Form LM-2 Labor Organization Annual Report

U.S. Department of Labor
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. 1245-0003
Expires 08-31-2016

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

3. (a) AMENDED — If this is an amended report, check here:

2. PERIOD COVERED
MO
DAY

YEAR

From

(b) HARDSHIP — If filing under hardship procedures check here:

Through

(c) TERMINAL — If this is a terminal report, check here:
8. MAILING ADDRESS (Type or print in capital letters.)

4. AFFILIATION OR ORGANIZATION NAME

First Name
5. DESIGNATION (Local, Lodge, etc.)

6. DESIGNATION NUMBER

Last Name

P.O. Box - Building and Room Number
Number and Street

7. UNIT NAME (if any)
City
9. Are your organization’s records kept at its mailing address?

Yes

No

State

ZIP Code + 4

(If “No,” provide address in Item 69.)
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
(If other title,
/
/
(
)
—
see instructions.)
Date
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Telephone Number

71. SIGNED: ____________________________________________________ TREASURER
(If other title,
/
/
(
)
—
see instructions.)
Date

Telephone Number
Page 1 of 26

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

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

11(a). During the reporting period did the labor organization have a political action
committee (PAC) fund?
Yes
No

19. What is the date of the labor organization’s next regular election
of officers?

11(b). During the reporting period did the labor organization have a subsidiary
organization as defined in Section X of these Instructions?
Yes
No

20. How many members did the labor organization have at the end
of the reporting period? (Total from the Members Line 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
Yes
No
auditor/representative?

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
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
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

Dues/Fees

Amount

Unit

(a) Regular Dues/Fees

per

(b) Working Dues/Fees

per

(c) Initiation Fees

per

(d) Transfer Fees

per

(e) Work Permits

per

Minimum

Maximum

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 2010); (Tech. Rev. 2/2013)

Page 2 of 26

STATEMENT A – ASSETS AND LIABLITIES

FILE NUMBER:

Complete Schedules 1 Through 20 Before Completing Statement A

ASSETS

ASSETS

Schedule
Number

Start of Reporting Period
(A)

End of Reporting Period
(B)

Start of Reporting Period
(C)

End of Reporting Period
(D)

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

29. TOTAL ASSETS

LIABILITIES

LIABILITIES

Schedule
Number

30. Accounts Payable

8

31. Loans Payable

9

32. Mortgages Payable
33. Other Liabilities

10

34. TOTAL LIABILITIES

35. NET ASSETS (Item 29 Less Item 34)

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 3 of 26

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

AMOUNT

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

66. Subtotal
67. Withholding Tax 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 2010); (Tech. Rev. 2/2013)

Page 4 of 26

SCHEDULE 1 – ACCOUNTS RECEIVABLE AGING SCHEDULE
Entity or Individual Name
(A)

FILE NUMBER:

Total Account
Receivable
(B)

90 - 180 Days
Past Due
(C)

180+ Days
Past Due
(D)

Liquidated Account
Receivable
(E)

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.
Total of all itemized accounts receivable
Totals from all other accounts receivable
Totals (Total of Column (B) will be automatically entered in Item 23, Column (B))

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 5 of 26

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)

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. Name: _______________________________
Purpose: _______________________________
Security: _______________________________
Terms of Repayment: _____________________

Total of loans not listed above
Totals of all lines above
Totals will be automatically entered In

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

…………………Item 24.………………………..Item 61.…………………………Item 45……………………………..Item 69………………….….……Item 24
Column (A)
with Explanation
Column (B)
Page 6 of 26

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)

Amount Received
(E)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Total of all lines above
Less Reinvestments

(The total from Net
Sales Line will be
automatically entered
in Item 43.)

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Net Sales

Page 7 of 26

SCHEDULE 4 – PURCHASE OF INVESTMENTS AND FIXED ASSETS
Description (if land or buildings, give location)
(A)

FILE NUMBER:
Cost
(B)

Book Value
(C)

Cash Paid
(D)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Total of all lines above
Less Reinvestments

(The total from Net
Purchases Line will be
automatically entered
in Item 60.)

