10/28/13 DOL Form Report (Disclosure) Return FORM LM-2 LABOR ORGANIZATION ANNUAL REPORT
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1 Return U.S. Department of Labor Office of Labor-Management Standards Washington, D FORM LM-2 LOR ORGNZTON NNUL REPORT MUST E USED Y LOR ORGNZTONS WTH $250,000 OR MORE N TOTL NNUL REEPTS ND LOR ORGNZTONS N TRUSTEESHP Form pproved Office of Management and udget No Expires: This report is manadatory under P.L , as amended. Failure to comply may result in criminal prosecution, fines, or civil penalties as provided by 29 U.S or 440. RED THE NSTRUTONS REFULLY EFORE PREPRNG THS REPORT. For Official Use Only 1. FLE NUMER PEROD OVERED From 01/01/2012 Through 12/31/ (a) MENDED - s this an amended report: No (b) HRDSHP - Filed under the hardship procedures: No (c) TERMNL - This is a terminal report: No 4. FFLTON OR ORGNZTON NME TEMSTERS 5. DESGNTON (Local, Lodge, etc.) LOL UNON 7. UNT NME (if any) 6. DESGNTON NR MLNG DDRESS (Type or print in capital letters) First Name ROERT P.O ox - uilding and Room Number Number and Street 5939 ENDER RD Last Name LEVER 9. re your organization's records kept at its mailing address? Yes ity HUMLE State ZP ode Each of the undersigned, duly authorized officers of the above labor organization, declares, under penalty of perjury and other applicable penalties of law, that all of the information submitted in this report (including information contained in any accompanying documents) has been examined by the signatory and is, to the best of the undersigned individual's knowledge and belief, true, correct and complete (See Section V on penalties in the instructions.) 70. SGNED: ROERT W LEVER PRESDENT 71. SGNED: Dominic G Fierro TRESURER : Mar 28, 2013 Telephone Number: : Mar 28, 2013 Telephone Number: TEMS 10 THROUGH 21 FLE NUMER: During the reporting period did the labor organization create or participate 20. How many members did the labor organization have at the end of the reporting 2,405 in the administration of a trust or a fund or organization, as defined in the No period? instructions, which provides benefits for members or beneficiaries? 21. What are the labor organization's rates of dues and fees? 11(a). During the reporting period did the labor organization have a political Rates of Dues and Fees Yes action committee (P) fund? Dues/Fees Unit Minimum Maximum 11(b). During the reporting period did the labor organization have a subsidiary No (a) Regular Dues/Fees Variousper Month organization as defined in Section X of these nstructions? (b) Working Dues/Fees N/ per N/ During the reporting period did the labor organization have an audit or (c) nitiation Fees VROUS per NEW MEM review of its books and records by an outside accountant or by a parent body Yes (d) Transfer Fees per 0 0 auditor/representative? (e) Work Permits per 0 0 kcerds.dol-esa.gov/query/orgreport.do 1/12
2 13. During the reporting period did the labor organization discover any loss or shortage of funds or other assets? (nswer "Yes" even if there has been repayment or recovery.) 14. What is the maximum amount recoverable under the labor organization's fidelity bond for a loss caused by any officer, employee or agent of the labor organization who handled union funds? 15. During the reporting period did the labor organization acquire or dispose of any assets in a manner other than purchase or sale? 16. Were any of the labor organization's assets pledged as security or encumbered in any way at the end of the reporting period? 17. Did the labor organization have any contingent liabilities at the end of the reporting period? 18. During the reporting period did the labor organization have any changes in its constitution or bylaws, other than rates of dues and fees, or in practices/procedures listed in the instructions? 19. What is the date of the labor organization's next regular election of officers? No $284,000 No No No Yes 10/2015 STTEMENT - SSETS ND LLTES FLE NUMER: SSETS SSETS Schedule Start of Reporting Period End of Reporting Period Number 22. ash $1,155,139 $1,375, ccounts Receivable 1 $0 24. Loans Receivable U.S. Treasury Securities $0 $0 26. nvestments Fixed ssets 6 $312,520 $307, Other ssets 7 $11,000 $11, TOTL SSETS $1,478,659 $1,693,791 LLTES LLTES Schedule Start of Reporting Period End of Reporting Period Number 30. ccounts Payable Loans Payable Mortgages Payable $0 $0 33. Other Liabilities 10 $1,306 $1, TOTL LLTES $1,306 $1, NET SSETS $1,477,353 $1,692,365 kcerds.dol-esa.gov/query/orgreport.do 2/12
