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pdfPublic reporting burden for this collection of information is estimated to average 35 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. Persons are not required to respond to the collection of information unless it displays a valid OMB control
number. Reporting of this information is mandatory and is required by the Labor-Management Reporting and Disclosure Act of 1959, as
amended (LMRDA), for the purpose of public disclosure. As this is public information, there are no assurances of confidentiality. If you
have any comments regarding this estimate or any other aspect of this information collection, including suggestions for reducing this
burden, please send them to the U.S. Department of Labor, Office of Labor- Management Standards, Division of Interpretations and
Standards, Room N-5609, 200 Constitution Avenue, NW, Washington, DC 20210.
DO NOT SEND YOUR COMPLETED FORM LM-21 TO THE ABOVE ADDRESS.
INSTRUCTIONS FOR FORM LM-21
RECEIPTS AND DISBURSEMENTS REPORT
GENERAL INSTRUCTIONS
I.
WHY FILE
only when he/she performs the activities but also when
he/she agrees to perform the activities or to have them
performed.
The Labor-Management Reporting and Disclosure Act of
1959, as amended (LMRDA), requires public disclosure
of agreements or arrangements made between any
person, including labor relations consultants and other
individuals and organizations, and an employer to
undertake certain activities concerning employees or
labor organizations. Pursuant to Section 203(b) of the
LMRDA, every person who undertakes any such activity
under an agreement or arrangement with an employer
must file with the Secretary of Labor a detailed report of
receipts and disbursements annually for each fiscal year
during which payments were made as a result of any
such agreement or arrangement. The Secretary, under
the authority of the LMRDA, has prescribed the filing of
the Receipts and Disbursements Report, Form LM-21, to
satisfy this reporting requirement.
A “direct or indirect party” to an agreement or
arrangement includes (1) persons who have secured the
services of another or of others in connection with an
agreement or arrangement of the type referred to in
Section 203(b) of the LMRDA, and (2) persons who have
undertaken activities at the behest of another or of others
with knowledge or reason to believe that they are
undertaken as a result of an agreement or arrangement
between an employer and any other person. However,
bona fide regular officers, supervisors, or employees of
an employer are exempt from this reporting requirement
to the extent that the services they undertook to perform
were undertaken as such bona fide regular officers,
supervisors, or employees of their employer.
These reporting requirements of the LMRDA and of the
regulations and forms issued under the Act only relate to
the disclosure of specific agreements, arrangements,
and/or activities. The reporting requirements do not
address whether such agreements, arrangements, or
activities are lawful or unlawful. The fact that a particular
agreement, arrangement or activity is or is not required
to be reported does or does not indicate whether it is or
is not subject to any legal prohibition.
NOTE: Selected definitions from the LMRDA follow
these instructions.
III. WHAT MUST BE REPORTED
The information required to be reported in Form LM-21,
as set forth in the form and instructions, includes (1)
receipts of any kind received directly or indirectly from
employers on account of labor relations advice or
services, and (2) disbursements of any kind made
directly or indirectly in connections with such services for
each fiscal year during which payments were made or
received as a result of an agreement or arrangement to
undertake activities of the type described in LMRDA
Section 203(b).
II. WHO MUST FILE
Any person who, as a direct or indirect party to any
agreement or arrangement with an employer to
undertake activities of the type described in Section
203(b) of the Act, must file a Form LM-21 for any fiscal
year during which a payment was made or received as a
result of the agreement or arrangement. A “person” is
defined by LMRDA Section 3(d) to include, among
others, labor relations consultants and other individuals
and organizations. A person “undertakes” activities not
Any person required to file Form LM-21 must also file a
Form LM-20, Agreement and Activities Report. You
must file Form LM-20 within 30 days after entering into
any such agreement or arrangement.
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The reporting individual(s), and the reporting
organization, if any, are also subject to civil prosecution
for violations of the filing requirements. Section 210 of
the LMRDA provides that, “whenever it shall appear that
any person has violated or is about to violate any of the
provisions of this title, the Secretary may bring a civil
action for such relief (including injunctions) as may be
appropriate.”
