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
IRON WORKERS LOCAL 383
HEALTH CARE PLAN
Employer identification number

39-1365594
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 8B NO OTHER COMMITTEES WITH AUTHORITY BESIDES BOARD OF TRUSTEES (GOVERNING BODY)
FORM 990, PART VI, SECTION B, LINE 11 BOARD REVIEWS 990 WITH ACCOUNTANT BEFORE MANUALLY SIGNED BY OFFICER
FORM 990, PART VI, SECTION B, LINE 12C ANNUAL TRUSTEE QUESTIONNAIRE.
FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE FOR VIEWING DURING NORMAL FUND OFFICE BUSINESS HOURS
FORM 990, PART VII BARRY SCHOLZ - P.O. BOX 419, APPLETON, WI 54912. DUWAYNE KNOBLOCH - 909 JONATHAN LANE, LECRESENT, MN 55947. TIM DEMINTER - 1602 S. PARK STREET, SUITE 210, MADISON, WI 53715. PATRICK WHITING - 4814 EAST BROADWAY, MADISON, WI 53716. JOHN RILEY - 1314 EMIL STREET, MADISON, WI 53713. JOHN FELLER - 300 S. BEDFORD STREET, MADISON, WI 53703. ANTHONY ANASTASI - 2525 PIONEER DRIVE, BELOIT, WI 53511. ADAM MAVES - 8844 LAKE VIEW LANE, AMHERST, WI 54406.
FORM 990, PART XII, LINE 2C THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT TO PERFORM THE AUDIT OF THE PLAN'S FINANCIAL STATEMENTS.
FORM 990, SCHEDULE R, PARTS II-IV IN ADDITION TO THE CONTRIBUTING EMPLOYERS REPORTED AS RELATED ORGANIZATIONS ON SCHEDULE R, PARTS II-IV, ONE EMPLOYER DID NOT PROVIDE A TAX CLASSIFICATION AS THEY CLOSED OR TERMINATED THEIR UNION AFFILIATION. THE PLAN MADE A REASONABLE EFFORT TO OBTAIN THE TAX CLASSIFICATION FROM ALL CONTRIBUTING EMPLOYERS, BUT NINE OF THE CONTRIBUTING EMPLOYERS HAVE NOT YET RESPONDED TO THE MULTIPLE REQUESTS.
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


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