Public reporting burden for this collection of inform ation is estimated to average approximately 1 03 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completi ng and reviewing the collection of information. Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. Reporting of this information is mandatory and is required by the Labor

- Management Reporting and Disclosure Act of 1959, as amended, for the purpose of public disclosure. As this is public information, there are no assurances of confidentiality. If you have any comments regarding this estimate or any other aspect

of this information col lection, including suggestions for reducing this burden, please send them to the U.S. Department of Labor, Office of Labor

- Management Standards, Division of Interpretations and Standards,

Room N

- 5609, 200 Constitution Avenue, NW, Washington, DC 20210.



# IN STRUCTIONS FOR FORM LM

- 3

LABOR ORGANIZATION ANNUAL REPORT

GENERAL INSTRUCTIONS

I. WHO MUST FILE

Every labor organization subject to the Labor

Management Reporting and Disclosure Act of 1959, as amended (LMRDA), the Civil Service Reform Act (CSRA), or th e Foreign Service Act (FSA) must file a financial report, Form

LM

- 2, LM

- 3, or LM

- 4, each year with the Office

of Labor

- Management Standards (OLMS) of the U.S. Department of Labor. These laws cover labor organizations that represent employees who work in pr ivate industry, employees of the U.S. Postal Service, and most Federal government employees. Labor organizations that represent or include only state, county, or municipal government employees are not covered by these laws and, therefore, are not required to file. If you have a question about whether your organization is required to file, contact the nearest OLMS field

office listed at the end of these instructions.



### II. WHAT FORM TO FILE

Every labor organization subject to the LMRDA, CSRA, or FSA with tota l annual receipts of less than $250,000 may file the simplified annual report Form LM

- 3, if not in trusteeship as defined in Section IX of these

instructions. The term “total annual receipts” means all financial receipts of the labor organization during it s fiscal year, regardless of the source, including receipts of any special funds as described in Section VIII of these instructions and any “subsidiaries” as

defined in Section X. Labor organizations with greater total annual receipts and those in trustee ship must file the

more detailed Form LM

- 2. Labor organizations with less than $10,000 in total annual receipts may file the abbreviated 2

- page annual report

Form LM

- 4, if not in trusteeship.



### III. WHEN TO FILE

Form LM

- 3 must be filed within 90 days after the end of your organization’s fiscal year (12

- month reporting period). The law does not authorize the U.S. Department of Labor to grant an extension of time for filing reports for any reason. The penalties for delinquency are described in Section VI of

th ese instructions.

If your organization went out of existence during its fiscal year, a terminal financial report must be filed within 30 days after the
date it ceased to exist. See Section XII of these instructions for information on filing a

terminal fin ancial report.



### IV. HOW TO FILE

Form LM

- 3 must be submitted electronically to the Department. Form LM

- 3 filer s will be able to file report s in paper format only if they assert a temporary hardship exemption.

If you have difficulty navigating the software

, or have questions about its functions and features, call the OLMS Help Desk at: (866)

401

- 1109. For questions concerning the reporting requirements, please send an e

mail to OLMS

- Public@dol.gov or call (202)

693

- 0123

.TEMPORARY HARDSHIP EXEMPTION:

If a labor organization experiences unanticipated technical difficulties that prevent the timely preparation and submission of an electronic filing, the organization may assert a temporary hardship exemption to prepa re and s ubmit

Form LM

- 3 in paper format by the required due date. An electronic format copy of the filed paper format document shall be submitted to the Department within ten business days after the required due date. Unanticipated technical difficulties t hat may result in additional delays should be brought

to the attention of the OLMS Division of Interpretations and Standards, which can be reached at the address below, by email at

OLMS

- Public@dol.gov , by phone at ( 202 )

693

- 0123, or by fax at 202

- 693

- 1340.

Note: If either the paper filing or the electronic filing is not received in the timeframe specified above, the report will be considered delinquent.



### V. PUBLIC DISCLOSURE

The LMRDA requires that the U.S. Department of Labor make labor organization fin ancial reports available for inspection by the public. Reports for the year 2000 and later may be viewed and

downloaded from the OLMS Online Public

Disclosure Room at www.unio nreports.gov

. Copies of reports and union constitutions and bylaws can be ordered at the same Web site. Reports may also be examined and copies purchased at the OLMS Public

Disclosure Room at:

U.S. Department of Labor

Office of Labor

- Management Standard s 200 Constitution Avenue, NW

Room N

- 1519 Washington, DC 20210

- 0001 Telephone: ( 202 ) 693

- 0125



### VI. OFFICER RESPONSIBILITIES

AND PENALTIES

The president and treasurer or the corresponding principal officers of the labor organization required to sign Form LM

- 3 are personally responsible for its filing and accuracy. Under the LMRDA, officers are subject to criminal penalties for willful failure to file a required report and for false reporting. False reporting includes making any false statement or misrepresen tation of

a material fact while knowing it to be false,

or for knowingly failing to disclose a material

fact in a required report or in the information required to be contained in it or in any information required to be submitted with it.

The reporting la bor organization and the

officers required to sign Form LM

- 3 are also subject to civil prosecution for violations of the filing requirements. Section 210 of the LMRDA (29 U.S.C. 440) provides that “whenever it shall appear that any person

has violated or i s about to violate any of the provisions of this title, the Secretary may bring a civil action for such relief (including injunctions) as may be appropriate.”

Under the CSRA and FSA and implementing regulations, false reporting and failure to report may r esult in administrative

enforcement action and litigation. The officers responsible for signing Form LM

- 3 are also subject to criminal penalties for

false reporting under Sections 1001 of Title

18 and 1746 of Title 28 of the United States

Code.



### VII. RECOR DKEEPING

The officers required to file Form LM

- 3 are responsible for maintaining records which will provide in sufficient detail the information and data necessary to verify the accuracy and completeness of the report. The records must be kept for at least 5 years after the

date the report is filed. Any record necessary to verify, explain, or clarify the report must be retained, including, but not limited to, vouchers, worksheets, receipts,

and applicable resolutions, and any electronic documents, including recordkeeping software, used to complete, read, and file the report.



### VIII. FUNDS TO BE REPORTED

Your labor organization’s Form LM

- 3 must report financial information for a ll funds of your organization. Include any special purpose funds or accounts, such as strike funds, vacation funds, and scholarship funds

2even it they are not part of your organization’s general treasury. All labor organization political action committee (PAC) funds are considered t o be labor organization funds. However, to avoid duplic ate reporting, PAC funds which are kept separate from your labor organization’s treasury are not required to be included in your organization’s Form LM

- 3 if publicly available reports on the PAC funds are filed with a Federal or state agency.

