Form Lm-1 - Labor Organization Information Report Page 2
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1
2
3File Number
Name of Labor Organization
Information Items (To be completed by initial filers only)
10. Where is your organization chartered to operate?
11. When is your organization's next regular election of officers?
County
State
Month
Year
City
13. Is your organization:
12. Are any of your organization's members:
14. What are your organization's expected
annual receipts (dues, fees, etc.):
Private Industry Employees
A Local, Lodge, Branch, etc.
Less than $10,000
U.S. Postal Service Employees
An Intermediate Body (a conference,
$10,000 - $249,999
general committee, joint board, system
board, joint council, district, etc.)
Federal Government Employees
$250,000 or more
A National or International
(Check as many boxes as are applicable)
15. List the names and titles of all your organization's officers.
Name
Title
Add More Names & Titles
16. What are your organization's rates of dues and fees? (Enter a minimum and maximum if more than one rate applies for any line.)
per
Minimum
Maximum
a. Regular Dues/Fees $
(month, year, etc.)
Minimum
Maximum
b. Working Dues
$
c. Initiation Fees
Minimum
Maximum
$
d. Transfer Fees
Minimum
Maximum
$
e. Work Permits
per
Minimum
Maximum
$
(month, year, etc.)
17. Two copies of your organization's current constitution and bylaws must be filed with this report. Under certain circumstances, your parent national or
international organization may file copies on your behalf (see the instructions for this item). Is your parent national or international submitting copies on your
behalf?
Yes
No
Add More Item 17 Information
If your organization is filing any governing documents with this report, list them below.
Form LM-1 (2003)
Page 2 of 3
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