Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE TRUST HIRES A PROFESSIONAL THIRD-PARTY ADMINISTRATOR TO COLLECT CONTRIBUTIONS, PAY CLAIMS AND MEDICAL INSURANCE PREMIUMS, AND RECORD ACCOUNTING TRANSACTIONS. | |
| FORM 990, PART VI, SECTION A, LINE 6 | PLAN PARTICIPANTS CONSIST OF MEMBERS OF THE LOCAL 206 OF THE INTERNATIONAL BROTHERHOOD OF TEAMSTERS, CHAUFFEURS, WAREHOUSEMEN AND HELPERS OF AMERICA UNION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE PLAN ADMINISTRATOR, LEGAL COUNSEL, AND PRESENTED TO THE BOARD OF TRUSTEES BEFORE FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | TRUSTEES AND SERVICE PROVIDERS OF THE TRUST ARE EXPECTED TO DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICT OF INTEREST. AN INFORMAL REVIEW OF POTENTIAL AND ACTUAL CONFLICTS OF INTEREST MAY BE CONDUCTED IN ACCORDANCE WITH THE ANNUAL AUDIT OF THE TRUST AND THE CONFLICT OF INTEREST POLICY WILL BE DISCUSSED BY THE TRUSTEES FROM TIME TO TIME. | |
| FORM 990, PART VI, SECTION B, LINE 15 | NONE OF THE BOARD OF TRUSTEES ARE COMPENSATED. HOWEVER, THE PLAN'S PROFESSIONAL SERVICE PROVIDERS COMPENSATION FOR SERVICES RENDERED IS APPROVED BY THE BOARD OF TRUSTEES AFTER DISCUSSION WITH LEGAL COUNSEL AND OTHER PLAN CONSULTANTS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | UPON REQUEST | |
| CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC | FORM 990, PART VII | THOMAS LEEDHAM - 1860 NE 162ND AVE., PORTLAND, OR 97230-5642. SUSAN WOOD - 1860 NE 162ND AVE., PORTLAND, OR 97230-5642. STEPHEN PUSTAY - P.O. BOX 350, WOODBURN, OR 97071-0350. TERRY ANN BODWIN - 5200 SHEILA ST., COMMERCE, CA 90040-3906. |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -10,937. |
| AUDITED FINANCIAL STATEMENTS ARE REVIEWED BY THE BOARD OF TRUSTEES | PART XI, LINE 2C | THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS |
| Software ID: | |
| Software Version: |