Your organiz ation is required to report financial information about any “subsidiary organizations.” Financial information about your organization and its subsidiary organizations may be combined on a single

Form LM

- 3 or you may attach to your Form

LM

- 3 report the reg ular annual report of the financial condition and operations of the subsidiary organization with a signed certification by an independent public

accountant . See Section X of these instructions for information on reporting

financial information for subsidia ry organizations.

If combining the information concerning subsidiary organizations, be sure to include the requested information and amounts for the subsidiary organizations as well as for all other assets of your union in all items.



## SPECIAL INSTRUCTIONS

FOR CERTAIN

ORGANIZATIONS

IX. LABOR ORGANIZATIONS IN

TRUSTEESHIP

Any labor organization which has placed a subordinate labor organization in trusteeship

is responsible for filing the subordinate’s

annual financial report. A trusteeship is

defined in sect ion 3(h) of the LMRDA as “any receivership, trusteeship, or other method of supervision or control whereby a

labor organization suspends the autonomy

otherwise available to a subordinate body

under its constitution or bylaws.”

Annual financial reports fil ed for any labor organization in trusteeship must be filed on

Form LM

- 2 rather than Form LM

- 3. The report must be signed by the president and treasurer or corresponding principal officers of the labor organization which imposed the trusteeship and by the t rustees of the

subordinate labor organization

. Form LM

- 2

can be downloaded from the OLMS Web

site at www.olms.dol.gov . For additional information contact any of the offices liste d

at the end of these instructions.



### X. LABOR ORGANIZATIONS WITH

SUBSIDIARY ORGANIZATIONS

A subsidiary organization, within the meaning of these instructions, is any separate organization of which the ownership is wholly vested in the reporting labor organ ization or its officers or its membership, which is governed or controlled by the officers, employees, or members of the reporting labor organization, and which is wholly financed by the reporting labor organization. A subsidiary organization is considered to be wholly financed if the initial financing was provided by the reporting labor organization even if the subsidiary organization is currently wholly or partially self

- sustaining. An example of a subsidiary organization is a building corporation which h olds title to a building; the labor organization owns the building corporation, selects the officers, and finances the operation of the building corporation.

If your organization has no subsidiary organization as defined above, skip to

Section Xl of the se instructions.

A labor organization is required to report

financial information for each of its subsidiary organizations using one of the following methods:

Method (1)

— Consolidate the financial information for the subsidiary organization(s)

and the l abor organization on a single Form

LM

- 3.

Method (2)

— File, with the labor organization’s Form LM

- 3, the regular annual report of the financial condition and operations of the subsidiary organization, accompanied by a statement signed by an independent pu blic accountant certifying that the financial report presents fairly the financial condition and operations of the

3subsidiary organization and was prepared in accordance with generally a ccepted accounting principles. Financial information reported separate ly for subsidiary organizations under this method must include the name of the subsidiary organization and the name and file number of the labor organizat ion as shown on its

Form LM

- 3. The financial report of the subsidiary organization must cover the same reporting period as that used by the reporting labor organization.

When method (2) is used and the subsidiary organization is an investment, the financial interest of the reporting labor organization in the subsidiary organization must be reported

in Ite m 28 (Investments) of the labor organization’s Form LM

- 3.

When method (2) is used and the subsidiary organization is of a non

- investment nature, the financial interest of the reporting labor organization in the subsidiary organization must be reported in Item 30 (Other Assets) of the labor organization’s Form LM

- 3.

The same type of information required on

Form LM

- 3 regarding disbursements to officers and employees and loans made by labor organizations must also be reported with respect t o the subsidiary organization. In method (1)

, the information relating to the subsidiary organization must be combined with that of the labor organization and reported on the labor organization’s Form

LM

- 3 in Item 24 (All Officers and Disbursements to Officers) and in Item 56 (Additional Information) for Items 17 (Employees) and 18 (Loans), in the detail required by the instructions. If method (2) is used, an attachment must be submitted containing the information required by the instructions for Items 17, 18, and 24.

The information regarding loans made by the subsidiary organization must include a listing of the names of each officer, employee, or member of the labor organization and each officer or employee of the subsidiary organization whose total loan

indebtedness to the subsidiary organization, to the labor organization, or to both at any time during the reporting period exceeded $250. However, if method (2) is used, the amount reported by the subsidiary organization should be only the amount owed to the subsidiary or ganization.

The annual financial report must also include all disbursements made by the subsidiary organization to or on behalf of its

officers and offic ers of the labor organization. The report must also list the name and position of the subsidiary

organ ization’s employees whose total gross salaries, allowances, and other disbursements from the subsidiary organization, the reporting labor organization, and any affi liates were more than $10,000. However, if method (2) is used, only the disbursements of the subsidiary organization for its employees should be reported.



### XI. COMPLETING FORM LM

- 3

M ost pages have a “ Save and Calculate ”

button to total and transfer data to fields in various parts of the form. You may click on

one or more of these buttons as you f ill out the form at any time.

You should click on the “Validate Form ”

button at any time to check for errors. This action will generate a “ Validation Summary Page ” listing any errors that will need to be corrected before you will be able to sign the

form. Clicking on the signature lines will also perform the validation function.



### INFORMATION ITEMS 1

- 23

Answer Items 1 through 23 as instructed.

Select the appropriate box for those questions requiring a "Yes" or "No" answer;

do not leave both boxes blank. Ent er a single "0" in the boxes for items requiring a

number or dollar amount if there is nothing
to report.

1. FILE NUMBER

— The software will enter

the labor organization’s 6

- digit file number here and at the top of each page of Form

LM

- 3. If the labor org anization does not

have the number on file and cannot obtain the number from prior reports filed with the Department, the number can be obtained

from the OLMS Online Public Disclosure

Room at www.unionreports.gov

, or by contacting the nearest OLMS field office

listed at the end of these instructions.

42. PERIOD COVERED

— The software will

enter the beginning and ending dates of the period covered by this report. These are the dates you entered when you started a new Form LM

- 3. If the dates are incorrect, you

must either delete this form and start again,

or contact the OLMS Help Desk at (866)

401

- 1109 for assistance

.

If the labor organization changed its fiscal year, the ending date in Item 2 (Period Covered) shou ld be the labor organization’s new fiscal year ending date and the labor organization should indicate in Item 56 (Additional Information) that the report is for a period of less than 12 months because its fiscal year has changed. For example, if the

labor organization’s fiscal year ending date changes from June 30 to December 31, a report must be filed for the partial year from July 1 to December 31. Thereafter, the labor organization’s annual report should cover a

full 12

- month period from January 1 to

Dec ember 31.

