Form Lm-3 - Labor Organization Annual Report - 2004 Page 3
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5FILE NUMBER:
24. ALL OFFICERS AND DISBURSEMENTS TO OFFICERS
Enter Amounts in Dollars Only – Do Not Enter Cents
(A) Name
(List all persons who held office during the reporting period even if they
Gross Salary (before
received no salary or other disbursements. Use all capital letters.)
taxes and other
Allowances and Other
(C) Status *
deductions)
Disbursements
Total
(B) Title
(Enter title of officer, such as PRESIDENT or TREASURER.)
(D)
(E)
(F)
Last Name
First Name
Middle Initial
1.
Title
Status
Last Name
First Name
2.
Title
Status
3.
Last Name
First Name
Middle Initial
Title
Status
Last Name
First Name
Middle Initial
4.
Title
Status
5.
Last Name
First Name
Middle Initial
Title
Status
6.
Last Name
First Name
Middle Initial
Title
Status
Last Name
First Name
Middle Initial
7.
Title
Status
8.
Totals from additional pages (if any)
9.
Totals of Lines 1 through 8
10. Less Deductions
The Total from Line 11 will be entered in Item 45 11. Net Disbursements
* Code for (C) Status: past officer – P; continuing officer – C; new officer during the reporting
(If any officer was not elected at a regular election in accordance with your
period – N.
organization’s constitution and bylaws, explain in Item 56 on page 1.)
Form LM-3 (Revised 2004)
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