3 STTEMENT - REEPTS ND DSURSEMENTS FLE NUMER: SH REEPTS SH MOUNT SH DSURSEMENTS SH MOUNT 36. Dues and gency Fees $1,745, Representational ctivities 15 $491, Per apita Tax $0 51. Political ctivities and 16 $0 38. Fees, Fines, ssessments, Work Permits $12, ontributions, Gifts, and Grants 17 $8, Sale of Supplies $ $382, nterest $1, Union dministration 19 $60, Dividends $0 55. enefits 20 $164, Rents $27, Per apita Tax $426, Sale of nvestments and Fixed ssets Strike enefits $0 44. Loans Obtained Fees, Fines, ssessments, etc. $0 45. Repayments of Loans Made Supplies for Resale $0 46. On ehalf of ffiliates for Transmittal to Them $0 60. Purchase of nvestments and Fixed ssets From Members for Disbursement on Their ehalf $ Loans Made Other Receipts 14 $4, Repayment of Loans Obtained TOTL REEPTS $1,792, To ffiliates of Funds ollected on Their ehalf $0 64. On ehalf of ndividual Members $ Direct Taxes $38, Subtotal $1,572, Withholding Taxes and Payroll Deductions 67a. Total Withheld $85,420 67b. Less Total Disbursed $85,301 67c. Total Withheld ut Not Disbursed $ TOTL DSURSEMENTS $1,572,768 SHEDULE 1 - OUNTS REEVLE GNG SHEDULE FLE NUMER: Entity or ndividual Name Total ccount Receivable Days Past Due 180+ Days Past Due Liquidated ccount Receivable Total of all itemized accounts receivable $0 $0 $0 $0 Totals from all other accounts receivable Totals(Total of olumn will be automatically entered in tem 23, olumn) $0 $0 $0 $0 SHEDULE 2 - LONS REEVLE FLE NUMER: List below loans to officers, employees, or members which at any time during the reporting period exceeded $250 and list all loans to business enterprises regarless of amount. Loans Outstanding at Start of Period Loans Made During Period Repayments Received During Period ash (1) Other Than ash (2) Loans Outstanding at End of Period Total of loans not listed above Total of all lines above $0 $0 $0 $0 $0 Totals will be automatically entered in... tem 24 tem 61 tem 45 tem 69 tem 24 olumn with Explanation olumn SHEDULE 3 - SLE OF NVESTMENTS ND FXED SSETS FLE NUMER: kcerds.dol-esa.gov/query/orgreport.do 3/12
4 Description (if land or buildings give location) ost ook Value Gross Sales Price Received Total of all lines above $0 $0 $0 $0 Less Reinvestments (The total from Net Sales Line will be automatically entered in tem 43)Net Sales SHEDULE 4 - PURHSE OF NVESTMENTS ND FXED SSETS FLE NUMER: Description (if land or buildings, give location) ost ook Value ash Paid Total of all lines above $0 $0 $0 Less Reinvestments (The total from Net Purchases Line will be automatically entered in tem 60.)Net Purchases SHEDULE 5 - NVESTMENTS FLE NUMER: Description Marketable Securities. Total ost. Total ook Value. List each marketable security which has a book value over $5,000 and exceeds 5% of Line. Other nvestments D. Total ost E. Total ook Value F. List each other investment which has a book value over $5,000 and exceeds 5% of Line E. lso, list each subsidiary for which separate reports are attached. G. Total of Lines and E (Total will be automatically entered in tem 26, olumn) $0 SHEDULE 6 - FXED SSETS FLE NUMER: Description ost or Other asis Total Depreciation or Expensed ook Value. Land (give location) Land 1 : HUMLE, $202,128 $202,128 $0. uildings (give location) $0 $0 $0 $0. utomobiles and Other Vehicles D. Office Furniture and Equipment $91,410 $70,973 $20,437 $0 E. Other Fixed ssets $85,221 $0 $85,221 $0 F. Totals of Lines through E (olumn Total will be automatically entered in tem 27, olumn) Form LM-2 (Revised 2003) Value $378,759 $70,973 $307,786 $0 SHEDULE 7 - OTHER SSETS FLE NUMER: Description ook Value kcerds.dol-esa.gov/query/orgreport.do 4/12
