California Field Ironworkers Trust Funds

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Applications & Forms

You are able to download many of the Trust Fund's Applications and Forms from this web site.  To do so you will need Adobe Acrobat Reader. Please click on the link to download this package if you do not have it installed on your computer.          

 

Form Name Form Description
  
   PEN-001
  Retirement Declaration
Used by a retired ironworker whose pension has been approved states the rules on working. Must be signed and returned.

 

PEN-002 
Disability Retirement Declaration

Used by an ironworker retiring on a Disability Pension – states the rules on working and must be signed and returned.

 

PEN-003 
Retiree Work Application

Used by a retired ironworker who would like to return to work and continue to receive his/her pension.

PEN-004
Pension Election Payment Form

Used by a retired ironworker whose pension has been approved to elect either a single or husband and wife pension.

 

PEN-005 
Electronic Deposit Authorization

This form is used by a retired ironworker who wishes to have his/her pension check electronically transferred to their bank account.

PEN-006
Designation of Beneficiary

Used by a retired ironworker whose pension has been approved to designate a beneficiary.

PEN-007
Pension Tax Form

This form is used by a retired ironworker receiving a pension check as a Federal and State Tax Deduction election.
   PEN-009
  Pension Application
 This form is to be used by an ironworker to apply for a pension.

ELG-001
Student Status Verification

This form is used by a dependent child(ren) between the ages of 21 year up to 24 years who are full time students (12 units or more) in an accredited college, university, or trade school.

ELG-002
Disability Certificate

This form is used by an Ironworker who has been injured and will be unable to work for a specified period of time.  By completing this form you may be entitled to an extension on your welfare coverage and/or additional pension credits.  This form must be completed if you are intending to withdraw your Annuity Balance due to Total and Permanent Disability.

CL-001
Active Fee-For-Service


Active Fee For Service Medical Benefit Plan Summary

CL-002
Retiree Fee-For-Service


Retiree Fee For Service Medical Benefit Plan Summary
   CL-003
  Medicare Retiree 
  Fee-For-Service
 
Medicare Retiree Fee-For-Service Benefit Summary

EMP-003
Report of Constructions Contractor's Wage Rates

This form is used in lieu of WD-10 issued by the U.S. Department of Labor. The information requested is authorized under the Ironworkers Master Collective Bargaining Agreement. The identity of the respondent will be kept confidential to the maximum extent possible.
   
   VAC-001
  Address Change
 
This form is used by an Active Ironworker to change his/her address. This form must be mailed - we will not accept faxed or emailed copies.

VAC-002
Vacation Electronic Deposit Authorization

This form is used by a member who wishes to have his/her vacation check electronically deposited to his/her bank account

Please contact our office via email or by calling 1-800-527-4613 if you have any further questions or comments.

Copyright © 1998-2010 California Field Ironworkers Employees Benefits' Corporation.