Michigan Workers Organizing Committee 2014 Form LM-2

Return
FORM LM-2 LABOR ORGANIZATION ANNUAL REPORT

U.S. Department of Labor
Office of Labor-Management Standards
Washington, DC 20210
MUST BE USED BY LABOR ORGANIZATIONS WITH $250,000 OR MORE IN TOTAL ANNUAL

RECEIPTS AND LABOR ORGANIZATIONS IN TRUSTEESHIP
Form Approved
Office of Management and Budget
No. 1245-0003
Expires: 08-31-2016
This report is mandatory under P.L. 86-257, as amended. Failure to comply may result in criminal prosecution, fines, or civil penalties as provided by 29 U.S.C. 439 or 440.
READ THE INSTRUCTIONS CAREFULLY BEFORE PREPARING THIS REPORT.
For Official Use Only
1. FILE NUMBER
544-952
2. PERIOD COVERED
From
01/01/2014
Through
12/31/2014
3. (a) AMENDED - Is this an amended report:

(b) HARDSHIP - Filed under the hardship procedures:
(c) TERMINAL - This is a terminal report:
4. AFFILIATION OR ORGANIZATION NAME

MICHIGAN WORKERS ORGANIZING COMMITTEE
5. DESIGNATION (Local, Lodge, etc.)
No
No
No
8. MAILING ADDRESS (Type or print in capital letters)

First Name
MARK
6. DESIGNATION NBR
0
Last Name
RALEIGH
P.O Box - Building and Room Number

SUITE 843
7. UNIT NAME (if any)
Number and Street

269 WALKER STREET
9. Are your organization's records kept at its mailing address?
Yes
City
DETROIT
State
MI
ZIP Code + 4
48207
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. SIGNED:
Mark E Raleigh
PRESIDENT
71. SIGNED:
Zachary T Altefogt
TREASURER
Date:
Mar 30, 2015
Telephone Number:
313-468-9610
Date:
Mar 30, 2015
Telephone Number:
313-318-7784
Form LM-2 (Revised 2010)
ITEMS 10 THROUGH 21
10. During the reporting period did the labor organization create or participate
in the administration of a trust or a fund or organization, as defined in the
instructions, which provides benefits for members or beneficiaries?
11(a). During the reporting period did the labor organization have a political
action committee (PAC) fund?
11(b). During the reporting period did the labor organization have a subsidiary
organization as defined in Section X of these Instructions?
12. During the reporting period did the labor organization have an audit or
review of its books and records by an outside accountant or by a parent body
auditor/representative?
No
No
No
No
FILE NUMBER: 544-952

20. How many members did the labor organization have at the end of the reporting
period?
21. What are the labor organization's rates of dues and fees?
Rates of Dues and Fees
Dues/Fees
Amount
Unit
Minimum
Maximum
(a) Regular Dues/Fees
N/A per
N/A
N/A
N/A
(b) Working Dues/Fees
N/A per
N/A
N/A
N/A
(c) Initiation Fees
N/A per
N/A
N/A
N/A
(d) Transfer Fees
N/A per
N/A
N/A
N/A
(e) Work Permits
N/A per
N/A
N/A
N/A
13. During the reporting period did the labor organization discover any loss or
shortage of funds or other assets? (Answer "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?
Yes
$500,000
No
No
No
No
STATEMENT A - ASSETS AND LIABILITIES
ASSETS
ASSETS
22.
23.
24.
25.
26.
27.
28.
Cash
Accounts Receivable
Loans Receivable
U.S. Treasury Securities
Investments
Fixed Assets
Other Assets
Schedule
Number
LIABILITIES
30.
31.
32.
33.
34.
Accounts Payable
Loans Payable
Mortgages Payable
Other Liabilities
TOTAL LIABILITIES
35. NET ASSETS

End of Reporting Period

(B)
$282,454
$0
$0
$0
$122,843
$282,454
1
2
5
6
7
29. TOTAL ASSETS
LIABILITIES
Start of Reporting Period

