Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 3 | THE FUND HAS CONTRACTED WITH A THIRD PARTY ADMINISTRATOR TO MANAGE THE FUND. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE PLAN HAS "PARTICIPANTS" WHO RECEIVE DISTRIBUTIONS OF ASSETS ONLY IN THE FORM OF QUALIFYING MEDICAL EXPENSES AS STATED IN THE PLAN DOCUMENT. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE PLAN ADMINISTRATOR REVIEWS THE FORM 990 AND THEN THE CHAIRPERSON OF THE TRUSTEES REVIEWS THE FORM 990 BEFORE SIGNING IT. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE ONLY TO PLAN PARTICIPANTS UPON REQUEST AT THE OFFICE OF THE PLAN ADMINISTRATOR. OTHERWISE NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9 | MEDICARE PART D REIMBURSEMENTS RECEIVED -38,935 MEDICARE PART D REIMBURSEMENTS RECEIVED 38,935 |
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