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Net Purchases

Page 8 of 26

SCHEDULE 5 – INVESTMENTS

FILE NUMBER:

Description
(A)

Amount
(B)

Marketable Securities
A. Total Cost
B. Total Book Value
C. List each marketable security which has a book value over $5,000 and exceeds 5% of Line B.
(1)
(2)
(3)
(4)
Other Investments
D. Total Cost
E. Total Book Value
F. List each other investment which has a book value over $5,000 and exceeds 5% of Line E. Also, list each subsidiary for which separate reports are attached.
(1)
(2)
(3)
(4)
(5)
G. Total of Lines B and E (Total from Line G will be automatically entered in Item 26, Column (B))

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 9 of 26

SCHEDULE 6 – FIXED ASSETS

Description
(A)

FILE NUMBER:

Cost or Other Basis
(B)

Total Depreciation or
Amount Expensed
(C)

Book Value
(D)

Value
(E)

A. Land (give location)

1.

2.

3.

B. Buildings (give location)

1.

2.

3.

C. Automobiles and Other Vehicles

D. Office Furniture and Equipment

E. Other Fixed Assets

F. Totals of Lines A through E (Column (D) Total will be automatically entered in
Item 27, Column (B))

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 10 of 26

SCHEDULE 7 – OTHER ASSETS

FILE NUMBER:

Description
(A)

Book Value
(B)

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

Total (Total will be automatically entered in Item 28, Column (B))

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 11 of 26

SCHEDULE 8 – ACCOUNTS PAYABLE AGING SCHEDULE
Entity or Individual Name
(A)

FILE NUMBER:

Total Account
Payable
(B)

90 - 180 Days
Past Due
(C)

180+ Days
Past Due
(D)

Liquidated Account
Payable
(E)

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.
Total of all Itemized Accounts Payable
Total from all other accounts payable
Totals (Total for Column (B) will be automatically entered in Item 30, Column (D))
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 12 of 26

SCHEDULE 9 – LOANS PAYABLE

FILE NUMBER:
Repayment Made During Period

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

Loans Owed at
Start of Period
(B)

Loans Obtained
During Period
(C)

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.
13.
Total Loans Payable
Totals will be automatically entered in

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

………………….……Item 31.………………………..Item 44 …………………….……Item 62…………………………..Item 69………………………Item 31
Column (C)
with Explanation
Column (D)

Page 13 of 26

SCHEDULE 10 – OTHER LIABILITIES

FILE NUMBER:

Description
(A)

Amount at End of Period
(B)

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

Total Other Liabilities (Total will be automatically entered in Item 33, Column (D))

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 14 of 26

SCHEDULE 11 – ALL OFFICERS AND DISBURSEMENTS TO OFFICERS
(A)
Name

(B)
Title

FILE NUMBER:

(C)

(D)

(E)

(F)

(G)

(H)

Status

Gross Salary
Disbursements (before
any deductions)

Allowances Disbursed

Disbursements for
Official Business

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

TOTAL

Last, First, MI
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

TOTAL OFFICER DISBURSEMENTS
LESS DEDUCTIONS
NET DISBURSEMENTS
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 15 of 26

SCHEDULE 12 – DISBURSEMENTS TO EMPLOYEES
(A)
Name

(B)
Title

FILE NUMBER:

(C)

(D)

(E)

(F)

(G)

(H)

Other Payer

Gross Salary
Disbursements (before
any deductions)

Allowances Disbursed

Disbursements for
Official Business

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

TOTAL

Last, First, MI
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

%

%

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

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

Schedule 15
Representational Activities

%

Schedule 16
Political Activities and Lobbying

TOTAL EMPLOYEE DISBURSEMENTS
LESS DEDUCTIONS
NET DISBURSEMENTS
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 16 of 26

SCHEDULE 13 – MEMBERSHIP STATUS

Category of Membership
(A)

FILE NUMBER:

Number
(B)

Voter Eligibility
(C)

1.

Yes

2.

Yes

3.

Yes

4.

Yes

5.

Yes

6.

Yes

7.

Yes

Members (Total of all lines above)

Agency Fee Payers*

Total Members/Fee Payers (Total of Members and Fee Payers Lines)

*Agency Fee Payers are not considered members of the labor organization

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 17 of 26

DETAILED SUMMARY PAGE – SCHEDULES 14 THROUGH 19

FILE NUMBER:

Complete Itemization Pages BEFORE the Detailed Summary Page

SCHEDULE 14

1. Named Payer Itemized Receipts

1. Named Payee Itemized Disbursements

2. Named Payer Non-Itemized Receipts

2. Named Payee Non-Itemized Disbursements
SCHEDULE 17

3. All Other Receipts

OTHER RECEIPTS
4. Total Receipts (add Lines 1 through 3)

Item
48

CONTRIBUTIONS,
GIFTS, AND
GRANTS

3. To Officers
4. To Employees
5. All Other Disbursements
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
SCHEDULE 18

3. To Officers

GENERAL
OVERHEAD

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

SCHEDULE 16
POLITICAL
ACTIVITIES AND
LOBBYING

3. To Officers
4. To Employees
5. All Other Disbursements

Item
50

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
SCHEDULE 19

3. To Officers

UNION
ADMINISTRATION

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

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Item
52

Item
53

3. To Officers
4. To Employees
5. All Other Disbursements

Item
51

6. Total Disbursements (add Lines 1 through 5)

Item
54

Page 18 of 26

SCHEDULE 14 – OTHER RECEIPTS

FILE NUMBER:

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

Purpose
(C)

Date
(D)

Amount
(E)

(B) Type or Classification

Total Itemized Transactions with this Payee/Payer
Total Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this Payee/Payer for This Schedule

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 19 of 26

SCHEDULE 15 – REPRESENTATIONAL ACTIVITIES

FILE NUMBER:

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

Purpose
(C)

Date
(D)

Amount
(E)

(B) Type or Classification

Total Itemized Transactions with this Payee/Payer
Total Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this Payee/Payer for This Schedule

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 20 of 26

SCHEDULE 16 – POLITICAL ACTIVITIES AND LOBBYING

FILE NUMBER:

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

Purpose
(C)

Date
(D)

Amount
(E)

(B) Type or Classification

Total Itemized Transactions with this Payee/Payer
Total Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this Payee/Payer for This Schedule

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 21 of 26

SCHEDULE 17 – CONTRIBUTIONS, GIFTS, AND GRANTS

FILE NUMBER:

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

Purpose
(C)

Date
(D)

Amount
(E)

(B) Type or Classification

Total Itemized Transactions with this Payee/Payer
Total Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this Payee/Payer for This Schedule

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 22 of 26

SCHEDULE 18 – GENERAL OVERHEAD

FILE NUMBER:

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

Purpose
(C)

Date
(D)

Amount
(E)

(B) Type or Classification

Total Itemized Transactions with this Payee/Payer
Total Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this Payee/Payer for This Schedule

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 23 of 26

SCHEDULE 19 – UNION ADMINISTRATION

FILE NUMBER:

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

Purpose
(C)

Date
(D)

Amount
(E)

(B) Type or Classification

Total Itemized Transactions with this Payee/Payer
Total Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this Payee/Payer for This Schedule

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 24 of 26

SCHEDULE 20 – BENEFITS

FILE NUMBER:
Description
(A)

To Whom Paid
(B)

Amount
(C)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
Total of all lines above (Total will be automatically entered in Item 55.)

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

Page 25 of 26

69. ADDITIONAL INFORMATION SUMMARY

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)

FILE NUMBER:

Page 26 of 26