SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
Northwest Laborers - Employers Health
and Security Trust Fund
Employer identification number

91-1283260
Return Reference Explanation
Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company The day to day management and operations of the plan are handled by a third party administrator, zenith American solutions, Inc.
Form 990, Part VI, Line 11b: Form 990 Review Process The form 990 is reviewed by the chairman of the board of trustees as well as the plan administrator prior to its filing.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available The plan provides for participant inspection of documents and financial statements upon request through the plan administrators.
Other Changes In Net Assets Or Fund Balances - Other Increases 2015 accumulated eligibility = $16359845
Other Changes In Net Assets Or Fund Balances - Other Decreases 2016 accumulated eligibility = -$20347927
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


Additional Data


Software ID: 15000324
Software Version: 2015v3.0