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 5, PART V, LINE 3B | ORGANIZATION DID NOT HAVE UNRELATED BUSINESS INCOME |
| FORM 990, PAGE 6, PART VI, LINE 9 | 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 MICHAEL SAPORITO 315-317 NORTH WASHINGTON STREET STE2 WILKES-BARRE, PA 18705 SUSAN CHUKINAS 902 CAMARO RUN DRIVE WEST CHESTER, PA 19380 DEBRA MOROCCO 1595 SMITH TOWNSHIP STATE ROAD RT 18 ATLASBURG, PA 15004 RUSSELL SABOL 210 WEST PIKE STREET CANONSBURG, PA 15317 THOMAS JONES 15292 COVINGTON COURT MILTON , DE 19968 ROSS MCCLELLAN 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) |
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