(A)
$122,843
Schedule
Number
8
9
Start of Reporting Period

(A)
End of Reporting Period

(B)
$0
$0
$0
$0
$122,843
$282,454
10
STATEMENT B - RECEIPTS AND DISBURSEMENTS
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
CASH RECEIPTS
Dues and Agency Fees
Per Capita Tax
Fees, Fines, Assessments, Work Permits
Sale of Supplies
Interest
Dividends
Rents
Sale of Investments and Fixed Assets
Loans Obtained
Repayments of Loans Made
On Behalf of Affiliates for Transmittal to Them
From Members for Disbursement on Their Behalf
Other Receipts
TOTAL RECEIPTS
SCH
AMOUNT
3
9
2
14
$0 50.
$0 51.
$0 52.
$0 53.
$0 54.
$0 55.
$0 56.
57.
58.
59.
$0 60.
$0 61.
$2,052,685 62.
$2,052,685 63.
64.
65.
CASH DISBURSEMENTS
Representational Activities
Political Activities and Lobbying
Contributions, Gifts, and Grants
General Overhead
Union Administration
Benefits
Per Capita Tax
Strike Benefits
Fees, Fines, Assessments, etc.
Supplies for Resale
Purchase of Investments and Fixed Assets
Loans Made
Repayment of Loans Obtained
To Affiliates of Funds Collected on Their Behalf
On Behalf of Individual Members
Direct Taxes
SCH
15
16
17
18
19
20
AMOUNT
$0
$0
$0
$209,047
$1,424,050
$0
$259,977
$0
$0
4
2
9
$0
$0
$0
66. Subtotal
67. Withholding Taxes and Payroll Deductions
67a. Total Withheld
67b. Less Total Disbursed
67c. Total Withheld But Not Disbursed
68. TOTAL DISBURSEMENTS
$1,893,074
$0
$0
$1,893,074

SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE

Total Account
Receivable
(B)
Entity or Individual Name

(A)
Total of all itemized accounts receivable
Totals from all other accounts receivable
Totals(Total of Column (B) will be automatically entered in Item 23, Column(B))
90-180 Days
Past Due
(C)
$0
$0
$0
$0
$0
$0
$0
$0
SCHEDULE 2 - LOANS RECEIVABLE

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.
(A)

Loans
Outstanding at
Start of Period
(B)
Total of loans not listed above

Total of all lines above
Totals will be automatically entered in...
Liquidated
Account
Receivable
(E)
180+ Days
Past Due
(D)
Loans Made
During Period
(C)
$0
Item 24
Column (A)
Repayments Received During Period

Cash
(D)(1)
$0
Item 61
Other Than Cash

(D)(2)
$0
Item 45
Loans
Outstanding at
End of Period
(E)
$0
Item 69
with Explanation
$0
Item 24
Column (B)

SCHEDULE 3 - SALE OF INVESTMENTS AND FIXED ASSETS
Description (if land or buildings give location)

(A)
Cost
(B)
Book Value
(C)
$0
Gross Sales Price

(D)
$0
Amount Received
(E)
$0
$0
Less Reinvestments
(The total from Net Sales Line will be automatically entered in Item 43)Net Sales
SCHEDULE 4 - PURCHASE OF INVESTMENTS AND FIXED ASSETS
Description (if land or buildings, give location)

(A)
Cost
(B)
Book Value
(C)
$0
Cash Paid
(D)
$0
$0
Less Reinvestments
(The total from Net Purchases Line will be automatically entered in Item 60.)Net Purchases
SCHEDULE 5 - INVESTMENTS

Description
(A)
Amount
(B)
Marketable Securities
A. Total Cost
B. Total Book Value
C. List each marketable security which has a book value over $5,000 and exceeds 5% of Line B.
Other Investments
D. Total Cost
E. Total Book Value
F. List each other investment which has a book value over $5,000 and exceeds 5% of Line E. Also, list each subsidiary for which separate reports are
attached.
G. Total of Lines B and E (Total will be automatically entered in Item 26, Column(B))
$0
SCHEDULE 6 - FIXED ASSETS

Description
(A)
A.
B.
C.
D.
Total Depreciation or
Amount Expensed
(C)
Cost or Other Basis

(B)
Land (give location)

Buildings (give location)
Automobiles and Other Vehicles
Office Furniture and Equipment
Book Value
(D)
Value
(E)
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
E. Other Fixed Assets