3. AMENDED , HARDSHIP EXEMPTED, OR

TERMINAL REPORT

— Do not complete

this item unless this report is an amended

, hardship exempted, or terminal report. Select Item 3(a) if the labor organization is filing an amended report correcting a previously filed report. Select Item 3(b) if the labor organization is filing under the hardship exemption procedures defined in

Section IV. Select Item 3( c ) if the labor organization has gone out of business by disbanding, merging into another labor organization, o r being merged and

consolidated with one or more labor organizations to form a new labor organization

. Be sure the date the labor organization ceased to exist is entered in Item 2 (Period Covered) after the word "Through." See Section XII (Labor Organizati ons That Have Ceased to Exist) of

these instructions for more information on filing a terminal report.

4. AFFILIATION OR ORGANIZATION

NAME

— The software access es this

information from the OLMS database and

will enter the name of the national or

internat ional labor organization that granted

the labor organization a charter. "Affiliates," within the meaning of these instructions, are labor organizations chartered by the same parent body, governed by the same constitution and bylaws, or having the

relations hip of parent and subordinate. For example, a parent body is an affiliate of all of its subordinate bodies, and all subordinate bodies of the same parent body are affiliates

of each other.

If the labor organization has not reported

such an affiliation, th e software will enter the

name of the labor organization as currently

identified in the labor organization's constitution and bylaws or other organizational documents.

This item cannot be edited. If the labor organization needs to change this information, contact OLMS at (202) 693

- 0124.

5. DESIGNATION

— The software will enter

the specific designation that is used to identify the labor organization, such as Local, Lodge, Branch, Joint Board, Joint Council, District Council, etc. This field

cannot be edite d.

6. DESIGNATION NUMBER

— The

software will enter the number or other identifier, if any, by which the labor organization is known. This field cannot be

edited.

7. UNIT NAME

— The software will enter

any additional or alternate name by which

the labor o rganization is known, such as "Chicago Area Local." This field cannot be

edited.

8. MAILING ADDRESS

— The software will

enter the current address where mail is most likely to reach the labor organization as quickly as possible. The first and last name

of the person, if any, to whom such mail should be sent and any building and room

number should be included. These fields are

pre

- filled from the OLMS database but can be edited by the filer.

9. PLACE WHERE RECORDS ARE KEPT

— If the records required to be ke pt by the labor organization to verify this report are kept at the address reported in Item 8 (Mailing Address), answer "Yes." If not,

answer "No" and provide in Item 56

5(Additional Information) the address where the labor organization's records are kept.

10. SUBSIDIARY ORGANIZATIONS

— If

Item 10 is answered “Yes,” provide in Item

56 (Additional Information) the name, address, and purpose of each subsidiary organization. Indicate whether the information concerning its financial condition and operations is included in this Form LM

- 3 or in a separate report. See Section X of

these instructions for information on reporting subsidiary organizations.

11. TRUSTS OR FUNDS

— Answer Item 11

“Yes” if your labor organization created or participated in the administrat ion of a “trust in which a labor organization is interested” which is defined in section 3(I) of the

LMRDA as “a trust or other fund or organization (1) which was created or established by a labor organization, or one

or more of the trustees or one or more members of the governing body of which is selected or appointed by a labor organization, and (2) a primary purpose of which is to provide benefits for the members of such labor organization or their

beneficiaries.”

If Item 11 is answered “Yes,” provide i n Item

56 (Additional Information) the name, address, and purpose of each trust. If a
report has been filed for the trust or other

fund under the Employee Retirement Income Security Act of 1974 (ERISA), report

in Item 56 (Additional Information) the

ERISA file number (Employer Identification

Number

— EIN) and plan number, if any.

12. POLITICAL ACTION COMMITTEE

FUNDS

— If Item 12 is answered “Yes,” provide in Item 56 (Additional Information)

the full name of each separate political

action committee (PAC) an d list the name of any government agency, such as the

Federal Election Commission or a state agency, with which the PAC has filed a publicly available report, and the relevant file

number of the PAC. (PAC funds which are kept separate from your labor organ ization’s treasury are not required to be included in your organization’s Form LM

- 3 if publicly available reports on the PAC funds are filed

with a Federal or state agency. See Section VIII of these instructions for additional information on PAC funds.)

1 3. ACQUISITION OR DISPOSITION OF

ASSETS

— If Item 13 is answered “Yes,”

describe in Item 56 (Additional Information)

the manner in which your organization acquired or disposed of assets, such as donating office furniture or equipment to charitable organiza tions, trading in assets, writing off a receivable, or giving away other tangible or intangible property of the labor organization. Include the type of asset, its value, and the identity of the recipient or donor, if any. Also report in Item 56 (Additional Information) the cost or other basis at which any acquired assets were entered on your organization’s books or the cost or other basis at which any assets disposed of were carried on your organization’s books.

For assets that were traded in, enter in Ite m 56 (Additional Information) the cost, book value, and trade

- in allowance.

14. AUDIT OR REVIEW OF BOOKS AND

RECORDS

— If Item 14 is answered “Yes,”

indicate in Item 56 (Additional Information) whether the audit or review was performed by an outside accou ntant or a parent body auditor/representative. If the audit or review

was performed by an outside a ccountant, provide the name of the accountant or accounting firm. Report any audit or review by an outside accountant or a parent body auditor/representative in which your organization’s books and records were

examined to verify their accuracy and validity. The term “audit or review” does not include providing assistance in developing a bookkeeping system, providing routine bookkeeping services, or merely comp iling

information from your organization’s books and records to prepare Form LM

- 3 or other financial reports. Also, do not answer Item

14 “Yes” if the audit or review was performed by an audit committee or trustees of your organization.

15. LOSSES OR SHOR TAGES

— If Item

15 is answered “Yes,” describe the loss or shortage in detail in Item 56 (Additional Information) , including such information as

the amount of the loss or shortage of funds or a description of the property that was lost,

6how it was lost, an d to what extent, if any, there has been an agreement to make restitution or any recovery by means of repayment, fidelity bond, insurance, or other

means.

16. ADDITIONAL POSITIONS OF

OFFICERS

— Answer Item 16 “Yes” only if an officer of your organization was paid $10,000 or more in salary, wages, and allowances by your organization and was paid $10,000 or more in salary, wages, and allowances as an officer or employee of

another labor organization or of an employee benefit plan. In calculating

whether an o fficer was paid $10,000 or more, include allowances paid on a daily, weekly, monthly, or other periodic basis. Do

not include allowances paid on the basis of mileage or meals or amounts officers received as reimbursed expenses. If Item 16 is answered “Yes, ” provide in Item 56 (Additional Information) the name of each officer, the name of the other labor organization(s) or employee benefit plan(s),

and the officer’s position in the other labor organization(s) or employee benefit plan(s).

17. EMPLOYEES

— Ans wer Item 17 “Yes” if any employee of your organization

received more than $10,000 in gross
salaries, allowances, and other direct and indirect disbursements during the reporting period (direct and indirect disbursements are

defined in the instructions for Item 24 [All Officers and Disbursements to Officers] ). In computing the total, add together all

disbursements made to each employee by your organization (including any subsidiary organization) and any affiliates. (“Affiliates” means labor organizations cha rtered by the

same parent body, governed by the same

constitution and bylaws, or having the relationship of parent and subordinate.)

