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FORM LM-10: EMPLOYER REPORT E 86'HSDUWPHQWRI/DERU 1DPH (PSOR\HU (Department of Labor)

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FORM LM-10
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EMPLOYER REPORT
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READ THE INSTRUCTIONS CAREFULLY BEFORE PREPARING THIS REPORT
Part A
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President Treasurer
Page 1 of 3
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Treasurer
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Read the following questions and the accompanying instructions carefully, taking into consideration the exclusions listed in
the instructions for these items, and check either ''Yes" or ''No'' for each item. For each item that is answered ''Yes'', you must
attach a Part B which appears on Page 3. Complete a separate Part B for each ''Yes'' answer to any of Items 8.a. through 8.f.
Also, if the answer is ''Yes'' for more than one person or organization, complete a separate Part B for each person or
organization. If you answer ''Yes'', enter the number of Part Bs that are submitted for that item in the line indicated.
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DURING THE FISCAL YEAR COVERED BY THIS REPORT:
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TOTAL NUMBER OF PART Bs FOR THIS REPORT IS
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Page 2 of 3
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FORM LM-10: EMPLOYER REPORT E 86'HSDUWPHQWRIDERU 1DPH (PSORHU (Department of Labor)

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Completed 26 January 2021

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