5 SEURTY DEPOST ON LESE $11,000 Total (Total will be automatically entered in tem 28, olumn) $11,000 SHEDULE 8 - OUNTS PYLE GNG SHEDULE FLE NUMER: Entity or ndividual Name Total ccount Payable Days Past Due 180+ Days Past Due Liquidated ccount Payable Total for all itemized accounts payable $0 $0 $0 $0 Total from all other accounts payable $0 $0 $0 $0 Totals (Total for olumn will be automatically entered in tem 30, olumn) $0 $0 $0 $0 SHEDULE 9 - LONS PYLE FLE NUMER: Source of Loans Payable at ny Time During the Reporting Period Loans Owed at Start of Period Loans Obtained During Period Repayment During Period ash (1) Repayment During Period Other Than ash (2) Loans Owed at End of Period Total Loans Payable $0 $0 $0 $0 $0 tem 31 tem 44 tem 62 tem 69 tem 31 Totals will be automatically entered in... olumn with Explanation olumn SHEDULE 10 - OTHER LLTES FLE NUMER: Description at End of Period PYROLL DEDUTONS PYLE $426 SEURTY DEPOST $1,000 Total Other Liabilities (Total will be automatically entered in tem 33, olumn) $1,426 SHEDULE 11 - LL OFFERS ND DSURSEMENTS TO OFFERS FLE NUMER: Name RSH, ROERT J PRESDENT Representational ctivities NTU, NGEL M VE PRESDENT Representational ctivities Title 2 9 Status Political ctivities and Political ctivities and Gross Salary Disbursements (before any deductions) llowances Disbursed (F) Disbursements for Official usiness (G) Other Disbursements not reported in through (F) (H) TOTL $36,853 $6,519 $43,372 ontributions 2 dministration $29,336 $8,117 $37,453 ontributions dministration 6 1 kcerds.dol-esa.gov/query/orgreport.do 5/12
6 FERRO, DOMN G SERETRY TRESURER Representational ctivities STUND, DNEL P TRUSTEE Representational ctivities NERREN, MHEL TRUSTEE Representational ctivities PETERSON, GLENN M REORDNG SERETRY Representational ctivities LNE, ROY M TRUSTEE Representational ctivities Political ctivities and Political ctivities and Political ctivities and Political ctivities and Political ctivities and $35,062 $3,816 $38,878 ontributions kcerds.dol-esa.gov/query/orgreport.do 6/12 dministration $8,036 $710 $8,746 ontributions dministration $5,936 $2,947 $8,883 ontributions dministration $8,936 $1,622 $10,558 ontributions dministration $68,314 $11,080 $79,394 ontributions dministration Total Officer Disbursements $192,473 $0 $34,811 $0 $227,284 Less Deductions $43,552 Net Disbursements $183,732 SHEDULE 12 - DSURSEMENTS TO EMPLOYEES FLE NUMER: Name Title RO, FRNK J USNESS GENT/ORGNZER N/ Representational ctivities FGN, SHNNON M OOKKEEPER N/ Representational ctivities 10 Other Payer Political ctivities and Political ctivities and Gross Salary Disbursements (before any deductions) llowances Disbursed (F) Disbursements for Official usiness (G) Other Disbursements not reported in through (F) (H) TOTL $66,810 $9,491 $76,301 ontributions dministration $59,592 $42 $59,634 ontributions 10 dministration RSH, NN DMNSTRTOR $17,984 $55 $18,
7 N/ Representational ctivities KOHLER, LS NEGOTTOR N/ Representational ctivities 10 Political ctivities and Political ctivities and ontributions 10 dministration $8,567 $3,735 $12,302 ontributions dministration TOTLS REEVED Y EMPLOYEES MKNG LESS THN $10000 $17,911 $23,439 $41, Representational ctivities Political ctivities and ontributions dministration Total Employee Disbursements $170,864 $0 $36,762 $0 $207,626 Less Deductions $41,868 Net Disbursements $165,758 SHEDULE 13 - MEMERSHP STTUS FLE NUMER: ategory of Membership Number Voting Eligibility TVE MEMERS - FULL DUES 2,405 Yes Members (Total of all lines above) 2,405 gency Fee Payers* 33 Total Members/Fee Payers 2,438 *gency Fee Payers are not considered members of the labor organization. DETLED SUMMRY PGE - SHEDULES 14 THROUGH 19 FLE NUMER: SHEDULE 14 OTHER REEPTS 1. Named Payer temized Receipts $0 2. Named Payer Non-itemized Receipts $0 3. ll Other Receipts $4, Total Receipts $4,400 SHEDULE 17 ONTRUTONS, GFTS & GRNTS 1. Named Payee temized Disbursements $0 2. Named Payee Non-itemized Disbursements $0 3. To Officers $0 4. To Employees $0 5. ll