Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI-A, Line 3 | THE ORGANIZATION UTILIZES THE SERVICES OF I.E. SHAFFER, | |
| A THIRD PARTY ADMINISTRATOR, AND FABIAN & BYRN, LLC, | ||
| A CLAIMS ADMINISTRATOR. | ||
| Pt VI-B, Line 11a | A COPY OF THE FORM 990 IS PROVIDED TO EACH TRUSTEE AT A MEETING | |
| PRIOR TO THE FILING DATE, WHERE QUESTIONS THAT A TRUSTEE HAS | ||
| ARE ADDRESSED. | ||
| Pt VI-B, Line 12c | THE ORGANIZATION HAS A REGULARLY SCHEDULED QUARTERLY | |
| MEETING WHERE IT MONITORS COMPLIANCE WITH THE POLICY. | ||
| Pt VI-B, Line 15 | NO COMPENSATION - EMPLOYEE BENEFIT PLAN | |
| Pt VI-C, Line 19 | THE DOCUMENTS ARE AVAILABLE TO PARTICIPANTS AND THE PUBLIC UPON REQUEST | |
| Form 990EZ, Part I, Line 16 | INSURANCE CLAIMS ADMINISTRATION INSURANCE CONSULTING BANK CHARGES ACTUARY INVESTMENT ADVISORY CONSULTING OFFICE EXPENSE | |
| Form 990, Part IX, Line 24f | PAYROLL AUDIT FEES 4918. 4918. 0. 0. INSURANCE 8157. 8157. 0. 0. PRESCRIPTION PRICING AUDIT 17000. 17000. 0. 0. COLLECTION FEES - LEGAL 37215. 37215. 0. 0. LAWSUIT JUDGMENT 136962. 136962. 0. 0. |
| Software ID: | 10000104 |
| Software Version: |