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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
544-979

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


CAROLINA WORKERS ORGANIZING COMMITTEE
5. DESIGNATION (Local, Lodge, etc.)

No
No
No

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


First Name
BEN

6. DESIGNATION NBR
0

Last Name
WILKINS

P.O Box - Building and Room Number

7. UNIT NAME (if any)


Number and Street
324 SOUTH WILMINGTON

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

Yes

City
RALEIGH
State
NC

ZIP Code + 4
27601

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:
Benjamin H Wilkins
PRESIDENT
71. SIGNED:
Keith M Bullard
TREASURER
Date:
Mar 18, 2015
Telephone Number:
919-389-6986
Date:
Mar 18, 2015
Telephone Number:
919-798-2585
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: 544-979


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?
Form LM-2 (Revised 2010)

No
$100,000
No
No
No
No
07/2015

STATEMENT A - ASSETS AND LIABILITIES

FILE NUMBER: 544-979

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

Start of Reporting Period


(A)

LIABILITIES

30.
31.
32.
33.
34.

Accounts Payable
Loans Payable
Mortgages Payable
Other Liabilities
TOTAL LIABILITIES

35. NET ASSETS


Form LM-2 (Revised 2010)

$5,929

$23,454
$0

$0

$0

$5,929

$23,454

1
2
5
6
7

29. TOTAL ASSETS

LIABILITIES

End of Reporting Period


(B)

Schedule
Number
8
9

Start of Reporting Period


(A)

End of Reporting Period


(B)

$0

$0

$0

$0

$5,929

$23,454

10

STATEMENT B - RECEIPTS AND DISBURSEMENTS

36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.

FILE NUMBER: 544-979

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.
$1,542,713 62.
$1,542,713 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
$149,240
$1,262,320
$0
$113,628
$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

$1,525,188
$0
$0
$1,525,188

Form LM-2 (Revised 2010)


SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE

FILE NUMBER: 544-979


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))
Form LM-2 (Revised 2010)

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)

FILE NUMBER: 544-979


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)

Form LM-2 (Revised 2010)


SCHEDULE 3 - SALE OF INVESTMENTS AND FIXED ASSETS

FILE NUMBER: 544-979

Description (if land or buildings give location)


(A)
Total of all lines above

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
Form LM-2 (Revised 2010)
SCHEDULE 4 - PURCHASE OF INVESTMENTS AND FIXED ASSETS

FILE NUMBER: 544-979

Description (if land or buildings, give location)


(A)

Cost
(B)

Total of all lines above

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
Form LM-2 (Revised 2010)
SCHEDULE 5 - INVESTMENTS

FILE NUMBER: 544-979


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))
Form LM-2 (Revised 2010)

$0

SCHEDULE 6 - FIXED ASSETS

FILE NUMBER: 544-979


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))
Form LM-2 (Revised 2003)
SCHEDULE 7 - OTHER ASSETS

FILE NUMBER: 544-979


Description
(A)

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

Book Value
(B)
$0

Form LM-2 (Revised 2010)


SCHEDULE 8 - ACCOUNTS PAYABLE AGING SCHEDULE

FILE NUMBER: 544-979


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))
Form LM-2 (Revised 2010)

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

FILE NUMBER: 544-979

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)

Form LM-2 (Revised 2010)


SCHEDULE 10 - OTHER LIABILITIES

FILE NUMBER: 544-979

Description
(A)
Total Other Liabilities (Total will be automatically entered in Item 33, Column(D))
Form LM-2 (Revised 2010)

Amount at End of Period


(B)
$0

SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS

(A)
Name

(B)
Title

A
B
C

WILKINS, BENJAMIN
PRESIDENT
C

Schedule 15
Representational Activities

A
B
C

MACK, CORINE
VICE PRESIDENT
C

Schedule 15
Representational Activities

A
B
C

BULLARD, KEITH
SECRETARY/TREASURER
N

Schedule 15
Representational Activities

(C)
Status

FILE NUMBER: 544-979


(D)
Gross Salary
Disbursements
(before any
deductions)

(E)
Allowances
Disbursed

$0

50 %

Schedule 16
Political Activities and
Lobbying

0%

0%

Schedule 16
Political Activities and
Lobbying

0%

Schedule 17
Contributions

(G)
Other
Disbursements not reported in
(D) through (F)

$0

0%

$0

Schedule 17
Contributions
$0

25 %

$0

Schedule 17
Contributions
$0

Schedule 16
100 % Political Activities and
Lobbying

(F)
Disbursements for
Official Business

Schedule 18
General Overhead

$0

0%

$0

0%

$0

Schedule 18
General Overhead

Schedule 18
General Overhead

Schedule 19
Administration

$0

50 %

$0

0%

$0

0%

(H)
TOTAL

Schedule 19
Administration
$0

0%

Schedule 19
Administration

$0

0%

$0

75 %

A
B
C

COLES, ANTHONY
SECRETARY/TREASURER
P

Schedule 15
Representational Activities

$0

25 %

Schedule 16
Political Activities and
Lobbying

0%

Total Officer Disbursements


Less Deductions
Net Disbursements
Form LM-2 (Revised 2010)