F. Totals of Lines A through E (Column(D) Total will be automatically entered
in Item 27, Column(B))
SCHEDULE 7 - OTHER ASSETS

Description
(A)
Total (Total will be automatically entered in Item 28, Column(B))
Book Value
(B)
$0

SCHEDULE 8 - ACCOUNTS PAYABLE AGING SCHEDULE

Total Account
Payable
(B)
Entity or Individual Name

(A)
Total for all itemized accounts payable
Total from all other accounts payable
Totals (Total for Column(B) will be automatically entered in Item 30, Column(D))
90-180 Days
Past Due
(C)
$0
$0
$0
Liquidated
Account
Payable
(E)
180+ Days Past

Due
(D)
$0
$0
$0
$0
$0
$0
SCHEDULE 9 - LOANS PAYABLE
$0
$0
$0
Source of Loans Payable at Any

Time During the Reporting Period
(A)
Loans Owed at
Start of Period
(B)
Total Loans Payable
Loans Obtained
During Period
(C)
$0
Item 31
Column (C)
Totals will be automatically entered in...
Repayment
During Period
Cash
(D)(1)
$0
Item 44
Repayment
During Period
Other Than Cash
(D)(2)
Loans Owed at
End of Period
(E)
$0
Item 62
$0
Item 69
with Explanation
$0
Item 31
Column (D)

SCHEDULE 10 - OTHER LIABILITIES
Description
(A)
Total Other Liabilities (Total will be automatically entered in Item 33, Column(D))
Amount at End of Period

(B)
$0
SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS
(A)
Name
(B)
Title
A
B
C
RALEIGH, MARK
PRESIDENT
C
Schedule 15
A
B
C
WILLIAMS II, CHARLES

VICE PRESIDENT
C
Schedule 15
A
B
C
ALTEFOGT, ZAC
SECRETARY/TREASURER
C
Schedule 15
(C)
Status

(D)
Gross Salary
Disbursements
(before any
deductions)
(E)
Allowances
Disbursed
$0
0%
Schedule 16
Political Activities and
Lobbying
0%
Schedule 16
Lobbying
0%
Schedule 16
Lobbying
0%
Schedule 17
Contributions
(G)
Other
Disbursements not reported in
(D) through (F)
$0
0%
$0
Schedule 17
Contributions
$0
0%
$0
Schedule 17
Contributions
$0
0%
(F)
Disbursements for
Official Business
Schedule 18
General Overhead
$0
0%
$0
0%
$0
Schedule 18
General Overhead
$0
0%
$0
0%
Schedule 18
General Overhead
Schedule 19
Administration
Schedule 19
Administration
$0
0%
Schedule 19
Administration
(H)
TOTAL
$0
100 %
$0
100 %
$0
100 %
Total Officer Disbursements

Less Deductions
Net Disbursements
$0
$0
$0
$0
$0
SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES

Schedule 15
Total Employee Disbursements
Less Deductions
I
$0
Schedule 16
Political Activities and Lobbying
Schedule 17
Contributions
$0
$0
Schedule 18
General Overhead
$0
Schedule 19
Administration
$0
$0
Net Disbursements
$0

SCHEDULE 13 - MEMBERSHIP STATUS

Category of Membership
(A)
Number
(B)
Members (Total of all lines above)

Agency Fee Payers*
Total Members/Fee Payers
*Agency Fee Payers are not considered members of the labor organization.
Voting Eligibility
(C)
0
0
DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19
1.
2.
3.
4.
SCHEDULE 14 OTHER RECEIPTS

Named Payer Itemized Receipts
Named Payer Non-itemized Receipts
All Other Receipts
Total Receipts
SCHEDULE 15 REPRESENTATIONAL ACTIVITIES

Named Payee Itemized Disbursements
Named Payee Non-itemized Disbursements
To Officers
To Employees
All Other Disbursements
Total Disbursements
SCHEDULE 16 POLITICAL ACTIVITIES AND LOBBYING
1. Named Payee Itemized Disbursements
2. Named Payee Non-itemized Disbursements
3. To Officers
4. To Employees
5. All Other Disbursements
6. Total Disbursement
1.
2.
3.
4.
5.
6.
SCHEDULE 14 - OTHER RECEIPTS
$2,045,885
$0
$6,800
$2,052,685
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
1.
2.
3.
4.
5.
6.
1.
2.
3.
4.
5.
6.
1.
2.
3.
4.
5.
6.
SCHEDULE 17 CONTRIBUTIONS, GIFTS & GRANTS