If Item 17 is answered “Yes,” report in Item

56 (Additional Information) the name and position of each employee and the na mes of the other affiliated labor organizations which

made disbursements to or on behalf of the employee. Also report in Item 56 (Additional Information) the total disbursements made

to each employee or on the employee’s behalf by your organization, includ ing all salary and allowances (before any deductions) and other disbursements (including reimbursed expenses).

18. LOANS

— Answer Item 18 “Yes” if any officer, employee, or member owed your organization, together with any subsidiary organization, more tha n $250 at any time during the reporting period; or if your organization made a loan, regardless of
amount, to any business enterprise during the reporting period. Include any direct or

indirect loans whether or not evidenced by a promissory note or secured by a mortgage. An example of an indirect loan is a disbursement by your organization to an

educational institution for the tuition expense of an officer, employee, or member which must be repaid to your organization by that

individual.

If Item 18 is answ ered “Yes,” report in Item

56 (Additional Information) the name of each individual and business enterprise, the

amount each individual owed at the end of

the reporting period, and the amount loaned

to each business enterprise during the reporting period. A lso report in Item 56 (Additional Information) the purpose, terms for repayment, and any security for each

such loan.

NOTE: Advances, including salary advances, are considered loans and must be reported in Item 26 (Loans Receivable) and Item 53 (Loans Mad e). However, advances to officers and employees of your organization for travel expenses necessary

for conducting official business are not

considered loans if the following conditions

are met:

• the amount of an advance for a specific trip does not exceed t he amount of expenses reasonably expected to be

incurred for official travel in the near future, and the amount of the advance is fully repaid or fully accounted for by vouchers or paid receipts within 30 days after the completion or cancellation of

the tr avel.

• the amount of a standing advance to

an officer or employee who must frequently travel on official business does not unreasonably exceed the average monthly travel expenses for

which the individual is separately

reimbursed after the submission of

7vouc hers or paid receipts, and the individual does not exceed 60 days

without engaging in official travel.

See the instructions for Item 24, Column (E) (All Officers and Disbursements to Officers)

, Item 30 (Other Assets)

, and Item 46 (Cash

Disbursements to Em ployees) for reporting

travel advances which meet these criteria.

19. NUMBER OF MEMBERS

— Enter the

number of members in your organization at

the end of the reporting period. Include all categories of members who pay dues. Do not include nonmember employe es who make payments in lieu of dues as a

condition of employment under a union security provision in a collective bargaining agreement.

20. FIDELITY BOND

— Enter the maximum

amount recoverable for a loss caused by any officer, employee, or agent of your organization who handled your organization’s funds. Enter “0” if your organization was not covered by a fidelity bond during the reporting period.

NOTE: If your organization had property and

annual financial receipts which totaled more than $5,000, each o f your organization’s officers, employees, and agents who handles funds or other property of your organization must be bonded. The amount

of the bond must be at least 10% of the

value of the funds handled by the individual during the last reporting period, up to a maximum bond of $500,000. The bond must

be obtained from a surety company approved by the Secretary of the Treasury. If you have any questions or need more information about bonding requirements,

contact the nearest OLMS field office listed

at the end of these instructions.

21. CHANGES IN CONSTITUTION AND

BYLAWS OR PRACTICES/PROCEDURES

— If Item 21 is answered “Yes” because your organization’s constitution and bylaws were changed during the reporting period (other than rates of dues and fees), a d ated copy of the new constitution and bylaws

must either be submitted as an electronic

attachment to the Form LM

- 3 the labor organization submits to OLMS, or the labor organization may submit a dated copy of the new constitution and bylaws to:

Office of L abor

- Management Standards 200 Constitution Ave., NW, Room N

- 1519 Washington, DC 20210

- 0001

If your organization is governed by a uniform constitution and bylaws prescribed by your organization’s parent national or international body, your organization’s

p arent body may file the constitution and bylaws on your behalf. If your parent body files a constitution and bylaws on your behalf, answer Item 21 “Yes” and state that

fact in Item 56 (Additional Information)

.

If Item 21 is answered “Yes” because your

org anization changed any of the practices/procedures listed below during the reporting period and the practices/ procedures are not described in your organization’s constitution and bylaws, your organization must file an amended Form

LM

- 1 (Labor Organization Information Report) with its Form LM

- 3 to update
information on file with OLMS:

• qualifications for or restrictions on membership;

• levying assessments;

• participating in insurance or other benefit plans;

• authorizing disbursement of labor organization funds;

• auditing financial transactions of the

labor organization;

• calling regular and special meetings;

• authorizing bargaining demands;

• ratifying contract terms;

• authorizing strikes;

• disciplining or removing officers or agents for breaches of their trust;

• imposi ng fines and suspending or expelling members including the grounds for such action and any provision made for notice, hearing, judgment on the evidence, and appeal procedures;

• selecting officers and stewards and any representatives to other bodies composed of labor organizations’ representatives;

• invoking procedures by which a member

may protest a defect in the election of

8officers (including not only all procedures for initiating an election protest but also all procedures for subsequently appealing an adv erse decision, e.g., procedures for appeals to superior or parent bodies, if any); and

• issuing work permits.

Form LM

- 1 can be downloaded from the

OLMS Web site at www.olms.dol.go v . If you

are unable to download the form, contact any of the offices listed at the end of these instructions to obtain a copy.

NOTE: Federal employee labor organizations subject solely to the Civil Service Reform Act or Foreign Service Act are not requi red to submit an amended

Form LM

- 1 to describe revised or changed practices/procedures

.

22. NEXT REGULAR ELECTION

— Enter

the month and year of your organization’s next regular election of general officers (president, vice president, treasurer,
secretary, etc.). Do not report the date of any interim election to fill vacancies.

23. DUES AND FEES

— Enter the dues and

fees established by your organization. If

more than one rate applies, enter the

minimum and maximum rates. Enter “0” where appropriate.

Line (a): Enter the regular dues or fees or

other periodic payments which a member must pay to be in good standing in your organization and enter the calendar basis for the payment (per month, per year, etc.). If your organization requires members to pay

“worki ng” dues as a part of regular dues, also report the amount or percent of “working” dues and enter the basis for the payment (per hour, per month, etc.). Include only the dues or fees of regular members

and not dues or fees of members with special rates, su ch as apprentices, retirees, or unemployed members.

Line (b): Enter the initiation fees required

from new members.

Line (c): Enter the fees other than dues required from transferred members. Such fees are those charged to persons applying

for a transfer of membership to your organization from another labor organization

with the same affiliation. Do not report fees charged to members transferring from one class of membership to another within your organization.