$0

Schedule 17
Contributions

$0

0%

$0

$0

$0

Schedule 18
General Overhead

0%

Schedule 19
Administration

$0

Schedule 15
Representational Activities
Total Employee Disbursements
Less Deductions

75 %

$0

$0
$0

SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES


I

$0

FILE NUMBER: 544-979

Schedule 16
Political Activities and Lobbying

Schedule 17
Contributions
$0

$0

Schedule 18
General Overhead
$0

Schedule 19
Administration
$0

$0

Net Disbursements

$0

Form LM-2 (Revised 2010)


SCHEDULE 13 - MEMBERSHIP STATUS

FILE NUMBER: 544-979


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.
Form LM-2 (Revised 2010)

Voting Eligibility
(C)
0
0

DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19

1.
2.
3.
4.

1.
2.
3.
4.
5.
6.
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
Named Payee Itemized Disbursements
Named Payee Non-itemized Disbursements
To Officers
To Employees

FILE NUMBER: 544-979

$1,540,603
$0
$2,110
$1,542,713

$0
$0
$0
$0

1.
2.
3.
4.
5.
6.

$0

1.
2.
3.
4.
5.
6.

$0
$0
$0
$0

1.
2.
3.
4.

SCHEDULE 17 CONTRIBUTIONS, GIFTS & GRANTS


Named Payee Itemized Disbursements
Named Payee Non-itemized Disbursements
To Officers
To Employees
All Other Disbursements
Total Disbursements
SCHEDULE 18 GENERAL OVERHEAD
Named Payee Itemized Disbursements
Named Payee Non-itemized Disbursements
To Officers
To Employees
All Other Disbursements
Total Disbursements
SCHEDULE 19 UNION ADMINISTRATION
Named Payee Itemized Disbursements
Named Payee Non-itemized Disbursements
To Officers
To Employees

$0
$0
$0
$0
$0

$0
$73,728
$0
$0
$75,512
$149,240
$1,132,768
$74,866
$0
$0

5. All Other Disbursements


6. Total Disbursement
Form LM-2 (Revised 2010)

$0

5. All Other Disbursements


6. Total Disbursements

$54,686
$1,262,320

SCHEDULE 14 - OTHER RECEIPTS


Name and Address
(A)
CITY OF CHARLESTON
80 BROAD STREET
CHARLESTON
NC
29401
Type or Classification
(B)
INTERNATIONAL UNION
Name and Address
(A)
FARBER LAW FIRM
40902
RALEIGH
NC
27629
Type or Classification
(B)

FILE NUMBER: 544-979

Purpose
(C)
UNUSED COURT FINE MONEY
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)
09/19/2014

Purpose
(C)
UNUSED STRIKE BAIL MONEY
UNUSED STRIKE BAIL MONEY
UNUSED STRIKE BAIL MONEY
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)
09/10/2014
09/15/2014
09/18/2014

Amount
(E)
$9,978
$9,978
$9,978

Amount
(E)
$15,554
$10,000
$6,800
$32,354
$32,354

LAW FIRM
Name and Address
(A)
SEIU
1800 MASS AVE. NW
WASHINGTON
DC
20036
Type or Classification
(B)
INTERNATIONAL UNION

Purpose
(C)
SUBSIDY
SUBSIDY
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
01/31/2014
02/28/2014
03/28/2014
04/25/2014
05/09/2014
05/30/2014
06/27/2014
08/01/2014
08/28/2014
09/26/2014
10/10/2014
10/31/2014
11/21/2014
12/09/2014
12/23/2014

Amount
(E)
$59,224
$122,507
$119,507
$119,507
$119,507
$12,500
$115,195
$108,610
$96,532
$221,757
$105,329
$6,000
$31,901
$123,141
$20,900
$116,154
$1,498,271
$1,498,271

Form LM-2 (Revised 2010)


SCHEDULE 15 - REPRESENTATIONAL ACTIVITIES

FILE NUMBER: 544-979


There was no data found for this schedule.

SCHEDULE 16 - POLITICAL ACTIVITIES AND LOBBYING

FILE NUMBER 544-979


There was no data found for this schedule.

SCHEDULE 17 - CONTRIBUTIONS, GIFTS & GRANTS

FILE NUMBER: 544-979


There was no data found for this schedule.