To Officers
To Employees
Total Disbursements
SCHEDULE 18 GENERAL OVERHEAD
To Officers
To Employees
Total Disbursements
SCHEDULE 19 UNION ADMINISTRATION
To Officers
To Employees
Total Disbursements
$0
$0
$0
$0
$0
$98,480
$73,602
$0
$0
$36,965
$209,047
$1,370,262
$24,115
$0
$0
$29,673
$1,424,050
Name and Address

(A)
SEIU INTERNATIONAL
1800 MASS AVE. NW
WASHINGTON
DC
20036
Type or Classification
(B)
NOT FOR PROFIT UNION
Purpose
(C)
SUBSIDY
SUBSIDY
SUBSIDY
SUBSIDY
SUBSIDY
SUBSIDY
SUBSIDY
SUBSIDY
SUBSIDY
SUBSIDY
SUBSIDY
SUBSIDY
SUBSIDY
SUBSIDY
Total Itemized Transactions with this Payee/Payer
Total Non-Itemized Transactions with this Payee/Payer
Total of All Transactions with this Payee/Payer for This Schedule
Date
(D)
01/03/2014
01/21/2014
02/04/2014
03/28/2014
04/25/2014
05/30/2014
06/27/2014
06/27/2014
08/01/2014
08/28/2014
09/26/2014
10/31/2014
11/21/2014
12/23/2014
Amount
(E)
$152,195
$152,195
$152,195
$152,195
$152,195
$152,195
$23,350
$152,195
$152,195
$196,195
$152,195
$152,195
$152,195
$152,195
$2,045,885
$2,045,885

SCHEDULE 15 - REPRESENTATIONAL ACTIVITIES

There was no data found for this schedule.
SCHEDULE 16 - POLITICAL ACTIVITIES AND LOBBYING
FILE NUMBER 544-952

SCHEDULE 17 - CONTRIBUTIONS, GIFTS & GRANTS

SCHEDULE 18 - GENERAL OVERHEAD

Name and Address
(A)
BELLOWS ASSOCIATES, P.A.
7890 PETERS ROAD, STE G-102
PLANTATION
FL
33324
(B)
ACCOUNTING FIRM
Name and Address
(A)
CAPRI CLEANING
8095 PROSPECT AVE
WARREN
MI
48089
Purpose
(C)
ACCOUNTING FEES
Purpose
(C)
Date
(D)
08/25/2014
Amount
(E)
Date
(D)
Amount
(E)
$6,030
$6,030
$2,594
$8,624
$10,320
$10,320
(B)
CLEANING SERVICE
Name and Address
(A)
DEBORAH CHOLY, ATTORNEY
220 BAGLEY ST, STE 900
DETROIT
MI
48226
(B)
LAW FIRM
Name and Address
(A)
GLENN M. SEMMINGTON
503 S. SAGINAW ST, STE 100
FLINT
MI
48502
(B)
LAW FIRM
Name and Address
(A)
GREWAL LAW PLLC
2290 SCIENCE PARKWAY
OKEMOS
MI
48864
(B)
LAW FIRM
Name and Address
(A)
IMAGE POINTE
657
WATERLOO
IA
50704
(B)
Purpose
(C)
LEGAL FEES
Purpose
(C)
LEGAL FEES
Purpose
(C)
LEGAL FEES
Date
(D)
09/02/2014
Amount
(E)
Date
(D)
11/04/2014
Amount
(E)
Date
(D)
08/27/2014
Amount
(E)
$5,000
$5,000
$4,875
$9,875
$5,000
$5,000
$4,725
$9,725
$5,500
$5,500
$5,500
Purpose
(C)
Date
(D)
Purpose
(C)
Date
(D)
Amount
(E)
$15,803
$15,803
SUPPLIER
Name and Address
(A)
JAB TECH
36380 GARFIELD RD, STE 3
CLINTON TWP
MI
48035
Amount
(E)
$8,610
$8,610
(B)
IT SUPPORT
Name and Address
(A)
JON POSNER
645 GRISWOLD ST
DETROIT
MI
48226
(B)
LAW FIRM
Name and Address
(A)
MCCONNELL COMMUNICATIONS
400 MONROE ST, STE 610
DETROIT
MI
48226
(B)
TELEPHONE COMPANY
Name and Address
(A)
MCNICHOLS OFFICE CENTER
11000 W. MCNICHOLS
DETROIT
MI
48221
(B)
LANDLORD
Name and Address
(A)
NAACP
8220 2ND AVE
DETROIT
MI
48202
(B)
Purpose
(C)
LEGAL FEES
Date
(D)
10/17/2014
Date
(D)
07/23/2014
08/11/2014
09/26/2014
10/02/2014
12/01/2014
12/12/2014
Purpose
(C)
Date
(D)
REIMBURSE FOR SERVICES