Line (d): If your organization issues work

p ermits, enter the fees required and enter

the calendar basis for the payment (per month, per year, etc.). Work permit fees are fees charged to nonmembers of your organization who work within its jurisdiction.

Do not report as work permit fees those fees

ch arged to nonmember applicants for membership pending acceptance of their membership application, or fees charged to persons applying for transfer of membership to your organization pending acceptance of their application for transfer.



## FINANCIAL DETAILS

R EPORT ONLY DOLLAR
AMOUNTS

Report all amounts in dollars only. Round

cents to the nearest dollar. Amounts ending in $.01 through $.49 should be rounded down. Amounts ending in $.50 through $.99 should be rounded up.



### REPORTING CLASSIFICATIONS

Complete all items and lines on the form as given. Do not use different accounting classifications or change the wording of any

item or line.



### COMPLETE ALL ITEMS 24

THROUGH 55

Complete Item 24 and all items in Statement A

and Statement B. Enter “0” where appropriate.



## LIST OF OFFICERS AND

DISBURSEMENTS TO THEM

ITEM 24. ALL OFFICERS AND

DISBURSEMENTS TO OFFICERS

— List

all the labor organization’s officers and report all salaries and other direct and

indirect disbursements to officers during the reporting period. Howe ver, direct and

9indirect disbursements not involving the payment of some form of cash (cash, checks, money orders, etc.) should not be reported in Item 24 but must be explained in

Item 56 (Additional Information) . Any direct

or indirect cash disbursement r equired to be

included in Item 24 should not be reported in

other disbursement items.

NOTE: A “direct disbursement” to an officer

is a payment made by your organization to

the officer in the form of cash, property, goods, services, or other things of valu e.

An “indirect disbursement” to an officer is a payment made by your organization to another party for cash, property, goods, services, or other things of value received by

or on behalf of the officer. “On behalf of the officer” means received by a party other

than the officer or your organization for the personal interest or benefit of the officer. Such payments include those made through a credit arrangement under

which charges are made to the account of your organization and are paid by your organizati on.

Column (A): Enter in (A) the last name, first

name, and middle initial of each person who

held office in the labor organization at any time during the reporting period. Include all the labor organization's officers whether or not any salary or other d isbursements were made to them or on their behalf by the labor organization. "Officer" is defined in section 3(n) of the LMRDA (29 U.S.C. 402) as "any constitutional officer, any person authorized to perform the functions of president, vice president, secr etary, treasurer, or other executive functions of a labor organization, and any member of its executive board or similar governing body."

Column (B): Enter in (B) the title of the position each officer listed held during the reporting period. If an office r held more than one position during the reporting period, list each additional position and the dates on which the officer held the position in Item 56 (Additional Information).

Column (C): Use the drop

- down menu to

select the status of each officer: "N" for a

new officer who took office during the reporting period; "P" for a past officer who was not in office at the end of the reporting period; or "C" for a continuing officer who

was in office before the reporting period and

was still in office at the en d of the reporting period. If any officer was not elected at a regular election in accordance with the labor organization's constitution and bylaws or

other governing documents on file with OLMS, explain the manner in which the

officer was chosen in Item 5 6 (Additional Information).

Column (D): Enter the gross salary of each

officer (before tax withholdings and other payroll deductions). Include disbursements

for “lost time” or time devoted to union

activities.

Column (E): Enter the total of all other

dir ect and indirect disbursements to each officer other than salary, including allowances, disbursements which were necessary for conducting official business of

your organization, and disbursements essentially for the personal benefit of the

officer and not necessary for conducting official business of your organization. Examples of disbursements to be reported

in Column (E) include: allowances made by

direct and indirect disbursements to each officer on a daily, weekly, monthly, or other periodic basis; allo wances paid on the basis of mileage or meals; all expenses that were reimbursed directly to an officer; expenses

for officers’ meals and entertainment; and various goods and services furnished to officers but charged to your organization.

Column (E) must also include:

• the total maintenance and operating costs of any automobile owned or leased by your organization and assigned to an officer regardless of

whether the use was for official business or for the personal benefit of the officer.

If more than 50% of the use of the automobile was for the personal benefit

of the officer, the amount of decrease in

the market value attributable to the officer’s personal use must be reported

in Item 56 (Additional Information)

.

• all disbursements for transportation by

pu blic carrier between the officer’s home and place of employment or for other transportation not involving the conduct

of official business.

10• all other direct and indirect

disbursements to each officer not included elsewhere in this report.

Include all direc t and indirect

disbursements which were essentially for the personal benefit of the officer and not necessary for conducting official

business of your organization. However,

disbursements for occasional non

- cash gifts of insubstantial value need not be

inc luded in Column (E) if reported in Item 51 (Contributions, Gifts, and Grants).

• travel advances which are not

considered loans as explained in the

instructions for Item 18 (Loans)

.

Do not report the following disbursements in

Item 24:

• loans to officers whi ch must be reported

in Item 26 (Loans Receivable) and Item 53 (Loans Made);

• benefits to officers which must be reported in Item 50 (Benefits);

• reimbursements to an officer for the purchase of investments or fixed assets, such as reimbursing an officer for a file cabinet purchased for office use, which must be reported in Item 52 (Purchase

of Investments and Fixed Assets) and explained in Item 56 (Additional Information) ;

• indirect disbursements for temporary lodging (room rent charges only) or transportation by public carrier necessary for conducting official

business while the officer is in travel status away from his or her home and principal place of employment with your organization if payment is made by your organization directly to the provider or

throu gh a credit arrangement and these

disbursements are reported in Item 48 (Office and Administrative Expense); however, charges other than room rent on hotel bills must be reported in Column (E);

• disbursements made by your organization to someone other than an officer as a result of transactions arranged by an officer in which property, goods, services, or other things of value were received by or on behalf of your organization rather than the officer, such

as rental of offices and meeting rooms, purchase of office supplies, refreshments and other expenses of membership banquets or meetings, and

food and refreshments for the entertainment of groups other than the officers and membership on official business;

• office supplies, equipment, and facilities

furnished to officers by your organization for use in conducting official business; and

• maintenance and operating costs of your organization’s assets other than automobiles owned or leased by your organization and assigned to officers.

The software will enter on L ine 8, Columns (D) and (E) the totals from any continuation pages for Item 24.

Column (F): The software will add Columns (D) and (E) for each of Lines 1 through 8

and enter the totals in Column (F).

The software will add Lines 1 through 8, Columns (D) th rough (F), and enter the

totals on Line 9.

Enter on Line 10 the total amount of withheld taxes, payroll deductions, and other

deductions. Disbursements for the transmittal of withheld taxes, payroll deductions, and other deductions must be reported in Ite m 54 (Other Disbursements). Any portion of withheld taxes or any payroll

or other deductions which have not been

transmitted at the end of the reporting period are liabilities of your organization and must be reported in Item 35 (Other Liabilities)

. Payrol l or other deductions retained by your

labor organization (such as repayments of loans made) must be fully explained in Item

56 (Additional Information)

.

