Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4D | TO PROVIDE HEALTH AND WELFARE BENEFITS TO MEMBERS AND DEPENDENTS |
| FORM 990, PAGE 6, PART VI, LINE 9 | JOSEPH R. NOKOVICH 521 HALDEMAN AVENUE NEW CUMBERLAND, PA 17070 MICHAEL SIS 1 CLEAR SPRING ROAD ANVILLE, PA 17003 DAVID BRICKER 1001 PAXTON STREET HARRISBURG, PA 17105 BOB ALDERSON 210 WEST PIKE STREET, STE2 CANONSBURG, PA 15317 SHERRI NOEL 350 PRESTO SYGAN ROAD BRIDGEVILLE, PA 15017 DEBRA MOROCCO 1595 SMITH TOWNSHIP STATE ROAD RT 18 ATLASBURG, PA 15004 JOSEPH M. PADAVAN 315-317 NORTH WASHINGTON STREET STE2 WILKES-BARRE, PA 18705 THOMAS JONES 15292 COVINGTON COURT MILTON , DE 19968 BERNIE HALL 1945 LINCOLN HIGHWAY NORTH VERSAILLES, PA 15137 |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE RETURN REVIEWED AND APPROVED BY THE SIGNATURE TRUSTEE BEFORE SIGNING. |
| FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS ARE MADE AVAILABLE TO THOSE ENTITLED TO THEM (PARTICIPANTS AND BENEFICIARIES) |
| Software ID: | |
| Software Version: |