Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS COMPLETED BY AN ACCOUNTING FIRM, REVIEWED BY THE PLAN ADMINISTRATOR, AND PRESENTED TO THE CHAIRMAN OF THE BOARD OF TRUSTEES FOR REVIEW AND SIGNATURE. | |
| FORM 990, PART VI, SECTION C, LINE 18 | THE FORM 990 IS AVAILABLE UPON REQUEST. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS AVAILABLE TO ITS MEMBERS. IT DOES NOT HAVE A CONFLICT OF INTEREST POLICY. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 1,971,427. PRIOR PERIOD ADJUSTMENTS: 856,695. TOTAL TO FORM 990, PART XI, LINE 5: 2,828,122. |
| PRIOR PERIOD ADJUSTMENT OF $856,695 | FORM 990, PART XI, LINE 5 | AT THE BEGINNING OF THE YEAR, CLAIMS PAYABLE OF $856,695 WHERE INCLUDED AS A LIABILITY ON THE BALANCE SHHET HOWEVER THAT LIABILITY IS NOT IN ACCORDANCE WITH THE BOOKS AND RECORDS WHICH ARE MAINTAINED ON A ACCRUAL BASIS BUT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES FOR A ERISA HEALTH AND WELFARE PLAN. THE BALANCE SHEET AT THE END OF THE YEAR IS IN AGREEMENT WITH THE BOOKS AND RECORDS AND AGREES WITH THE AUDITED FINANCIAL STATEMENTS. |
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