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

Form Approved
Office of Management and Budget
No. 0000-0000
Expires: 00-00-0000

MUST BE USED BY LABOR ORGANIZATIONS WITH $250,000 OR MORE IN TOTAL
ANNUAL RECEIPTS AND LABOR ORGANIZATIONS IN TRUSTEESHIP
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
From

000-000

E

YEAR

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:

PRESIDENT

Date
Form LM- 2 (Revised 2008)

Telephone Number

(If other title, see
instructions.)

71. SIGNED:

TREASURER
(If other title, see
instructions.)
Date

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

000-000

20. How many members did the labor organization have at
the end of the reporting period? (Total from Line 8 of Schedule 13)

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

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

Unit

Minimum

Maximum

(a) Regular

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

per
(b) Working
per

No

(c) Initiation Fees

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?

per
(d) Transfer Fees
per

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

(e) Work Permits
per
No

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

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

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 2008)

STATEMENT A - ASSETS AND LIABILITIES

FILE NUMBER:

000-000

Complete Schedules 1 Through 29 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

Number

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 2008)

Schedule

10

STATEMENT B – RECEIPTS AND DISBURSEMENTS

FILE NUMBER:

000-000

Complete Schedules 1 Through 29 Before Completing Statement B

Item

CASH RECEIPTS

SCH #

AMOUNT

Item

CASH DISBURSEMENTS

SCH #

36. Dues and Agency Fees

14

50. Representational Activities

24

37. Per Capita Tax

15

51. Political Activities and Lobbying

25

38. Fees, Fines, Assessments, Work Permits

16

52. Contributions, Gifts, and Grants

26

39. Sale of Supplies

17

53. General Overhead

27

40. Interest

18

54. Union Administration

28

41. Dividends

19

55. Benefits

29

42. Rents

20

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

21

60. Purchase of Investments and Fixed Assets

4

47. From Members for Disbursement on Their Behalf

22

61. Loans Made

2

48. Other Receipts

23

62. Repayment of Loans Obtained

9

49. TOTAL RECEIPTS

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

66. Subtotal
67. Withholding Taxes and Other 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 2008)

AMOUNT

DETAILED SUMMARY PAGE – SALES & PURCHASES SCHEDULES 3 & 4
Complete Schedules 3 and 4 Before Completing Statement B

SCHEDULE 3 - SALE OF INVESTMENTS AND FIXED ASSETS
(1) Total of All Itemized Transactions With All Named Purchasers
(2) Total of All Non-Itemized Transactions With All Named Purchasers
(3) Total of All Other Sales of Investments and Fixed Assets
(4) Total
(5) Less Reinvestments
(6) Net Received from Sales

SCHEDULE 4 - PURCHASE OF INVESTMENTS AND FIXED ASSETS
(1) Total of All Itemized Transactions With All Named Sellers
(2) Total of All Non-Itemized Transactions With All Named Sellers
(3) Total of All Other Sales of Investments and Fixed Assets
(4) Total
(5) Less Reinvestments
(6) Net Purchases

Form LM- 2 (Revised 2008)

FILE NUMBER:

000-000

DETAILED SUMMARY PAGE – RECEIPT SCHEDULES 14 – 23

FILE NUMBER:

000-000

Complete Schedules 14 Through 23 Before Completing Statement B
1. Named Payer Itemized Receipts

SCHEDULE 14

1. Named Payer Itemized Receipts

SCHEDULE 19

2. Named Payer Non-itemized Receipts
3. All Other Receipts

Dues and Agency Fees

SCHEDULE 15

4. Total Receipts (add Lines 1 through 3)

3. All Other Receipts

ITEM
36

Dividends

1. Named Payer Itemized Receipts

SCHEDULE 20

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

ITEM
37

Rents

SCHEDULE 21

2. Named Payer Non-itemized Receipts

4. Total Receipts (add Lines 1 through 3)

ITEM
38

Behalf of Affiliates

SCHEDULE 22

2. Named Payer Non-itemized Receipts

4. Total Receipts (add Lines 1 through 3)

ITEM
39

Members Behalf

SCHEDULE 23

2. Named Payer Non-itemized Receipts

Form LM- 2 (Revised 2008)

4. Total Receipts (add Lines 1 through 3)

4. Total Receipts (add Lines 1 through 3)

ITEM
46

2. Named Payer Non-itemized Receipts

4. Total Receipts (add Lines 1 through 3)

ITEM
47

1. Named Payer Itemized Receipts

3. All Other Receipts

Interest

2. Named Payer Non-itemized Receipts

3. All Other Receipts

1. Named Payer Itemized Receipts

SCHEDULE 18

ITEM
42

1. Named Payer Itemized Receipts

3. All Other Receipts

Sales of Supplies

4. Total Receipts (add Lines 1 through 3)

3. All Other Receipts

1. Named Payer Itemized Receipts

SCHEDULE 17

2. Named Payer Non-itemized Receipts

1. Named Payer Itemized Receipts

3. All Other Receipts

Fees, Fines, Permits

ITEM
41

3. All Other Receipts

1. Named Payer Itemized Receipts

SCHEDULE 16

4. Total Receipts (add Lines 1 through 3)

1. Named Payer Itemized Receipts

2. Named Payer Non-itemized Receipts

Per Capita Tax

2. Named Payer Non-itemized Receipts

2. Named Payer Non-itemized Receipts
3. All Other Receipts

ITEM
40

Other Receipts

4. Total Receipts (add Lines 1 through 3)

ITEM
48

DETAILED SUMMARY PAGE – DISBURSEMENTS SCHEDULES 24 – 28

FILE NUMBER:

000-000

Complete Schedules 24 Through 28 Before Completing Statement B
1. Named Payee Itemized Disbursements

SCHEDULE 24

Representational
Activities

1. Named Payee Itemized Disbursements

SCHEDULE 27

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

3. To Officers

4. To Employees

4. To Employees

5. All Other Disbursements

5. All Other Disbursements

6. Total Disbursements (add lines 1 through 5)

Item
50

General Overhead

1. Named Payee Itemized Disbursements

SCHEDULE 25

Political Activities and
Lobbying

SCHEDULE 28

2. Named Payee Non-itemized Disbursements

3. To Officers

4. To Employees

4. To Employees

5. All Other Disbursements

5. All Other Disbursements

6. Total Disbursements (add lines 1 through 5)

Item
51

2. Named Payee Non-itemized Disbursements

4. To Employees
5. All Other Disbursements

Form LM- 2 (Revised 2008)

6. Total Disbursements (add lines 1 through 5)

Item
53

2. Named Payee Non-itemized Disbursements

3. To Officers

3. To Officers

Contributions, Gifts,
and Grants

6. Total Disbursements (add lines 1 through 5)

1. Named Payee Itemized Disbursements

1. Named Payee Itemized Disbursements

SCHEDULE 26

2. Named Payee Non-itemized Disbursements

Item
52

Union Administration

6. Total Disbursements (add lines 1 through 5)

Item
54

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 2008)

FILE NUMBER:

Total Account
Receivable
(B)

90-180 Days
Past Due
(C)

180+ Days
Past Due
(D)

000-000

Liquidated Account
Receivable
(E)

FILE NUMBER:

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)

000-000

Repayments Received During Period
Loans Made
During Period
(C)

Loans Outstanding
at Start of Period
(B)

Cash
(D)(1)

Other Than Cash
(D)(2)

Item 45

Item 69
with Explanation

Loans Outstanding at
End of Period
(E)

1. NamePurposeSecurity:
Terms of Repayment-

2. NamePurpose:
SecurityTerms of Repayment3. NamePurpose:
Security:
Terms of Repayment4. Totals from Continuation pages (if any)

$

$0

$

$0

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 2008)

Item 24
Column (A)

Item 61

Item 24
Column (B)

SCHEDULE 3 – SALE OF INVESTMENTS AND FIXED ASSETS

FILE NUMBER:

000-000

Complete Itemization Pages BEFORE the Detailed Summary Page

Name and Address
(A)

Description (if land or building give location)
(B)

Date
(C)

Cost
(D)

(H) Total of Transactions Listed Above
(I) Total of All Transactions from Continuation Pages with this Purchaser
(J) Total of All Itemized Transactions with this Purchaser (Sum of (H) and (I))
(K) Total of All Non-Itemized Transactions with this Purchaser
(L) Total of All Transactions with This Purchaser for this Schedule (Sum of (J) and (K))

Form LM- 2 (Revised 2008)

Book Value
(E)

Gross Sales
Price
(F)

Amount
Received
(G)

SCHEDULE 4 – PURCHASE OF INVESTMENTS AND FIXED ASSETS

000-000

FILE NUMBER:

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

Description (if land or building give location)
(B)

Date
(C)

Cost
(D)

Amount Paid
(F)

Book Value
(E)

`

(G) Total of Transactions Listed Above
(H) Total of All Transactions from Continuation Pages with this Seller
(I) Total of All Itemized Transactions with this Seller (Sum of (G) and (H))
(J) Total of All Non-Itemized Transactions with this Seller
(K) Total of All Transactions with this Seller for this Schedule (Sum of (I) and (J))

Form LM- 2 (Revised 2008)

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 2008)

000-000

Amount
(B)

FILE NUMBER:

SCHEDULE 6 - FIXED ASSETS

Description

Cost or Other
Basis

(A)

(B)

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 2008)

Total Depreciation or
Amount Expensed
(C)

000-000

Book Value

Value

(D)

(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 2008)

000-000

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 2008)

FILE NUMBER:

Total Account
Payable
(B)

90-180 Days
Past Due
(C)

180+ Days
Past Due
(D)

000-000

Liquidated
Account Payable
(E)

FILE NUMBER:

SCHEDULE 9 – LOANS PAYABLE

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

Loans Owed at
Start of Period
(B)

Loans Obtained
During Period
(C)

Item 31
Column (C)

Item 44

Repayment Made During Period
Cash
Other Than Cash
(D)(1)
(D)(2)

000-000

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 2008)

Item 62

Item 69
with Explanation

Item 31
Column (D)