The software subtracts Line 10, from Line 9,
Column F, and enters the difference on Line

11 and in It em 45 (To Officers).



## STATEMENT A

ASSETS AND LIABILITIES

The software will pre

- fill Columns A and C (Start of Reporting Period) from your organization’s report for the previous fiscal year. If the data is inaccurate, however, it

11can be edited manually. Be sure to explain any changes in Item 56 (Additional Information)

.



### ASSETS

25. CASH

— Enter the total of all your organization’s cash on hand and on deposit

at the start and end of the reporting period in Columns (A) and (B), respectively. Include

all cash on hand, such as undeposited cash, checks, and money orders; petty cash; and cash in safe deposit boxes. Cash on deposit includes funds in banks, credit unions, and other financial institutions, such as checking
accounts, savings accounts, certificates of deposit, and money market accounts. Also include any interest credited to your organization’s account during the reporting period.

NOTE: The checking account balances reported should be obtained from your organization’s books as reconciled with the

balan ces shown on bank statements.

26. LOANS RECEIVABLE

— Enter the total

of all loans owed to your organization at the

start and end of the reporting period in Columns (A) and (B), respectively. Include

all direct and indirect loans (whether or not

evidenced by promissory notes or secured by mortgages) owed to your organization by individuals, business enterprises, benefit plans, and other entities including labor organizations. An example of an indirect loan is a disbursement by your organization

to an educat ional institution for the tuition expense of an officer, employee, or member

which must be repaid to your organization by that individual. Do not include investments in corporate bonds or mortgages purchased on a block basis through a bank or similar insti tution which must be reported in Item 28 (Investments).

27. U.S. TREASURY SECURITIES

— Enter

the total value of all U.S. Treasury securities as shown on your organization’s books at

the start and end of the reporting period in Columns (A) and (B), respect ively. If the value reported is different from the original
cost, the original cost must be reported in

Item 56 (Additional Information) . Other U.S. Government obligations, state and municipal bonds, and foreign government securities

must be reported in It em 28 (Investments).

28. INVESTMENTS

— Enter in Columns (A) and (B), respectively, the total book value at the

start and end of the reporting period of all

investments other than U.S. Treasury

securities. The book value of these investments

is the lower o f cost or market value.

29. FIXED ASSETS

— Enter in Columns (A) and (B), respectively, the book value at the

start and end of the reporting period of all fixed assets, such as land, buildings, automobiles, and office furniture and equipment owned by your organization. The

book value of fixed assets is cost less depreciation.

30. OTHER ASSETS

— Enter in Columns (A) and (B), respectively, the total value as shown on your organization’s books at the

start and end of the reporting period of all assets (such a s accounts receivable, utility deposits, or travel advances which are not considered loans as explained in the

instructions for Item 18 [Loans] ) which have not been reported in Items 25 through 29.

31. TOTAL ASSETS

— The software adds

Items 25 through 30, Columns (A) and (B),

and enters the respective totals in Item 31.



### LIABILITIES

32. ACCOUNTS PAYABLE

— Enter the

total amount of your organization’s accounts payable at the start and end of the reporting period in Columns (C) and (D), respectively.

Ordina rily, accounts payable are those obligations incurred on an open account for goods and services rendered.

33. LOANS PAYABLE

— Enter in Columns (C) and (D), respectively, the total amount of all loans owed by your organization at the

start and end of the r eporting period, including those represented by notes. Do

not include loans secured by mortgages or

similar liens on real property (land or buildings) which must be reported in Item 34 (Mortgages Payable).

34. MORTGAGES PAYABLE

— Enter the

total amount of your organization’s obligations which were secured by

12mortgages or similar liens on real property (land or buildings) at the start and end of the reporting period in Columns (C) and (D), respectively.

35. OTHER LIABILITIES

— Enter in Columns (C) and (D), respectively, the total amount as shown on your organization’s

books at the start and end of the reporting period of all other liabilities not reported in Items 32 through 34.

36. TOTAL LIABILITIES

— The software

adds Items 32 through 35, Columns (C) and (D), and enters the respective totals in Item

36.

37. NET ASSETS

— The software subtracts

Item 36 (Total Liabilities), Column (C) from Item 31 (Total Assets), Column (A) and

enters the difference in Item 37, Column (C).

The software also subtracts Item 3 6, Column (D) from Item 31, Column (B) and

enters the difference in Item 37, Column (D).



## STATEMENT B

RECEIPTS AND

DISBURSEMENTS

Under Statement B, receipts must be

recorded when money is actually received by the labor organization and disbursements

must be recorded when money is actually paid out by the labor organization.

The purpose of Statement B is to report the

flow of cash in and out of your organization during the reporting period. Transfers between separate bank accounts or between special funds of your organization, such as vacation or strike funds, do not represent the flow of cash in and out of your organization. Therefore, these transfers

should not be reported as receipts and disbursements of your organization. For example, do not report a tr ansfer of cash from your organization’s savings account to

its checking account. Likewise, the use of funds reported in Item 25 (Cash) to purchase certificates of deposit and the redemption of certificates of deposit should not be reported in Statement B.

Since Statement B reports all cash flowing in

and out of your organization, “netting” is not permitted. “Netting” is the offsetting of receipts against disbursements and reporting only the balance (net) as either a receipt or disbursement. For example, if an officer received $1,000 from your organization for convention expenses, used only $800 and returned the remaining $200, the $1,000 disbursement must be reported

in Item 24 (All Officers and Disbursements to Officers) and the $200 receipt must be
report ed in Item 43 (Other Receipts) . It would be incorrect to report only an $800 net

disbursement to the officer.

Receipts and disbursements by an agent on

behalf of your organization are considered receipts and disbursements of your organization and must be reported in the same detail as other receipts and disbursements. For example, if your organization owns a building managed by a rental agent, the agent’s rental receipts and

disbursements for expenses must be reported on your organization’s Form LM

- 3.

Also , if your organization’s parent body or an intermediate body functions as an agent receiving and disbursing funds of your organization to third parties, these receipts

and disbursements must be reported on your organization’s Form LM

- 3.



### CASH RECEIPTS

38. DUES

— Enter the total dues received by your organization. Include dues received directly by your organization from members,

dues received from employers through a checkoff arrangement, and dues transmitted to your organization by a parent body or

other a ffiliate. Report the full dues received, including any portion that will later be

transmitted to an intermediate or parent body as per capita tax. Also report in Item 38 payments in lieu of dues received from

any nonmember employees as a condition of emplo yment under a union security provision in a collective bargaining agreement.

