Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Part VI Line 11b | PLAN SPONSOR REVIEWED THE 990 TAX FORM |
| Part VI Line 19 | ALL REQUIRED DOCUMENTS ARE AVAILABLE FOR INSPECTION AT OFFICE |
| Part VI Line 19 | LOCATED AT 5250 LOWER HUNTINGTON RD FORT WAYNE IN 46809 |
| PART III LINE 1 | THE ABOVE REFERENCED TRUST EXISTS SOLELY TO PROVIDE EMPLOYEE AND DEPENDENT |
| PART III LINE 1 | HEALTH & WELFARE BENEFITS. THE VEBA TRUST HAS NO EMPLOYEE |
| PART III LINE 1 | REPRESENTATIVE OFFICER. ALL FUNDS ARE HELD IN TRUST. FORM 990 AND 5500 ARE |
| PART III LINE 1 | COMPLETED AND FILED BY THEIR RESPECTIVE DUE DATES. FORMS ARE |
| PART III LINE 1 | AVAILABLE FOR VIEWING AT 5250 LOWER HUNTINGTON ROAD, FORT WAYNE |
| PART III LINE 1 | INDIANA 46899. PROGRAM REVENUE CONSIST OF EMPLOYER CONTRIBUTIONS. |
| PART III LINE 1 | PROGRAM EXPENSES CONSISTS OF HEALTH BENEFIT CLAIMS, ADMINISTRATIVE |
| PART III LINE 1 | COSTS AND INSURANCE PREMIUMS |
| Software ID: | 21013244 |
| Software Version: | ta21mefv1.0 |