| 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.
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PEN-002 Disability Retirement Declaration
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Used by an ironworker retiring on a Disability Pension – states the rules on working and must be signed and returned.
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PEN-003 Retiree Work Application
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Used by a retired ironworker who would like to return to work and continue to receive his/her pension. |
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PEN-004 Pension Election Payment Form
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Used by a retired ironworker whose pension has been approved to elect either a single or husband and wife pension.
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PEN-005 Electronic Deposit Authorization
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This form is used by a retired ironworker who wishes to have his/her pension check electronically transferred to their bank account. |
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PEN-006 Designation of Beneficiary
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Used by a retired ironworker whose pension has been approved to designate a beneficiary. |
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PEN-007 Pension Tax Form
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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. |
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ELG-001 Student Status Verification
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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. |
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ELG-002 Disability Certificate
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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. |
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CL-001 Active Fee-For-Service
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Active Fee For Service Medical Benefit Plan Summary
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CL-002 Retiree Fee-For-Service
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Retiree Fee For Service Medical Benefit Plan Summary |
CL-003 Medicare Retiree Fee-For-Service
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Medicare Retiree Fee-For-Service Benefit Summary |
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EMP-003 Report of Constructions Contractor's Wage Rates
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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. |
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VAC-002 Vacation Electronic Deposit Authorization
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This form is used by a member who wishes to have his/her vacation check electronically deposited to his/her bank account |