If an intermediate or parent body receives

dues checkoff directly from an employer on behalf of your organization, do not report in Item 38 the portion retained by that organizat ion for per capita tax or other purposes, such as a special assessment. Any amounts retained by the intermediate

13body or parent body other than per capita tax must be explained in Item 56 (Additional Information) . For example, if the intermediate body or p arent body retained $500 of your organization’s dues checkoff as payment for supplies purchased from that body by your organization, this should be explained in Item 56 (Additional Information) of your organization’s Form LM

- 3 but the $500 should not be re ported as a receipt or

a disbursement on your organization’s Form

LM

- 3. However, if the intermediate body or parent body disbursed part of your organization’s dues checkoff on your organization’s behalf, this amount should be

included in Item 38 and in the appropriate

disbursement item on your organization’s

Form LM

- 3. For example, if the intermediate body or parent body disbursed $500 of your organization’s dues checkoff to an attorney

who had provided legal services to your organization, this amount shoul d be reported

in Item 38 and as a disbursement in Item 49 (Professional Fees) of your organization’s

Form LM

- 3.

Do not report in Item 38 dues which your organization collected on behalf of other organizations for transmittal to them. For example, if your organization received dues

from a member of an affiliate who worked in

your organization’s jurisdiction, the dues

collected on the affiliate’s behalf must be reported in Item 43 (Other Receipts)

.

39. PER CAPITA TAX

— Enter the total per capita tax receive d by your organization if your organization is an intermediate or parent body; otherwise, enter “0” in Item 39. Include the per capita tax portion of dues received directly by your organization from

members of affiliates, per capita tax

received from subor dinates, either directly or through intermediaries, and the per capita tax portion of dues received through a

checkoff arrangement whereby local dues are remitted directly to an intermediate or parent body by employers. Do not include

dues collected on beh alf of subordinate organizations for transmittal to them. For example, if a parent body received dues checkoff directly from an employer and returned the local’s portion of the dues, the parent body must report the dues received

on behalf of the local in I tem 43 (Other Receipts). 40. FEES, FINES, ASSESSMENTS, AND

WORK PERMITS

— Enter your organization’s receipts from fees, fines, assessments, and work permits. Receipts by your organization on behalf of affiliates for transmittal to them must be reported in Item 43 (Other Receipts).

41. INTEREST AND DIVIDENDS

— Enter

the total amount of interest and dividends received by your organization from savings accounts, bonds, mortgages, loans, investments, and all other sources.

42. SALE OF INVESTMENTS AND FIXED

A SSETS

— Enter the net amount received by your organization for all investments (including U.S. Treasury securities) and

fixed assets sold. Do not include amounts received from the sale or redemption of

investments which were promptly reinvested (i.e., “rol led over”) during the reporting period.

The amount to be excluded for each

reinvestment is the lower of the following:

• the original cost of the investment sold;

• the amount reinvested when the amount

received from the sale was less than the

investment’s or iginal cost; or

• the amount reinvested when only a portion of the amount received from the sale was actually reinvested.

Interest and dividends received during the reporting period must be reported in Item 41 (Interest and Dividends)

.

Any portion of the a mount due your organization (gross sales price less deductions for selling expenses) from sales

of investments and fixed assets which has not been received by the end of the reporting period must be reported in Item 30 (Other Assets). However, if a mortgag e or note is taken back, it must be reported in Item 26 (Loans Receivable).

43. OTHER RECEIPTS

— Enter all receipts of your organization other than those reported

in Items 38 through 42, including proceeds

from the sale of supplies, loans obtained,

repaym ents of loans made, rents, and funds

collected for transmittal to third parties.

1444. TOTAL RECEIPTS

— The software

adds Items 38 through 43 and enters the

total in Item 44.



### CASH DISBURSEMENTS

45. TO OFFICERS

— The software enters

the total reported on L ine 11 of Item 24.

46. TO EMPLOYEES

— Enter the total of all salaries, allowances, travel advances which

are not considered loans as explained in the

instructions for Item 18 (Loans) , and other

direct and i ndirect disbursements (less deductions for FICA, withheld taxes, etc.) to employees of your organization during the reporting period. Include disbursements to

individuals other than officers who receive lost time payments even if your organization does

not consider them to be employees or does

not make a ny other direct or indirect

disbursements to them.

NOTE: The following worktable may be

used to determine the amount to be reported

in Item 46:

A. Total Gross Salaries, Allowances,

and Other Disbursements to Employees (before withheld taxes

and oth er deductions) $___________

B. Subtract: Total Withheld Taxes

and Other Deductions $___________

C. Net Disbursements to Employees $___________

The amount on Line C should agree with the

amount reported in Item 46.

47. PER CAPITA TAX

— Enter y our organization’s total amount of per capita tax paid as a condition or requirement of affiliation with your parent national or international union, state and local central bodies, a conference, joint or system board, joint council, federation, or other l abor organization.

48. OFFICE AND ADMINISTRATIVE

EXPENSE

— Enter your organization’s total

disbursements for its ordinary office and administrative expenses, for example, rent, utilities, office supplies, postage, subscriptions, fidelity bond premiums, et c.

As explained in the instructions for Item 24,

Column (E) (All Officers and Disbursements to Officers) , disbursements for hotel rooms or for transportation by public carrier of officers and employees on official business may be reported

in Item 48 when payment is made directly to the provider or through a credit arrangement. Do

not include in Item 48 salaries, allowances, or

other direct and indirect disbursements to officers and employees which must be reported

in Items 45 (Cash Disbursements to Office rs)

and 46 (Cash Disbursements to Employees)

.

Also report in Item 48 all taxes assessed against and paid by your organization, including your organization’s FICA taxes as an employer. Do not include disbursements

for the transmittal of taxes withheld from the salaries of officers and employees which must be reported in Item 54 (Other Disbursements) . Also, do not include indirect taxes, such as sales and excise taxes, for purchases reported in other disbursement

items.

49. PROFESSIONAL FEES

— Enter your

o rganization’s total disbursements for “outside” legal and other professional services (auditing, economic research, computer consulting, arbitration, etc.). Include any disbursements made for the expenses of individuals or firms providing professional serv ices to your organization.

Do not include direct and indirect disbursements to officers and employees

which must be reported in Items 45 Cash Disbursements to Officers) and 46 (Cash Disbursements to Employees)

.

50. BENEFITS

— Enter the total of all direct

and indirect benefit disbursements made by

your organization. Direct benefit

disbursements are those made to officers, employees, members, and their beneficiaries from your organization’s funds.

Indirect benefit disbursements are those made from your orga nization’s funds to a separate and independent entity, such as a trust or insurance company, which in turn and under certain conditions will pay

benefits to the covered individuals. An example of an indirect benefit disbursement is the premium on group lif e insurance.

1551. CONTRIBUTIONS, GIFTS, AND

GRANTS

— Enter the total of all disbursements for contributions, gifts, and grants made by your organization.