IV. WHO MUST SIGN THE REPORT
Both the president and the treasurer, or the
corresponding principal officers, of the reporting
organization must sign the completed Form LM-21. A
report from a sole proprietor or an individual on his/her
own behalf need only bear one signature.
V. WHEN TO FILE
VIII. RECORDKEEPING
Each person who has made or received payments as a
direct or indirect party to an agreement or arrangement
described in the form and instruction must file Form LM21 within 90 days after the end of the filer’s fiscal year.
The individuals required to file Form LM-21 are
responsible for maintaining records which will provide in
sufficient detail the information and data necessary to
verify the accuracy and completeness of the report. You
must retain the records for at least 5 years after the date
you filed the report. You must retain any record
necessary to verify, explain, or clarify the report,
including, but not limited to, vouchers, worksheets,
receipts, and applicable resolutions.
VI. WHERE TO FILE
The completed Form LM-21 and any required
attachments and additional pages must be mailed to the
following address:
U.S. Department of Labor
Office of Labor-Management Standards
200 Constitution Avenue, NW, Room N-5616
Washington, DC 20210
IX. COMPLETING FORM LM-21
Read the instruction carefully before completing Form
LM-21.
Information Entry. Entries on the report should be
typed or clearly printed in black ink. Do not use a pencil
or any other color ink.
VII. PUBLIC DISCLOSURE
Pursuant to the LMRDA, the U.S. Department of Labor is
required to make all submitted reports available for
public inspection. You may examine Form LM-21 reports
at, and purchase copies from, the OLMS Public
Disclosure Room at the address listed in Section VI, or at
the OLMS field office in whose jurisdiction the reporting
organization is located. At the end of these
instructions is a list of OLMS field offices.
Entering Dollars. In all Items dealing with monetary
values, report amounts in dollars only; do not enter
cents. Round cents to the nearest dollar. Enter a single
“0” in the boxes for reporting dollars if you have nothing
to report.
Additional Pages. If you need additional space to
complete an item, enter the additional information on
separate letter-size (8.5 x 11) page(s), indicating the
number of the item to which the information applies. Print
clearly at the top of each attached page the
following information: (1) full name of the reporting
person or organization, (2) its 5-digit file number as
reported in Item 1, if available; and (3) the ending date of
the reporting period as reported in Item 2. All
attachments must be labeled sequentially 1 of ___, 2 of
, etc.
Also, in the Internet Public Disclosure Room at
http://www.unionreports.gov, you may view and print
copies of receipts and disbursements reports, beginning
with the year 2000. You may also purchase copies of
receipts and disbursements reports from the Internet
Public Disclosure Room for 15 cents per page.
Requests for 30 or fewer pages are provided free of
charge.
VIII. RESPONSIBILITIES AND PENALTIES
The individual(s) required to sign Form LM-21 are
personally responsible for its filing and accuracy. Under
the LMRDA, these individuals are subject to criminal
penalties for willful failure to file a required report and/or
for false reporting. False reporting includes making any
false statement or misrepresentation of a material fact
while knowing it to be false, or for knowingly failing to
disclose a material fact in a required report or in the
information required to be contained in it or in any
information required to be submitted with it.
1. FILE NUMBER—Enter the five-digit file number
assigned by OLMS for the reporting individual or
organization. Persons who filed an LM-20 or LM-21 prior
to October 2003 received four-digit file numbers. OLMS
has now expanded file numbers to five digits. Place a
zero in front of your old four-digit file number to meet the
new format requirement. For example, if your old file
number was 1234, enter 01234 in Item 1 of this year’s
report. If you have never previously filed a Form LM-20
or LM-21, leave Item 1 blank.
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2. PERIOD COVERED BY THIS REPORT— Enter the
beginning and ending dates of the fiscal year covered in
this report. The report must not cover more than a 12month period. For example, if the reporting person’s 12month fiscal year begins on January 1 and ends on
December 31, do not enter a date beyond the 12-month
period, such as January 1 to January 1; this is an invalid
date entry.
organization in connection with a labor dispute
involving such employer. (Excluded are
agreements or arrangements that covers
services relating exclusively to supplying the
employer with information for use only in
conjunction with an administrative, arbitral, or
judicial proceeding.)
NOTE: The exclusions set forth above are applicable
only to an agreement or arrangement which covers no
activities reportable under LMRDA Section 203(b). If the
agreement or arrangement provides for any reportable
activity, you must report the information required for the
entire agreement or arrangement.
A. PERSON FILING (ITEMS 3 – 4)
3. NAME AND ADDRESS— Enter the full legal name
of the reporting individual or organization, a trade or
commercial name, if applicable (such as a d/b/a or
“doing business as” name), the name and title of the
person to whom mail should be directed, and the
complete address where mail should be sent and
received, including any building and room number.
NOTE ALSO: If you made or received payments under
any agreement or arrangement of the type described
above, you must list all receipts from employers on
account of labor relations advice or services in Part B,
and you must list all disbursements in connection with
such services in Part C.
4. ANY OTHER ADDRESS WHERE RECORDS ARE
AVAILABLE— If you maintain any of the records
necessary to verify this report at an address different
from the address listed in Item 3, enter the appropriate
name and address in Item 4. If you are completing the
report electronically, select the appropriate state or
U.S. territory from the drop-down list. If none apply,
select OTHER.
While Section 203 of the Act does not amend or modify
the rights protected by Section 8(c) of the National Labor
Relations Act, as amended (NLRA), the Act contains no
provision exempting the activities protected by that
section from the reporting requirements. Therefore, the
information required by this report must be reported
regardless of whether it relates to activities which are
protected by Section 8(c) of the NLRA.
GENERAL INSTRUCTIONS FOR RECEIPTS
AND DISBURSEMENTS
Receipts of any kind received directly or indirectly from
employers on account of labor relations advice or
services, and disbursements of any kind made directly or
indirectly in connection with such services, must be
reported with respect to each fiscal year during which
payments were made or received as a result of any
agreement or arrangement with an employer where the
object is, directly or indirectly:
NOTE: The text of Section 8(c) is set forth at the end of
these instructions.
B. STATEMENTS OF RECEIPTS (ITEMS 5 – 6)
(See special reporting instructions below. Complete
a separate Statement for each employer from whom
payments were received.)
5.a. NAME AND ADDRESS OF EMPLOYER—Enter
the full name and address of each employer from whom
receipts were received directly or indirectly on account of
labor relations advice or service. Enter the full legal
name of the employer, a trade or commercial name, if
applicable (such as a d/b/a or “doing business as”
name), the name of the person to whom mail should be
directed, and the complete address where mail should
be sent and received, including any building and room
number.
(1) To persuade employees to exercise or not to
exercise, or to persuade them as to the manner
of exercising, the right to organize and bargain
collectively through representatives of their
choice. (Excluded are agreements or
arrangements that cover services relating
exclusively to: (1) advising the employer; (2)
representing the employer before any court,
administrative agency, or tribunal of arbitration,
and (3) engaging in collective bargaining on the
employer’s behalf with respect to wages, hours,
or other terms or conditions of employment or
the negotiation of any agreement or any
questions arising under the agreement).
5.b. AGREEMENT TERMINATION DATE—
Complete Item 5.b. only for any employer listed in Item
5.a. with whom you have entered into an agreement or
arrangement to undertake the activities described under
General Instructions for Receipts and
Disbursements (above). If such an agreement was
terminated during the fiscal year covered by this report,
enter the termination date.
or
(2) To supply the employer with information
concerning activities of employees or a labor
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5.c. AMOUNT--Enter the total amount of the receipts
from the employer listed in Item 5.a. that are related to
labor relations advice or services during the fiscal year. If
any receipt was not in the form of cash, indicate the kind
of payment and list its cash value.
Column (a). Also exclude disbursements for
expenses incurred by the officer or employee for
goods or services or other things of value furnished
to the reporting organization or its clients (for
example, rent for a hall in which a speech on behalf
of the employer-client is to be given). You should
report any excluded items in the appropriate
category in Items 9 through 13.
6. TOTAL RECEIPTS FROM ALL EMPLOYERS—
Enter the total of the receipts from all employers.
Column (d) — Enter the total salary, allowances,
and other disbursements to the officer or employee.
