Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | NO OTHER COMMITTEES WITH AUTHORITY BESIDES BOARD OF TRUSTEES (GOVERNING BODY). |
| FORM 990, PART VI, SECTION B, LINE 11B | BOARD REVIEWS 990 WITH ACCOUNTANT BEFORE MANUALLY SIGNED BY OFFICER. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL TRUSTEE QUESTIONNAIRE. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE FOR VIEWING DURING NORMAL FUND OFFICE BUSINESS HOURS. |
| FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC | BARRY SCHOLZ - P.O. BOX 419, APPLETON, WI 54912. DUWAYNE KNOBLOCH - 909 JONATHAN LANE, LECRESENT, MN 55947. TIM DEMINTER - 5501 MANUFACTURERS DRIVE, MADISON, WI 53704. PATRICK WHITING - 4814 EAST BROADWAY, MADISON, WI 53716. JOHN RILEY - 1314 EMIL STREET, MADISON, WI 53713. JOHN FELLER - 300 S. BEDFORD STREET, MADISON, WI 53703. ANTHONY ANASTASI - 2525 PIONEER DRIVE, BELOIT, WI 53511. ADAM MAVES - 8844 LAKE VIEW LANE, AMHERST, WI 54406. GUS SCHULTZ - 660 JOHN NOLEN DRIVE, MADISON, WI 53713. |
| FORM 990, PART IX, LINE 24E | MEMBER DOLLAR BANK REIMBURSEMENTS 195,932. BIOMETRIC AND WELLNESS PROGRAM 86,723. PROGRAMMING EXPENSE 35,235. BANK CHARGES 11,728. EMPLOYEE ASSISTANCE PROGRAM 4,820. GOVERNMENTAL FEES AND ASSESSMENTS 2,391. EDUCATIONAL EXPENSES 1,272. CHANGE IN MEMBER DOLLAR BANK -5,163,637. |
| FORM 990, PART XII, LINE 2C | THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT TO PERFORM THE AUDIT OF THE PLAN'S FINANCIAL STATEMENTS. |
| FORM 990, SCHEDULE R, PARTS II-IV | IN ADDITION TO THE CONTRIBUTING EMPLOYERS REPORTED AS RELATED ORGANIZATIONS ON SCHEDULE R, PARTS II-IV, ONE EMPLOYER DID NOT PROVIDE A TAX CLASSIFICATION AS THEY CLOSED OR TERMINATED THEIR UNION AFFILIATION. THE PLAN MADE A REASONABLE EFFORT TO OBTAIN THE TAX CLASSIFICATION FROM ALL CONTRIBUTING EMPLOYERS, BUT TWENTY-THREE OF THE CONTRIBUTING EMPLOYERS HAVE NOT YET RESPONDED TO THE MULTIPLE REQUESTS. |
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