52. PURCHASE OF INVESTMENTS AND

FIXED ASSETS

— Enter the total

disbursements for all investments and fixed assets purchased by your organization. Do not include any unpaid balances still owed which should be reported in Item 33 (Loans Payable) or Item 34 (Mortgages Payable). Also, do not include disbursements for

reinvestment in U.S. Treasury securities a nd

investments of amounts received from sales of U.S. Treasury securities and investments as explained in the instructions for Item 42 (Sale of Investments and Fixed Assets). The

amount to be excluded from Item 52 for

reinvestment must be the same as the

a mount which was excluded from Item 42 (Sale of Investments and Fixed Assets) for

reinvestment.

53. LOANS MADE

— Enter the total

disbursements for loans made by your organization. Include all direct and indirect loans made to individuals, business enterpri ses, and other organizations, regardless of amount.

NOTE: Section 503(a) of the LMRDA prohibits labor organizations from making

direct or indirect loans to any officer or employee of the labor organization which results in a total indebtedness on the part of such officer or employee to the labor organization in excess of $2,000 at any time.

54. OTHER DISBURSEMENTS

— Enter all disbursements made by your organization

not reported in Items 45 through 53, including fees, fines, assessments, supplies

for resal e, repayments of loans obtained,

transmittals of funds collected for third parties, educational and publicity expenses, withholding taxes, and payments for the

account of affiliates and other third parties.

55. TOTAL DISBURSEMENTS

— The

software adds Item s 45 through 54 and

enters the total in Item 55.

NOTE: The following worktable may be

used to determine that the figures for receipts, disbursements, and cash are correctly reported on your organization’s

Form LM

- 3:

A. Cash at Start of Reporting

Per iod

– Item 25, Column (A) $___________

B. Add: Total Receipts

– Item 44 $___________

C. Total of Lines A and B $___________

D. Subtract: Total Disbursements

– Item 55 $___________

E. Cash at End of Period $___________

If Line E does not equal the amount reported

in Item 25, Column (B), there is an error in your organization’s report which should be

corrected.

56. ADDITIONAL INFORMATION

— Use

Item 56 to provide additional information as

indicated on Form LM

- 3 and in Section XII of

these instruc tions. Enter the number of the

item to which the information relates in the

Item Number column if the software has not

entered the number.

57

- 58. SIGNATURES

— The completed

Form LM

- 3 which is filed with OLMS must be signed by both the president and

treasu rer, or corresponding principal
officers, of the labor organization. 

### If the duties of the principal executive or principal financial officer are performed by an officer other than the president or treasurer, the report may be signed by the other officer. I f the report is signed by an officer other than the president or treasurer, enter the correct title in the title field next to the signature and explain in Item 56 (Additional Information) why the president or treasurer did not sign the report.

Before si gning the form, click the Validate button at the top of page one to ensure that the report passes validation and thus can be signed and submitted.

To electronically sign the form, click the signature spaces provided. E nter the date the report was signed and the telephone

16number at which the signatories conduct official business; you do not have to report a private, unlisted telephone number.

For a form that is printed and mailed to OLMS, have the officers sign it manually

and mail it to the Office of Lab or

Management Standards, 200 Constitution Ave., NW, Room N

- 1519 , Washington, DC

20210

- 0001. Original signatures are required on the printed Form LM

- 3 filed with OLMS; stamped or mechanical signatures are not acceptable. If the duties of the principal execu tive or principal financial

officer are performed by an officer other than the president or treasurer, the report may be signed by the other officer. If the report is signed by an officer other than the president or treasurer, cross out the printed title, enter the correct title in Item 57 or 58, and explain

in Item 56 (Additional Information) why the president or treasurer did not sign the report. Enter the date the report was signed and the telephone number at which the signatories

conduct official busine ss; you do not have to report a private, unlisted telephone number.



## XII. LABOR ORGANIZATIONS

THAT HAVE CEASED TO

EXIST

If your organization has gone out of

existence as a reporting labor organization, the last president and treasurer or the

officials res ponsible for winding up the affairs of your organization must file a

terminal financial report for the period from the beginning of the fiscal year to the date of

termination. A terminal financial report must be filed if your organization has gone out of

b usiness by disbanding, merging into another organization, or being merged and

consolidated with one or more labor organizations to form a new labor organization. A terminal financial report is not required if your organization changed its

affiliation but c ontinues to function as a
separate reporting labor organization.

The terminal financial report may be filed on

Form LM

- 3 if your organization filed its previous annual report on Form LM

- 3 and your organization’s total annual receipts, as

defined in Secti on II of these instructions, were less than $250,000 for the part of the

last fiscal year during which your organization existed. (If total annual receipts

were more than th i s limit, your organization

must use Form LM

- 2 to file its terminal financial repor t.) Your organization’s terminal financial report may be filed electronically or may be printed, manually signed, and submitted to the U.S. Department of Labor, Office of Labor

Management Standards, 200 Constitution Avenue, NW, Room N

- 1519 , Washington,

DC 20210

- 0001, within 30 days after the

date of termination.

To complete a terminal report on Form LM

3, follow the instructions in Section Xl and, in

addition:

• Enter the date your organization ceased

to exist in Item 2 (Period Covered) after

the word “Throu gh.”

• Select Item 3(b) indicating that your organization ceased to exist during the reporting period and that this is your organization’s terminal Form LM

- 3.

• Enter “3(b)” in the Item Number column

in Item 56 (Additional Information) and provide a detailed s tatement of the

reason your organization ceased to exist. Also report in Item 56 plans for the disposition of your organization’s cash and other assets, if any (for example,

transfer of cash and assets to the parent body). Provide the name and address of

t he person or organization that will

retain the records of the terminated organization. If your organization merged with another labor organization, report that organization’s name, address, and 6

- digit file number.

Contact the nearest OLMS field office li sted

below if you have questions about filing a terminal report.

OLMS Field Offices

Staff is available to answer questions at

OLMS offices in the following cities.

Atlanta, GA Birmingham, AL Boston, MA Buffalo, NY Chicago, IL Cincinnati, OH

17Cleveland, O H Dallas, TX Denver, CO Detroit, MI Fort Lauderdale, FL Honolulu, HI Kansas City, MO Los Angeles, CA Milwaukee, WI Minneapolis, MN Nashville, TN New Orleans, LA New York, NY

Philade l phia, PA Phoenix, AZ Pittsburgh, PA St. Louis, MO San Francisco, CA

Seattl e, WA Tampa, FL Washington, DC

Consult local telephone directory listings

under United States Government, Labor

D epartment, Office of Labor

- Management Standards, for the address and phone number of your nearest field office. Contact

information for OLMS f ield offices is also

available on the OLMS Web site at www.olms.dol.gov

.



### Revised XX / 201 5

18