Other Disbursements $8, Total Disbursements $8,686 SHEDULE 15 REPRESENTTONL TVTES 1. Named Payee temized Disbursements $48, Named Payee Non-itemized Disbursements $49, To Officers $167, To Employees $129, ll Other Disbursements $95, Total Disbursements $491,438 SHEDULE 16 POLTL TVTES ND LOYNG 1. Named Payee temized Disbursements $0 2. Named Payee Non-itemized Disbursements $0 3. To Officers $0 4. To Employees $0 5. ll Other Disbursements SHEDULE 18 GENERL OVERHED 1. Named Payee temized Disbursements $191, Named Payee Non-itemized Disbursements $70, To Officers $8, To Employees $77, ll Other Disbursements $34, Total Disbursements $382,576 SHEDULE 19 UNON DMNSTRTON 1. Named Payee temized Disbursements $0 2. Named Payee Non-itemized Disbursements $0 3. To Officers $51, To Employees $0 5. ll Other Disbursements $8,889 kcerds.dol-esa.gov/query/orgreport.do 7/12
8 6. Total Disbursement $0 6. Total Disbursements $60,010 SHEDULE 14 - OTHER REEPTS FLE NUMER: There was no data found for this schedule. SHEDULE 15 - REPRESENTTONL TVTES FLE NUMER: RTRN Name and ddress 9955 RTRN LVD ORLNDO FL Type or lassification OMMERL RLNE Name and ddress RKN MEZLSH. LLP 200 E ROD ST 10 TH FLOOR OLUMUS OH Type or lassification LW FRM Name and ddress DNE DUNHM MSSEY 4402 HPPNG T SUGR LND Type or lassification RTRTON Name and ddress GLLESPE, ROZEN, WTSKY & JONES P 3402 OK GROVE VE STE 200 DLLS Type or lassification LW FRM Name and ddress Total temized Transactions with this Payee/Payer Total Non-temized Transactions with this Payee/Payer $7,667 Total of ll Transactions with this Payee/Payer for This Schedule $7,667 LEGL SERVES 06/19/2012 $8,684 LEGL SERVES 07/17/2012 $12,102 Total temized Transactions with this Payee/Payer $20,786 Total Non-temized Transactions with this Payee/Payer $12,463 Total of ll Transactions with this Payee/Payer for This Schedule $33,249 RTRTON 01/18/2012 $5,221 Total temized Transactions with this Payee/Payer $5,221 Total Non-temized Transactions with this Payee/Payer Total of ll Transactions with this Payee/Payer for This Schedule $5,221 LEGL SERVES 02/15/2012 $7,173 Total temized Transactions with this Payee/Payer $7,173 Total Non-temized Transactions with this Payee/Payer $1,369 Total of ll Transactions with this Payee/Payer for This Schedule $8,542 kcerds.dol-esa.gov/query/orgreport.do 8/12
9 LEWS ELLSWORTH TOM W Type or lassification LW FRM Name and ddress SOUTHWEST RLNES DLLS Type or lassification OMMERL RLNE/REMURSE WGES ENEFTS Name and ddress SUGRMN & SUSKND 100 MRLE MLE #300 ORL GLES FL Type or lassification LW FRM Name and ddress UNTED RLNES QJP Type or lassification OMMERL RLNE Name and ddress ZUE WER 1516 UNVERSL TY LVD UNVERSL TY Type or lassification PROMOTONL TEMS LEGL SERVES 03/01/2012 $6,233 Total temized Transactions with this Payee/Payer $6,233 Total Non-temized Transactions with this Payee/Payer Total of ll Transactions with this Payee/Payer for This Schedule $6,233 Total temized Transactions with this Payee/Payer Total Non-temized Transactions with this Payee/Payer $15,254 Total of ll Transactions with this Payee/Payer for This Schedule $15,254 LEGL SERVES 12/01/2012 $9,507 Total temized Transactions with this Payee/Payer $9,507 Total Non-temized Transactions with this Payee/Payer $777 Total of ll Transactions with this Payee/Payer for This Schedule $10,284 Total temized Transactions with this Payee/Payer Total Non-temized Transactions with this Payee/Payer $5,398 Total of ll Transactions with this Payee/Payer for This Schedule $5,398 Total temized Transactions with this Payee/Payer Total Non-temized Transactions with this Payee/Payer $6,682 Total of ll Transactions with this Payee/Payer for This Schedule $6,682 kcerds.dol-esa.gov/query/orgreport.do 9/12