$5,000
$5,000
$5,000
Purpose
(C)
COMMUNICATIONS SERVICES
Purpose
(C)
Amount
(E)
Amount
(E)
$10,000
$10,000
$10,000
$14,450
$10,000
$10,000
$64,450
$64,450
Amount
(E)
$26,675
$26,675
Date
(D)
04/18/2014
Amount
(E)
$7,500
$7,500
$7,500
NOT FOR PROFIT

SCHEDULE 19 - UNION ADMINISTRATION
Name and Address

(A)
AMERICAN SERBIAN MEMORIAL HALL
19940 VAN DYKE ST
Purpose
(C)
EVENT
Date
(D)
09/02/2014
Amount
(E)
$5,200
DETROIT
MI
48234
(B)
EVENT
12/11/2014
Purpose
(C)
Date
(D)
$6,200
$11,400
$3,595
$14,995
EVENT VENUE
Name and Address
(A)
DELTA
614 E SERVICE DRIVE
DETROIT
MI
48242
(B)
AIRLINE
Name and Address
(A)
GOOD JOBS NOW
Purpose
(C)
269 WALKER ST, STE 843

DETROIT
MI
48207
(B)
NOT FOR PROFIT
Name and Address
(A)
GOOD SAMARITAN COMFORT

2178 FORT STREET

LICOLN PARK
MI
48146
(B)
BUS COMPANY
Name and Address
(A)
MICHIGAN ORGANIZING PROJECT
TRANSPORTATION
930 LAKE STREET

KALAMAZOO
MI
49001
(B)
NOT FOR PROFIT
Purpose
(C)
Purpose
(C)
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
Amount
(E)
$5,520
$5,520
Date
(D)
12/18/2014
Amount
(E)
$8,351
$8,351
$8,351
Date
(D)
04/21/2014
Amount
(E)
Date
(D)
01/10/2014
01/30/2014
02/13/2014
03/18/2014
04/18/2014
05/13/2014
06/05/2014
06/26/2014
07/18/2014
08/08/2014
08/22/2014
09/11/2014
09/22/2014
10/02/2014
Amount
(E)
$5,400
$5,400
$400
$5,800
$45,000
$45,000
$45,000
$45,000
$45,000
$45,000
$45,000
$45,000
$45,000
$25,000
$25,000
$37,944
$13,315
$22,000

Name and Address
(A)
Purpose
(C)
NCCE
1031 N.ACADEMIC WAY,STE 242
COEUR D'ALENE
ID
83814
(B)
NOT FOR PROFIT
Name and Address
(A)
NORTHERN STAR CHARTER & TOURS
7864
FLINT
MI
48507
(B)

