TY 2019 Form 990EZ

Form990EZ

Department of the Treasury
Internal Revenue Service

Short Form
Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)

Do not enter social security numbers on this form as it may be made public.

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-1150

2019

Open to Public
Inspection

Check if applicable:

Address change

Name change

Initial return

Final return/terminated

Amended return

Application pending

C Name of organization
VIC DAVIS CONSTRUCTION INC
VOLUNTARY EMPLOYEE BENEFITS ASSOC

Number and street (or P. O. box, if mail is not delivered to street address)1300 JAN WAY
Room/suite

City or town, state or province, country, and ZIP or foreign postal code KINGSPORT, TN37660

D Employer identification number

26-2597913

E Telephone number

(423) 246-7281

F Group Exemption
Number bullet

Part ⅢStatement of Program Service Accomplishments (see the instructions for Part III) Check if the organization used Schedule O to respond to any question in this Part III . .	Expenses (Required for section 501(c)(3) and 501(c)(4) organizations; optional for others.)
What is the organization's primary exempt purpose? THIS VEBA TRUST WAS CREATED FOR THE PURPOSE OF PROVIDING FUNDS TO ITS PARTICIPANTS FOR THE PAYMENT OF HEALH, MEDICAL, HOSPITAL, SURGICAL, DENTAL OR VISION CARE EXPENSES, INCLUDING INSURANCE PREMIUMS, DEDUCTIBLE AMOUNTS OR CO-PAYMENTS.
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 VEBA TRUST CREATED FOR HEALTHCARE EXPENSES (Grants $ ) If this amount includes foreign grants, check here ...			28a	4,390
29 THIS VEBA TRUST WAS CREATED FOR THE PURPOSE OF PROVIDING FUNDS TO ITS PARTICIPANTS FOR THE PAYMENT OF HEALTH, MEDICAL, HOSPITAL, SURGICAL, DENTAL OR VISION CARE EXPENSES, INCLUDING INSURANCE PREMIUMS, DEDUCTIBLE AMOUNTS OR CO-PAYMENTS. (Grants $ ) If this amount includes foreign grants, check here ...			29a
30 (Grants $ ) If this amount includes foreign grants, check here ...			30a
31 Other program services (describe in Schedule O) ................ (Grants $ ) If this amount includes foreign grants, check here...	31a
32 Total program service expenses (add lines 28a through 31a)..........	32	4,390

(a) Name and title	(b) Average hours per week devoted to position	(c) Reportable compensation (Forms W-2/1099-MISC) (if not paid, enter -0-)
D VIC DAVIS PRESIDENT	000.00	0

Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes," complete Schedule L, Part I

40b

Yes

Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II .......................

Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ..

49a

Did the organization make any transfers to an exempt non-charitable related organization?......

49a

If "Yes," was the related organization a section 527 organization?................

49b

Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and title of each employee	(b) Average hours per week devoted to position	(c) Reportable compensation (Forms W-2/1099-MISC)	(d) Health benefits, contributions to employee benefit plans, and deferred compensation	(e) Estimated amount of other compensation

Total number of other employees paid over $100,000 ............. bullet

Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and business address of each independent contractor	(b) Type of service	(c) Compensation

Return Reference	Explanation
FORM 990-EZ, PART I, LINE 16	EXPENSES OFFICE 25 TOTAL 25
FORM 990-EZ, PART III	THIS VEBA TRUST WAS CREATED FOR THE PURPOSE OF PROVIDING FUNDS TO ITS PARTICIPANTS FOR THE PAYMENT OF HEALH, MEDICAL, HOSPITAL, SURGICAL, DENTAL OR VISION CARE EXPENSES, INCLUDING INSURANCE PREMIUMS, DEDUCTIBLE AMOUNTS OR CO-PAYMENTS.
FORM 990-EZ, PART III, LINE 31	THIS VEBA TRUST WAS CREATED FOR THE PURPOSE OF PROVIDING FUNDS TO ITS PARTICIPANTS FOR THE PAYMENT OF HEALTH, MEDICAL, HOSPITAL, SURGICAL, DENTAL OR VISION CARE EXPENSES, INCLUDING INSURANCE PREMIUMS, DEDUCTIBLE AMOUNTS OR CO-PAYMENTS.

Return Reference

Explanation

FORM 990-EZ, PART I, LINE 16

EXPENSES OFFICE 25 TOTAL 25

FORM 990-EZ, PART III

THIS VEBA TRUST WAS CREATED FOR THE PURPOSE OF PROVIDING FUNDS TO ITS PARTICIPANTS FOR THE PAYMENT OF HEALH, MEDICAL, HOSPITAL, SURGICAL, DENTAL OR VISION CARE EXPENSES, INCLUDING INSURANCE PREMIUMS, DEDUCTIBLE AMOUNTS OR CO-PAYMENTS.

FORM 990-EZ, PART III, LINE 31

THIS VEBA TRUST WAS CREATED FOR THE PURPOSE OF PROVIDING FUNDS TO ITS PARTICIPANTS FOR THE PAYMENT OF HEALTH, MEDICAL, HOSPITAL, SURGICAL, DENTAL OR VISION CARE EXPENSES, INCLUDING INSURANCE PREMIUMS, DEDUCTIBLE AMOUNTS OR CO-PAYMENTS.

1	Contributions, gifts, grants, and similar amounts received ....................	1
2	Program service revenue including government fees and contracts ................	2
3	Membership dues and assessments .............................	3	20,736
4	Investment income ....................................	4
5a	Gross amount from sale of assets other than inventory .......	5a
b	Less: cost or other basis and sales expenses ............	5b
c	Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ......	5c
6	Gaming and fundraising events
a	Gross income from gaming (attach Schedule G if greater than $15,000)	6a
b	Gross income from fundraising events (not including $ of contributions from fundraising events reported on line 1) (attach Schedule G if the			sum of such gross income and contributions exceeds $15,000) ..	6b
c	Less: direct expenses from gaming and fundraising events ...	6c
d	Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c)	6d
7a	Gross sales of inventory, less returns and allowances ......	7a
b	Less: cost of goods sold .............	7b
c	Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) .........	7c
8	Other revenue (describe in Schedule O) ....................	8
9	Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 ..............	9	20,736

18	Excess or (deficit) for the year (Subtract line 17 from line 9) ............	18	16,321
19	Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
	end-of-year figure reported on prior year’s return) .................	19	568
20	Other changes in net assets or fund balances (explain in Schedule O) ...........	20
21	Net assets or fund balances at end of year. Combine lines 18 through 20 ..........	21	16,889

Sign Here

	Signature of officer	Date

	Type or print name and title

10	Grants and similar amounts paid (list in Schedule O) ................	10
11	Benefits paid to or for members ......................	11	4,390
12	Salaries, other compensation, and employee benefits ................	12
13	Professional fees and other payments to independent contractors ............	13
14	Occupancy, rent, utilities, and maintenance ...................	14
15	Printing, publications, postage, and shipping ...................	15
16	Other expenses (describe in Schedule O) ...................	16	25
17	Total expenses. Add lines 10 through 16 .................	17	4,415

Software ID:
Software Version:

Software ID:
Software Version: