Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART IV, LINE 32 | THE ORGANIZATION EXPERIENCED A MORE THAN 25% REDUCTION IN NET ASSETS DURING 2020 DUE TO THE FOLLOWING: 1. LARGER THAN NORMAL CLAIMS RESULTED IN AN INCREASE IN THE VARIABLE PREMIUM PAYMENTS. 2. MANY STAFF MEMBERS WERE FURLOUGHED BECAUSE OF COVID-19, RESULTING IN LOWER CONTRIBUTIONS TO THE TRUST. |
| PART V LINE 3 AND PART VIII COLUMN C | INVESTMENT INCOME OF $30 IS REPORTED ON THIS RETURN AS UNRELATED BUSINESS INCOME. FORM 990-T IS NOT REQUIRED AS UNRELATED BUSINESS INCOME IS LESS THAN $1,000. ALL OF THE INVESTMENT INCOME WAS SET-ASIDE AND EARMARKED OR PLACED IN A SEPARATE ACCOUNT. |
| FORM 990, PART VI, SECTION A, LINE 8A | THE GOVERNING BODY CONSISTS OF THE TRUSTEE ONLY. THE TRUSTEE IS RESPONSIBLE FOR ADMINISTERING THE TRUST PER THE TRUST AGREEMENT. SINCE THERE IS ONLY ONE MEMBER OF THE GOVERNING BODY, NO MEETINGS WERE HELD. |
| FORM 990, PART VI, SECTION A, LINE 8B | NO EXECUTIVE COMMITTEE |
| FORM 990, PART VI, SECTION B, LINE 11B | TRUSTEE REVIEWS RETURN PRIOR TO FILING |
| FORM 990, PART VI, SECTION C, LINE 19 | NOT AVAILABLE TO THE PUBLIC |
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