On the last line of this column, enter the total of all
salaries, allowances, and disbursements paid to any
officer and employee listed in Column (a).
SPECIAL REPORTING INSTRUCTIONS
If: (1) the reporting organization has receipts and
disbursements for “labor relations advice and services”
and for other services; and (2) the amounts attributable
to labor relations advice and services and the other
services are not separately shown on its records:
8. TOTAL DISBURSEMENTS TO OFFICERS AND
EMPLOYEES—Enter the total of all disbursements to
officers and employees (the total of all disbursements
listed in Item 7, Column (d)).
a) The reporting organization may allocate, on any
reasonable basis, that portion of the receipt or
disbursement which is attributable to labor relations
advice or services and attach an explanation of the
method of allocation used.
9. OFFICE AND ADMINISTRATIVE EXPENSES—
Enter disbursements made for all office and
administrative expenses in connection with labor
relations advice and services. Exclude salaries,
allowances, and other disbursements to officers and
employees that are reported in Item 7. Include, however,
such expenses as heat, light, rent, telephone, and office
supplies.
b) If allocation is not feasible, the reporting
organization may report the entire receipt or
disbursement with an explanation that the receipt or
disbursement in question includes matters not
connected with labor relations advice or services.
10. PUBLICITY—Enter the total disbursements related
to publicity in connection with labor relations advice or
services. Include such expenses as fees charged by
newspapers, radio, television stations, and magazines.
Also, include the cost of printing or copying if you employ
these processes in connection with labor relations
advice or services.
C. STATEMENT OF DISBURSEMENTS (ITEMS 7–14)
(See special reporting instructions above. )
7. DISBURSEMENTS TO OFFICERS AND
EMPLOYEES—Itemize all salaries, allowances, and
other disbursements (including reimbursed expenses) to
all officers and employees of the reporting organization
in connection with labor relations advice or services
provided to any employer.
11. FEES FOR PROFESSIONAL SERVICES—Enter
the total fees paid for professional services provided by
persons other than officers and employees of the
reporting organization. Include fees for such services as
auditing, economic research, legal services, and
investigating. Report only services procured in
connection with labor relations advice or services
provided to an employer.
Column (a) —List the name of the officer or
employee.
Column (b) — Report the gross salary of the officer
or employee before taxes and other deductions.
Column (c) — List the total of any allowance and
any direct or indirect disbursements for expenses
(including reimbursed expenses) paid to the officer
or employee. Include all disbursements for travel,
hotels, meals, and similar expenses for goods,
services, or other items of value paid in connection
with labor relations advice or service provided an
employer. Exclude expenses for hotel room or for
transportation of the officer or employee of the
reporting organization by public carrier for which
payment was made to the hotel or public carrier or
its agents by the reporting organization either
directly or through its credit arrangements rather
than to the officer or employee designated in
12. LOANS MADE—Enter the total of all loans made by
the reporting organization in connection with labor
relations advice or service provided to an employer.
13. OTHER DISBURSEMENTS—Enter the total of all
other disbursements made by the reporting organization
in connection with labor relations advice or services
provided to an employer. Any items of a significant
amount must be described separately in an attachment
to Form LM-21.
14. TOTAL DISBURSEMENTS—Enter the total of Items
8 through 13.
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D. SCHEDULE OF DISBURSEMENTS FOR
REPORTABLE ACTIVITY (ITEMS 15 – 16)
firm to persuade employees of X Company that their
union’s wage demands are unreasonable.”
General. You should complete the schedule of
disbursements only for those disbursements to persons
other than officers and employees of the reporting
organization, where an object of the disbursement,
directly or indirectly, is one or both of the following:
16. TOTAL DISBURSEMENTS—Enter the total
disbursements for all reportable activities (this is the
total of all disbursements listed in 15.d.)
SIGNATURES
17-18. SIGNATURES— The completed Form LM-21
which is filed with OLMS must be signed by both the
president and treasurer, or corresponding principal
officers, of the reporting organization. A report from an
individual, on his/her own behalf, need only bear one
signature which you should enter in Item 17. Otherwise,
this report must bear two (2) signatures.
