Olms interpretative Manual

(FORMATFORSIMPLIFIEDANNUALREPORTING)SIMPLIFIEDANNUAL REPORT

Affiliationname:

Designationnameandnumber:

Unitname:

Mailingaddress:

Nameofperson:

Numberandstreet:

City,StateandZip:

Filenumber:

Periodcovered:

From Through

NamesandTitlesofpresidentandtreasurerorcorrespondingprincipalofficers

ForcertificationseeNHQfilefolderfilenumber:

President

Wheresigned

Date

Treasurer

Wheresigned

Date

(TechnicalRevisions:Dec.2016)

INFORMATIONREQUIREDBYLAW

1. 
   LMRDA,SECTION201(b)
   

. . . the following information in such detail as may be necessary accurately to disclose itsfinancialconditionandoperationsfor itspreceding fiscal year--

1. 
   assetsandliabilitiesatthebeginningandendofthefiscalyear;
   
2. 
   receiptsofanykindandthesourcesthereof;
   
3. 
   salary, allowances, and other direct or indirect disbursements (including reimbursedexpenses)toeachofficerandalsotoeachemployeewho,duringsuchfiscal year,receivedmorethan $10,000 in the aggregate from such labor organization and any other labor organizationaffiliated with it or with which it is affiliated, or which is affiliated with the same national orinternational labor organization;
   
4. 
   directandindirectloansmadetoanyofficer,employee,ormember,whichaggregatedmorethan $250 during the fiscal year, together with a statement of the purpose, security, if any, andarrangementsfor repayment;
   
5. 
   direct and indirect loans to any business enterprise, together with a statement of thepurpose,security,if any, and arrangementsforrepayment; and
   
6. 
   other disbursements made by it including the purposes thereof;allinsuchcategoriesasthe Secretary mayprescribe.
   

See Instructions for Form LM-2, Section XI; LM-3, Section XI; and LM-4, General Instructions,Items1-24.

(Technical Revisions: Dec. 2016)214.002SEE29CFR403.2(b),403.3

214.101to214.850dealwiththeitems listedinsection201(b).