SCHEDULE 10 - OTHER LIABILITIES

FILE NUMBER:

Description
(A)

000-106

Amount at End of Period
(B)

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 2008)

Page 14 of 26

SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS
(A)* Name
1

(B)* Title

(E)

(F)

(G)

Other Disbursements
not Reported in (D)
through (G)
(H)

Total
(I)

Schedule 24
Representational
Activities ___%

Schedule 25 Political Activities and
Lobbying ___%

Schedule 26
Contributions
___%

Schedule 27 General
Overhead ___%

Schedule 28 Union
Administration ___%

Schedule 24
Representational
Activities ___%

Schedule 25 Political Activities and
Lobbying ___%

Schedule 26
Contributions
___%

Schedule 27 General
Overhead ___%

Schedule 28 Union
Administration ___%

Schedule 24
Representational
Activities ___%

Schedule 25 Political Activities and
Lobbying ___%

Schedule 26
Contributions
___%

Schedule 27 General
Overhead ___%

Schedule 28 Union
Administration ___%

Schedule 24
Representational
Activities ___%

Schedule 25 Political Activities and
Lobbying ___%

Schedule 26
Contributions
___%

Schedule 27 General
Overhead ___%

Schedule 28 Union
Administration ___%

Schedule 24
Representational
Activities ___%

Schedule 25 Political Activities and
Lobbying ___%

Schedule 26
Contributions
___%

Schedule 27 General
Overhead ___%

Schedule 28 Union
Administration ___%

A*
B*
C*
J*

5

Disbursements for
Official Business

A*
B*
C*
J*

4

Benefits

A*
B*
C*
J*

3

Allowances
Disbursed

000-000

A*
B*
C*
J*

2

(C)* Status

Gross Salary
Disbursements
(before any
deductions)
(D)

FILE NUMBER:

A*
B*
C*
J*

6. Totals from continuation pages (if any)
7. Total of Lines 1-6
8. Less deductions
9. Net disbursements
*(A) Enter the full name in the following format: Last Name, First Name, Middle Initial. List all persons who held office during the reporting period even if they received no salary or other disbursements. *(B) Enter
officer title, e.g., PRESIDENT or TREASURER. *(C) Code for Status: past officer - P; continuing officer - C; new officer during reporting period - N. (If any officer was not elected at a regular election in accordance
with the labor organization's constitution and bylaws, explain in Item 69.) *(J) Enter the PERCENTAGE (A%) of time officer worked on activities covered in the corresponding Schedules 24-28.
Form LM- 2 (Revised 2008)

SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES

(A) Name

1

(B) Title

(C) Other
Payer

(D) Gross Salary Disbursements
(before any deductions)

FILE NUMBER:

(E) Allowances
Disbursed

(F) Benefits

(G) Disbursements for
Official Business

(H) Other
Disbursements not
Reported in (D)
through (G)

000-000

(I) Total

A*
B*
C*
J*

2

Schedule 24 Representational Activities
___%

Schedule 25 Political Activities and
Lobbying ___%

Schedule 26
Contributions ___%

Schedule 27 General
Overhead ___%

Schedule 28 Union
Administration ___%

Schedule 24 Representational Activities
___%

Schedule 25 Political Activities and
Lobbying ___%

Schedule 26
Contributions ___%

Schedule 27 General
Overhead ___%

Schedule 28 Union
Administration ___%

Schedule 24 Representational Activities
___%

Schedule 25 Political Activities and
Lobbying ___%

Schedule 26
Contributions ___%

Schedule 27 General
Overhead ___%

Schedule 28 Union
Administration ___%

Schedule 24 Representational Activities
___%

Schedule 25 Political Activities and
Lobbying ___%

Schedule 26
Contributions ___%

Schedule 27 General
Overhead ___%

Schedule 28 Union
Administration ___%

Schedule 24 Representational Activities
___%

Schedule 25 Political Activities and
Lobbying ___%

Schedule 26
Contributions ___%

Schedule 27 General
Overhead ___%

Schedule 28 Union
Administration ___%

Schedule 24 Representational Activities
___%

Schedule 25 Political Activities and
Lobbying ___%

Schedule 26
Contributions ___%

Schedule 27 General
Overhead ___%

Schedule 28 Union
Administration ___%

A*
B*
C*
J*

3

A*
B*
C*
J*

4

A*
B*
C*
J*

5

A*
B*
C*
J*

6

A*

ALL OTHER EMPLOYEES

J*
7. Totals from continuation pages (if any)
8. Total of Lines 1-6
9. Less deductions
10. Net disbursements
Form LM- 2 (Revised 2008)

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)

9. Agency Fee Payers*

1 0. 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 2008)

000-000

FILE NUMBER:

000-000

ITEMIZATION PAGE FOR RECEIPTS/DISBURSEMENT SCHEDULES 14 -28

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 2008)

Amount
(E)

SCHEDULE 29 – 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 2008)

To Whom Paid
(B)

000-000

Amount
(C)

69. ADDITIONAL INFORMATION SUMMARY

Form LM- 2 (Revised 2008)

FILE NUMBER:

000-000