LM-10 Employer Report

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Form approved
Office of Management
and Budget
No.1245-0003
Expires XX-XX-XXXX

President

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Form LM-10 – Part A (2023)

Treasurer

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Did you make or promise or agree to make, directly or indirectly, any payment or loan of
money or other thing of value (including reimbursed expenses) to any labor organization
or to any officer, agent, shop steward, or other representative or employee of any labor
organization?

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Did you make, directly or indirectly, any payment (including reimbursed expenses) to any
of your employees, or to any group or committee of your employees, for the purpose of
causing them to persuade other employees to exercise or not to exercise, or as to the
manner of exercising, the right to organize and bargain collectively through
representatives of their own choosing without previously or at the same time disclosing
such payment to all such other employees?

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Did you make any expenditure where an object thereof, directly or indirectly, was to
interfere with, restrain, or coerce employees in the right to organize and bargain
collectively through representative of their own choosing?

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Did you make any expenditure where an object thereof, directly or indirectly, was to obtain
information concerning the activities of employees or of a labor organization in connection
with a labor dispute in which you were involved?

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Did you make any agreement or arrangement with a labor relations consultant or other
independent contractor or organization pursuant to which such person undertook activities
where an object thereof, directly or indirectly, was to persuade employees to exercise or
not to exercise, or as to the manner of exercising, the right to organize and bargain
collectively through representatives of their own choosing; or did you make any payment
(including reimbursed expenses) pursuant to such an agreement or arrangement?

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Did you make any agreement or arrangement with a labor relations consultant or other
independent contractor or organization pursuant to which such person undertook activities
where an object thereof, directly or indirectly, was to furnish you with information
concerning activities of employees or of a labor organization in connection with a labor
dispute in which you were involved; or did you make any payment pursuant to such
agreement or arrangement?

Form LM-10 - Part A (2023), Continued

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11.b. Amount of each
payment or expenditure.

If yes, enter your Unique Entity Identifier, if you have one. Enter the Federal contracting agency(ies) that are a party to the Federal contract(s).

Form LM-10 – Part B (2023)