Purpose
(C)
TRANSPORTATION
10/16/2014
10/30/2014
11/14/2014
12/02/2014
12/11/2014
12/19/2014
$30,389
$32,339
$23,734
$33,704
$21,457
$8,932
$678,814
$678,814
Date
(D)
12/10/2014
12/29/2014
Amount
(E)
Date
(D)
05/05/2014
Amount
(E)
Date
(D)
05/05/2014
Amount
(E)
$15,000
$25,000
$40,000
$2,967
$42,967
$5,220
$5,220
$4,801
$10,021
BUS COMPANY
Name and Address
(A)
ON THE MOVE COACHES
1267 W. HILL RD
FLINT
MI
48507
(B)
Purpose
(C)
TRANSPORTATION
$7,950
$7,950
$7,950
BUS COMPANY
Name and Address
(A)
SEIU HEALTHCARE MICHIGAN
2604 FOURTH STREET
DETROIT
MI
48201
(B)
NOT FOR PROFIT
Purpose
(C)
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
REIMBURSE
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
FOR SERVICES
Date
(D)
01/28/2014
02/26/2014
03/24/2014
04/29/2014
05/29/2014
06/27/2014
07/28/2014
08/25/2014
09/26/2014
10/31/2014
Amount
(E)
$58,324
$57,209
$52,068
$49,847
$60,329
$43,942
$45,372
$45,229
$45,051
$67,194
Name and Address

(A)
TRINITY TRANSPORTATION GROUP
4624 THIRTEENTH STREET
WYANDOTTE
MI
48192
(B)
BUS COMPANY

11/25/2014
12/23/2014
Purpose
(C)
Date
(D)
$613,127
69. ADDITIONAL INFORMATION SUMMARY
Amount
(E)
$6,832
$6,832
SCHEDULE 20 - BENEFITS
Description
(A)
Total of all lines above (Total will be automatically entered in Item 55.)
$42,399
$46,163
$613,127

To Whom Paid
(B)
Amount
(C)
$0
Question 13: The Union had a total of two misappropriated/altered checks as follows: 3/14 - A check issued on 12/18/13 was discovered in March 2014 to have been adjusted for a $400 increase.
1/15 - A check that was written for $50 was discovered to have been cashed for $150 for which $100 was subsequently recovered by the Union.
Statement A,
Cash Begin Total: Amended 2013 LM Report

Michigan Workers Organizing Committee 2014 Form LM-2

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Michigan Workers Organizing Committee 2014 Form LM-2

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FORM LM-2 LABOR ORGANIZATION ANNUAL REPORT

MUST BE USED BY LABOR ORGANIZATIONS WITH $250,000 OR MORE IN TOTAL ANNUAL

For Official Use Only

3. (a) AMENDED - Is this an amended report:

4. AFFILIATION OR ORGANIZATION NAME

8. MAILING ADDRESS (Type or print in capital letters)

P.O Box - Building and Room Number

7. UNIT NAME (if any)

Number and Street

9. Are your organization's records kept at its mailing address?

FILE NUMBER: 544-952

STATEMENT A - ASSETS AND LIABILITIES

FILE NUMBER: 544-952

35. NET ASSETS

End of Reporting Period

29. TOTAL ASSETS

Start of Reporting Period

Start of Reporting Period

End of Reporting Period

STATEMENT B - RECEIPTS AND DISBURSEMENTS

FILE NUMBER: 544-952

Form LM-2 (Revised 2010)

FILE NUMBER: 544-952

Entity or Individual Name

SCHEDULE 2 - LOANS RECEIVABLE

FILE NUMBER: 544-952

Total of loans not listed above

Repayments Received During Period

Other Than Cash

Form LM-2 (Revised 2010)

FILE NUMBER: 544-952

Description (if land or buildings give location)

Gross Sales Price

FILE NUMBER: 544-952

Description (if land or buildings, give location)

Total of all lines above

FILE NUMBER: 544-952

SCHEDULE 6 - FIXED ASSETS

FILE NUMBER: 544-952

Cost or Other Basis

Land (give location)

E. Other Fixed Assets

FILE NUMBER: 544-952

Total (Total will be automatically entered in Item 28, Column(B))

Form LM-2 (Revised 2010)

FILE NUMBER: 544-952

Entity or Individual Name

180+ Days Past

SCHEDULE 9 - LOANS PAYABLE

FILE NUMBER: 544-952

Source of Loans Payable at Any

Total Loans Payable

Totals will be automatically entered in...

Form LM-2 (Revised 2010)

FILE NUMBER: 544-952

Amount at End of Period

SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS

WILLIAMS II, CHARLES

FILE NUMBER: 544-952

Total Officer Disbursements

SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES

FILE NUMBER: 544-952

Form LM-2 (Revised 2010)