FORMS

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General Forms

Name Address Telephone Change Form

Annuity Fund

		Rules for Loans to Participants + Application for Loan
		Benefit Application Form (Qualified Joint And Survivor Annuity Election/Rejection Form) (Tax Withholding/Transfer Election Form)
		Special Tax Notice (Rev 12/2009)
		Election to Defer Payment

Health & Welfare Fund

		Spouse/Dependent Questionnaire
		Massage Therapist Provider Certification
		Claim for Vision Care Benefit
		Claim for Physical Examination Expenses
		Pharmacy Direct Member Reimbursement Form

Supplementary Unemployment Benefit Fund

Application for Sub Benefits

Training Fund

		CATV Industry IBEW Training Fund - Application for General Education Benefits
		CATV Industry IBEW Training Fund - Application for General Eduation Benefits SHORT COURSES (Employees Only)
		CATV Industry IBEW Training Fund - General Education Reimbursement Request Form
		Hawaii Electricians Training Fund - Wireperson Daily Progress Report
		Hawaii Training Fund - Telecommunication/CATV Installer Technician Daily Progress Report

Vacation & Holiday Fund

		Application for Vacation Benefits
		Application for Termination of Benefits

Federal Credit Union

Name/Address Change Form – FCU accounts only