How to Complete the Combined Employer Report of Contributions Form

  • Original of Form AM 1032 and Continuation Sheets Form R-3B (if used) must be mailed to the Bank on or before the fifteenth (15th) day of the month following the close of the month, which this report covers. Failure to remit your contributions will result in the assessment of Liquidated Damages and interest as specified in the Trust Agreements.

  • Reports must be submitted each and every month, even though no hours have been compensated during the month. If no Cement Masons were employed during this period, check box at top of form, sign and return.

  • The hours reported must include all hours compensated during the period covered by this report.

  • Copies of Form AM 1032 and copies of Form R-3B (Continuation Sheets) must be carefully preserved by the Employer at his principal place of business and should at all times be available for inspection by duly authorized representatives of the Trust Funds.

  • All payments should be sent to the Bank. All correspondence relating to such payments or to any of the Funds should be addressed to the administrative office. Please refer to your Identification Number whencorresponding.

  • Owners, partners or supervisory personnel above the rank of foreman, may be reported on the basis of 160 hours per month, regardless of the number of hours worked during the month. Reference should be made to Section8, SubsectionF, of the Cement Masons' Master Agreement. Otherwise, only employees performing Cement Mason's covered work should be reported to the Funds.

  • Report details of any change of ownership or activity on reverse side of page 1, or on separate attachment.

    Instructions for Preparing this Report

  1. EMPLOYER'S NAME, ADDRESS AND IDENTIFICATION NUMBER - Enter the Employer's name, business address and identification number unless shown on the form when received. If incorrectly shown, make any changes necessary to correct name or address.

  2. MONTH - The month covered by this report should be shown here. If incorrectly entered when the form is received make the necessary change.

  3. SIGNATURE - This report must be signed by (1)the individual, if the employer is an "individual", (2)the president, treasurer, or other officer if the employer is a corporation; or (3)a responsible and duly authorized member having knowledge of the firm's affairs if the employer is a partnership or other unincorporated organization. The signer's title and date on which the report is signed must also be shown.

  4. TOTAL HOURS SUBJECT TO CONTRIBUTION - The total of all hours reported on all pages MUST agree with the total reported herein.

  5. TOTAL AMOUNT - Enter in Box 5, the total amount (Item 4 at hourly rate indicated).

  6. ADJUSTMENTS - Any adjustment made necessary by reason of error on any previous report shall be detailed on a separate sheet of paper. Information to be included: work month, employee(s) name, social security number and number of hours to be adjusted.

  7. AMOUNT - Enter here Item 5 plus or minus any adjustments noted under Item 6. Add amounts shown in each of the boxes together and enter in total box. One check for the total amount must be forwarded to the Bank, as per advice contained under General Instruction Item E, together with the original of form AM 1032 Combined Employer Report of Contribution.

  8. EMPLOYEE'S SOCIAL SECURITY NUMBER - Insert the employee⁏s insurance account number issued to him by the Social Security Board.

  9. NAME OF EMPLOYEE - Please insert last name first, then first name, and middle initial.

  10. HOURS COMPENSATED - For your convenience the form contains 5 columns which can be used to enter the number of hours compensated during the 4 or 5 payroll periods covered by your report. However, for the Funds' purpose, only the total hours compensated as shown in Item 11 is required.

  11. TOTAL HOURS COMPENSATED - Report the total hours compensated for each employee during the payroll periods ending within the month. Owners, partners or supervisory personnel covered under the Funds should be reported on the basis of 160 hours, regardless of the number of hours worked during the payroll periods ending within the month.

  12. TOTAL NUMBER OF HOURS - Hours on all pages under Item 11 should be entered here.


    "Whenever an employer has agreed with any employee to make payments to a health or welfare fund, pension fund or vacation plan, or other such plan for the benefit of the employees, or a negotiated industrial promotion fund, or has entered into a collective bargaining agreement providing for such payments, it shall be unlawful for such an employer willfully or with intent to defraud to fail to make the payments required by the terms of any such agreement. A violation of any provision of this section where the amount the employer failed to pay into the fund or funds exceeds five hundred dollars ($500) shall be punishable by imprisonment in the state prison for a period of not more than five years or in the county jail for a period of not more than one year, by a fine of not more than one thousand dollars ($1,000) or by both such imprisonment and fine. All other violations shall be punishable as a misdemeanor. "