To persuade employees to exercise or not to
exercise, or to persuade employees as to the
manner of exercising, the right to organize and
bargain collectively through representatives of
their own choosing;
or
To supply an employer with information
concerning the activities of employees or a
labor organization in connection with a labor
dispute involving such employer, except
information for use solely in conjunction with
an administrative or arbitral proceeding or a
criminal or civil judicial proceeding.
If the report is from an organization and is signed by an
officer other than the president and/or treasurer, so
indicate in Items 17 and/or 18 by (1) crossing out the
pre-printed officer title(s) and (2) inserting the
appropriate officer title(s). You must have original
signatures on the Form LM-21 filed with OLMS;
stamped or mechanical signatures are unacceptable.
Do not report in Items 15 and 16 disbursements
which were related to labor relations advice or
services, but were not for the purposes described
above.
Enter the date the report was signed telephone number
used by the signatories to conduct official business. You
do not have to report a private, unlisted telephone
number.
15.a. EMPLOYER—Enter the name of the employer
for whom you made the disbursement.
SELECTED DEFINITIONS AND RELATED
PROVISIONS OF THE LABOR-MANAGEMENT
REPORTING AND DISCLOSURE ACT OF 1959, AS
AMENDED (LMRDA)
15.b. TRADE NAME—Enter the employer’s
trade or commercial name, if applicable (such as
a d/b/a or “doing business as” name).
Section 3.
15.c. TO WHOM PAYMENT WAS MADE—Enter
the name and address of the person to whom the
disbursement was made.
(a) ‘Commerce’ means trade, traffic,
commerce, transportation, transmission, or
communication among the several States or
between any State and any place outside thereof.
15.d. AMOUNT—Enter the dollar amount of
the disbursement.
(b) ‘State’ includes any State of the United
States, the District of Columbia, Puerto Rico, the
Virgin Islands, American Samoa, Guam, Wake
Island, the Canal Zone, and Outer Continental
Shelf lands defined in the Outer Continental Shelf
Lands Act (43 U.S.C. 1331-1343).
15.e. PURPOSE OF DISBURSEMENT—State the
purpose of the disbursement. You must describe the
purpose in sufficient detail to disclose the relationship
between the disbursement and the service which was
or will be provided for the employer. For example, if
you made a disbursement to a printing firm for the
purpose of printing pamphlets, it is not a sufficient
answer to state “to print pamphlets.” The answer
should indicate the reason for printing the pamphlets:
“To print pamphlets to be distributed to employees of
X Company. The pamphlets are intended to persuade
employees not to join a union.”
(c) ‘Industry affecting commerce’ means any
activity, business, or industry in commerce or in
which a labor dispute would hinder or obstruct
commerce or the free flow of commerce and
includes any activity or industry ‘affecting commerce’
within the meaning of the Labor Management
Relations Act, 1947, as amended, or the Railway
Labor Act, as amended.
Similarly, if a disbursement was made to secure the
services of a public relations company, it is not a
sufficient answer to state: “To hire representatives of
a public relations firm.” Instead, the following is an
appropriate answer: “To employ a public relations
(d) ‘Person’ includes one or more
individuals, labor organizations, partnerships,
associations, corporations, legal representatives,
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mutual companies, joint-stock companies,
trusts, unincorporated organizations, trustees,
trustees in cases under Title 11 of the United
States Code, or receivers.
(e) ‘Employer’ means any employer or
any group or association of employers engaged in
an industry affecting commerce (1) which is, with
respect to employees engaged in an industry
affecting commerce, an employer within the
meaning of any law of the United States relating
to the employment of any employees or
(2) which may deal with any labor organization
concerning grievances, labor disputes, wages,
rates of pay, hours of employment, or conditions
of work, and includes any person acting directly or
indirectly as an employer or as an agent of an
employer in relation to an employee but does not
include the United States or any corporation
wholly owned by the Government of the United
States or any State or political subdivision thereof.