10 SHEDULE 16 - POLTL TVTES ND LOYNG FLE NUMER There was no data found for this schedule. SHEDULE 17 - ONTRUTONS, GFTS & GRNTS FLE NUMER: There was no data found for this schedule. SHEDULE 18 - GENERL OVERHED FLE NUMER: PN ENERGY 4728 Name and ddress Type or lassification UTLTY OMPNY Name and ddress. JY MWHORTER, P NW FWY STE Type or lassification OUNTNT Name and ddress TY OF PUL WORKS Type or lassification UTLTES - WTER Name and ddress GSL NVESTMENTS 6800 WEST LOOP SOUTH # Type or lassification LNDLORD Total temized Transactions with this Payee/Payer Total Non-temized Transactions with this Payee/Payer $12,892 Total of ll Transactions with this Payee/Payer for This Schedule $12,892 UDTNG SERVES 04/11/2012 $12,270 Total temized Transactions with this Payee/Payer $12,270 Total Non-temized Transactions with this Payee/Payer $16,988 Total of ll Transactions with this Payee/Payer for This Schedule $29,258 Total temized Transactions with this Payee/Payer Total Non-temized Transactions with this Payee/Payer $5,086 Total of ll Transactions with this Payee/Payer for This Schedule $5,086 RENT 01/03/2012 $14,010 RENT 02/01/2012 $13,402 RENT 03/01/2012 $13,916 RENT 04/01/2012 $13,916 RENT 05/01/2012 $13,916 RENT 06/01/2012 $13,916 RENT 07/01/2012 $13,916 RENT 08/01/2012 $13,916 RENT 09/01/2012 $13,916 RENT 10/01/2012 $13,916 kcerds.dol-esa.gov/query/orgreport.do 10/12
11 Name and ddress NSURNE METWORK OF TEXS 708 SUL ROSS Type or lassification NSURNE GENY Name and ddress S SUPPORT 8558 KTY FWY STE Type or lassification OMPUTER MNTENE & ONSULTNG Name and ddress LOYNZ OQUETE HUMLE Type or lassification JNTORL SERVES Name and ddress TL TONERLND DLLS Type or lassification EQUPMENT LESNG RENT 11/01/2012 $13,916 RENT 12/01/2012 $16,189 Total temized Transactions with this Payee/Payer $168,845 Total Non-temized Transactions with this Payee/Payer Total of ll Transactions with this Payee/Payer for This Schedule $168,845 PROPERTY NSURNE 12/01/2012 $10,247 Total temized Transactions with this Payee/Payer $10,247 Total Non-temized Transactions with this Payee/Payer $1,264 Total of ll Transactions with this Payee/Payer for This Schedule $11,511 Total temized Transactions with this Payee/Payer Total Non-temized Transactions with this Payee/Payer $5,164 Total of ll Transactions with this Payee/Payer for This Schedule $5,164 Total temized Transactions with this Payee/Payer Total Non-temized Transactions with this Payee/Payer $10,080 Total of ll Transactions with this Payee/Payer for This Schedule $10,080 Total temized Transactions with this Payee/Payer Total Non-temized Transactions with this Payee/Payer $18,603 Total of ll Transactions with this Payee/Payer for This Schedule $18,603 SHEDULE 19 - UNON DMNSTRTON FLE NUMER: There was no data found for this schedule. kcerds.dol-esa.gov/query/orgreport.do 11/12
12 SHEDULE 20 - ENEFTS FLE NUMER: Description To Whom Paid PENSON ENTRL STTES $66,127 PENSON SOUTHERN REGON $45,061 HELTH ND WELFRE ENTRL STTES $53,558 Total of all lines above (Total will be automatically entered in tem 55.) $164, DDTONL NFORMTON SUMMRY FLE NUMER: Question 11(a): The Local has a political action committee named Teamsters Local 19 P. The P files reports with the Texas Ethics ommission. The file number is Question 12: Outside ccountant. Jay McWhorter, P, audited the Local's records for the year ended December 31, Question 18: The local changed its bylaws regarding elections. The time between nominations and the election was reduced to 30 days. See attached copies of the new bylaws. Statement, ccounts Receivable egin Total: There is not change in the accounts receivable. This is only to clear an error message that was generated by the software. Schedule 13, Row1: Schedule 13, Row1:TVE MEMERS FULL DUES RTES kcerds.dol-esa.gov/query/orgreport.do 12/12
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Return U.S. Department of Labor Office of Labor-Management Standards Washington, D 20210 FORM LM-2 LOR ORGNZTON NNUL REPORT MUST E USED Y LOR ORGNZTONS WTH $250,000 OR MORE N TOTL NNUL REEPTS ND LOR ORGNZTONS
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Return U.S. Department of Labor Office of Labor-Management Standards Washington, D 20210 FORM LM-2 LOR ORGNZTON NNUL REPORT MUST E USED Y LOR ORGNZTONS WTH $250,000 OR MORE N TOTL NNUL REEPTS ND LOR ORGNZTONS
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