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 | THE PLAN PROVIDES MEDICAL, DENTAL, VISION AND LIFE INSURANCE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | TRUSTEES REVIEW |
| FORM 990, PAGE 6, PART VI, LINE 19 | ON REQUEST |
| Software ID: | |
| Software Version: |