SCHEDULE 18 - GENERAL OVERHEAD

FILE NUMBER: 544-979

Name and Address


(A)
CRICKET MOBILE
323 S ARLINGTON STREET
SALISBURY
NC
28144
Type or Classification
(B)
PHONE COMPANY
Name and Address
(A)
ELYRON, LLC
8520 UNION GROVE CHURCH RD
CHAPEL HILL
NC
27516
Type or Classification
(B)
RENTAL AGENT
Name and Address
(A)
FUSION FILMS
534
PLEASANT GARDEN
NC
27313
Type or Classification
(B)
PRODUCTION COMPANY
Name and Address
(A)
KIT THRASH PROPERTIES
25 BROAD STREET
CHARLESTON
SC
29401
Type or Classification
(B)
RENTAL AGENT
Name and Address
(A)

Purpose
(C)
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)

Purpose
(C)
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)

Purpose
(C)
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)

Purpose
(C)
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)

Amount
(E)
$5,519
$5,519

Amount
(E)
$24,678
$24,678

Amount
(E)
$18,156
$18,156

Amount
(E)
$8,182
$8,182

NC TEES OF RALEIGH
2660 DISCOVERY DRIVE
RALEIGH
NC
27616
Type or Classification
(B)
MERCHANDIZER
Name and Address
(A)
OFFICE DEPOT
4001 CHAPEL HILL BLVD
DURHAM
NC
27707
Type or Classification
(B)
MERCHANDIZER
Name and Address
(A)
USA UNION PRO
2496 ROSS CROSSING RD
KEVIL
KY
42053
Type or Classification
(B)
MERCHANDIZER
Form LM-2 (Revised 2010)

Purpose
(C)
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)

Purpose
(C)
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)

Purpose
(C)
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)

$5,498
$5,498

ACTION NC
5550 EXECUTIVE CENTER DR
CHARLOTTE
NC
28212
Type or Classification
(B)
PAYROLL SERVICES

Amount
(E)
$5,579
$5,579

Amount
(E)
$6,116
$6,116

SCHEDULE 19 - UNION ADMINISTRATION


Name and Address
(A)

Amount
(E)

FILE NUMBER: 544-979


Purpose
(C)
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
REIMBURSE FOR SERVICES
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)
01/14/2014
02/11/2014
03/04/2014
03/28/2014
04/01/2014
04/29/2014
07/15/2014
08/29/2014
09/24/2014
11/24/2014
12/09/2014
12/29/2014
06/18/2014
08/06/2014
10/08/2014

Amount
(E)
$48,000
$80,000
$90,000
$20,030
$70,000
$85,000
$90,000
$95,000
$60,000
$95,000
$30,000
$95,000
$90,000
$80,000
$90,000
$1,118,030
$1,118,030

Name and Address


(A)
CLARION INN
3207 N BLVD
RICHMOND
VA
23230
Type or Classification
(B)
HOTEL COMPANY
Name and Address
(A)
EXPEDIA
3150 139TH AVE SE
BELLEVUE
WA
98005
Type or Classification
(B)
TRAVEL AGENT
Name and Address
(A)
EXTENDEDSTAY
11525 N COMMUNITY HOUSE RD
CHARLOTTE
NC
28277
Type or Classification
(B)
HOTEL COMPANY
Name and Address
(A)
FOOD LION
2110 EXECUTIVE DRIVE
SALISBURY
NC
28145
Type or Classification
(B)
MERCHANDIZER
Name and Address
(A)
QUALITY INN
6811 E MAYO BLVD STE 100
PHOENIX
AZ
85054
Type or Classification
(B)
HOTEL COMPANY

Purpose
(C)
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)

Purpose
(C)
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)

Purpose
(C)
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)

Purpose
(C)
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)

Purpose
(C)
ORGANIZER MEETING
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

Amount
(E)
$6,196
$6,196

Amount
(E)
$36,104
$36,104

Amount
(E)
$5,012
$5,012

Amount
(E)
$15,348
$15,348

Date
(D)
12/09/2014

Amount
(E)
$7,659
$7,659
$4,136
$11,795

Name and Address


(A)
RAMADA
2003 ATHENA COURT
GREENSBORO
NC
27407
Type or Classification
(B)
HOTEL COMPANY
Name and Address
(A)
US AIRWAYS
4000 SKY HARBOR BLVD
PHOENIX
AZ
85034
Type or Classification
(B)
AIRLINE
Form LM-2 (Revised 2010)

Purpose
(C)
ORGANIZER MEETING
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)
11/17/2014

Amount
(E)

Date
(D)

Amount
(E)

Purpose
(C)
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

$6,877
$6,877

SCHEDULE 20 - BENEFITS
Description
(A)
Total of all lines above (Total will be automatically entered in Item 55.)
Form LM-2 (Revised 2010)
69. ADDITIONAL INFORMATION SUMMARY
Statement A,
Accounts Receivable Begin Total: 0
Form LM-2 (Revised 2010)

$7,079
$7,079
$1,193
$8,272

FILE NUMBER: 544-979


To Whom Paid
(B)

Amount
(C)
$0

FILE NUMBER: 544-979

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