Payee/Payer for This Schedule (Sum of (H) and (I))

Form LM-2 (Revised 2003)

Amount
(E)

FILE NUMBER:

SCHEDULE — 16 - POLITICAL ACTIVITIES AND LOBBYING

Complete Itemization Pages BEFORE the Detailed Summary Page
Name and
Address
(A) NAME AND
ADDRESS
(A)

Purpose
(C) PURPOSE
(C)

Date
(D) DATE
(D)

(B) Type or Classification

(F) Total of Transactions Listed Above
(G) Total of All Transactions from Continuation Pages with this Payee/Payer
(H) Total of All Itemized Transactions with this Payee/Payer (Sum of (F) and (G))
(I) Total of All Non-Itemized Transactions with this Payee/Payer
(J) Total of All Transactions with This Payee/Payer for This Schedule (Sum of (H) and (I))
Form LM-2 (Revised 2003)

Amount
(E) AMOUNT
(E)

SCHEDULE 17 — CONTRIBUTIONS, GIFTS & GRANTS

FILE NUMBER:
Schedule

Complete Itemization Pages BEFORE the Detailed Summary Page
Name and Address
(A)

Purpose
(C)

Date
(D)

(B) Type or Classification

(F) Total of Transactions Listed Above
(G) Total of All Transactions from Continuation Pages with this Payee/Payer
(H) Total of All Itemized Transactions with this Payee/Payer (Sum of (F) and (G))
(I) Total of All Non-Itemized Transactions with this Payee/Payer
(J) Total of All Transactions with This Payee/Payer for This Schedule (Sum of (H) and (I))
Form LM-2 (Revised 2003)

Amount
(E)

FILE NUMBER:

SCHEDULE 18 — GENERAL OVERHEAD
Schedule

Complete Itemization Pages BEFORE the Detailed Summary Page
Name and Address
(A)

Purpose
(C)

Date
(D)

(B) Type or Classification

(F) Total of Transactions Listed Above
(G) Total of All Transactions from Continuation Pages with this Payee/Payer
(H) Total of All Itemized Transactions with this Payee/Payer (Sum of (F) and (G))
(I) Total of All Non-Itemized Transactions with this Payee/Payer
(J) Total of All Transactions with This Payee/Payer for This Schedule (Sum of (H) and (I))
Form LM-2 (Revised 2003)

Amount
(E)

SCHEDULE 19 — UNION ADMINISTRATION

FILE NUMBER:
Schedule

Complete Itemization Pages BEFORE the Detailed Summary Page
Name and Address
(A)

Purpose
(C)

Date
(D)

(B) Type or Classification

(F) Total of Transactions Listed Above
(G) Total of All Transactions from Continuation Pages with this Payee/Payer
(H) Total of All Itemized Transactions with this Payee/Payer (Sum of (F) and (G))
(I) Total of All Non-Itemized Transactions with this Payee/Payer
(J) Total of All Transactions with This Payee/Payer for This Schedule (Sum of (H) and (I))
Form LM-2 (Revised 2003)

Amount
(E)

SCHEDULE 20 — BENEFITS

FILE NUMBER:

Description
(A)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22. Total of Continuation pages (if any)
23. Total of Lines 1 through 22 (The Total from Line 23 will be automatically entered in Item 55.)

Form LM-2 (Revised 2003)

To Whom Paid
(B)

Amount
(C)

69. ADDITIONAL INFORMATION SUMMARY

Form LM-2 (Revised 2003)

FILE NUMBER:

SIGNATURE PAGE

FILE NUMBER:

Each of the undersigned, duly authorized officers of the above labor organization, declares, under penalty of perjury and other applicable law, that all of the information
submitted in this report (including the information contained in any accompanying documents) has been examined by the signatory and is, to the best of the
undersigned's knowledge and belief, true, correct, and complete. (See Section VI on penalties in the instructions.)

SIGNED:

SIGNED:

DATE:

DATE:

TELEPHONE:

TELEPHONE:

TITLE:

TITLE:

Form LM-2 (Revised 2003)