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, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 IS E-MAILED TO EACH TRUSTEE FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICTS ARE DISCLOSED DURING TRUSTEE MEETINGS, IF A CONFLICT ARISES THE TRUSTEE ABSTAINS FROM VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THIS QUESTION DOES NOT APPLY FOR THIS ORGANIZATION, AS THESE POSITIONS DO NOT EXIST. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. SUMMARY PLAN DESCRIPTIONS, SUMMARIES OF MATERIAL MODIFICATIONS, AND SUMMARY ANNUAL REPORTS ARE MAILED TO ALL PARTICIPANTS. |
| FORM 990, PART V, LINE 1A, NUMBER REPORTED IN BOX 3 OF FORM 1096: | THE FUND PROVIDED 76 1099-MISC TO SERVICE PROVIDERS AND 4 1099-R TO BENEFICIARIES RECEIVING DEATH BENEFITS. |
| FORM 990, PART V, LINE 2A, NUMBER REPORTED ON FORM W-3: | THE FUND HAS NO EMPLOYEES. FOUR W-2'S WERE PROVIDED TO PARTICIPANTS RECEIVING DISABILITY PAYMENTS. |
| FORM 990, PART IX, LINE 11G, OTHER FEES FOR SERVICES: | ACTUARIAL FEES $46,898 ANTHEM CLAIMS ADMINISTRATION $158,173 |
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