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 2, PART III, LINE 4D | MEDICAL, LIFE, AND AD&D INSURANCE PREMIUMS INCURRED TO PROVIDE BENEFITS TO PARTICIPATING MEMBERS AND THEIR DEPENDENTS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE 990 WAS PROVIDED TO ALL THE TRUSTEES FOR THEIR REVIEW AND APPROVAL PRIOR TO THE FILING OF THE RETURN. |
| FORM 990, PAGE 6, PART VI, LINE 19 | UPON REQUEST. |
| Software ID: | |
| Software Version: |