commerce if it (1) is the certified representative
of employees under the provisions of the
National Labor Relations Act, as
amended, or the Railway Labor Act, as
amended; or
(2) although not certified, is a
national or international labor organization
or a local labor organization recognized or
acting as the representative of employees
of an employer oremployers engaged in
an industry affecting commerce; or
(3) has chartered a labor
organization or subsidiary body which is
representing or actively seeking to
represent employees of employers within
the meaning of paragraph (1) or (2); or
(4) has been chartered by a
labor organization representing or
actively seeking to represent employees
within the meaning of paragraph (1) or
(2) as the local or subordinate body
through which such employees may
enjoy membership or become affiliated
with such labor organization; or
(f) ‘Employee’ means any individual
employed by an employer, and includes any
individual whose work has ceased as a
consequence of, or in connection with, any
current labor dispute or because of any unfair
labor practice or because of exclusion or
expulsion from a labor organization in any
manner or for any reason inconsistent with the
requirements of this Act.
(g) ‘Labor dispute’ includes any
controversy concerning terms, tenure, or
conditions of employment, or concerning the
association or representation of persons in
negotiating, fixing, maintaining, changing, or
seeking to arrange terms or conditions of
employment, regardless of whether the
disputants stand in the proximate relation of
employer and employee.
(i) ‘Labor organization’ means a labor
organization engaged in an industry affecting
commerce and includes any organization of any
kind, any agency, or employee representation
committee, group, association, or plan so engaged
in which employees participate and which exists
for the purpose, in whole or in part, of dealing with
employers concerning grievances, labor disputes,
wages, rates of pay, hours, or other terms or
conditions of employment, and any conference,
general committee, joint or system board, or joint
council so engaged which is subordinate to a
national or international labor organization, other
than a State or local central body.
(j) A labor organization shall be
deemed to be engaged in an industry affecting
(5) is a conference, general
committee, joint or system board, or joint
council, subordinate to a national or
international labor organization, which
includes a labor organization engaged in
an industry affecting commerce within
the meaning of any of the preceding
paragraphs of this subsection, other than
a State or local central body.
“Section 204.
Nothing contained in this Act shall be
construed to require an attorney who is a
member in good standing of the bar of any State,
to include in any report required to be filed
pursuant to the provisions of this Act any
information which was lawfully communicated to
such attorney by any of his clients in the course
of a legitimate attorney-client relationship.”
NATIONAL LABOR RELATIONS ACT
“Section 8(c).
The expressing of any views, argument, or
opinion, or the discussion thereof, whether in
written, printed, graphic, or visual form, shall not
constitute or be evidence of an unfair labor
practice under any of the provisions of this Act, if
such expression contains no threat of reprisal or
force or promise of benefit.”
6
If You Need Assistance
The Office of Labor-Management Standards has field
offices located in the following cities to assist you if
you have any questions concerning LMRDA and
CSRA reporting requirements.
Atlanta, GA
Birmingham, AL
Boston, MA
Buffalo, NY
Chicago, IL
Cincinnati, OH
Cleveland, OH
Dallas, TX
Denver, CO
Detroit, MI
Fort Lauderdale, FL
Honolulu, HI
Kansas City, MO
Los Angeles, CA
Milwaukee, WI
Minneapolis, MN
Nashville, TN
New Orleans, LA
New York, NY
Philadelphia, PA
Phoenix, AZ
Pittsburgh, PA
St. Louis, MO
San Francisco, CA
Seattle, WA
Tampa, FL
Washington, DC
Copies of labor organization annual financial reports,
employer reports, and labor relations consultant reports
filed for the year 2000 and after can be viewed and
printed at http://www.unionreports.gov. Copies of
reports for the year 1999 and earlier can be ordered
through the website.
Information about OLMS, including key personnel and
telephone numbers, compliance assistance materials,
the text of the LMRDA, and related Federal Register and
Code of Federal Regulations (CFR) documents, is also
available on the Internet at http://www.olms.dol.gov.
Additionally, you can call the OLMS national office at
(202) 693-0123 or email [email protected].
(Technical Revisions 3/2015)
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File Type | application/pdf |
File Title | Microsoft Word - LM-21 Instructions 10-15-03.doc |
Author | mbresnah |
File Modified | 2016-02-25 |
File Created | 2016-02-25 |