Please select the appropriate form in the left hand navigation to fill out the form online.      

The Funds Office prefers that you fill out the forms online then mail it to us.  Web forms are more legible than hand written forms. 

However if you would like to print a blank form and fill it out manually, click on the appropriate form below.

You need to have Adobe Acrobat Reader to view these forms.  Click here to get the lastest version.

International Reciprocity Form - This can not be filled out on line.

Express Scripts Mail Order Form - This can not be filled out online. 

Census Card - This can be filled out online.

Change of Address Form - This can be filled out online.

Beneficiary Card - Welfare Only -This can be filled out online.

Beneficiary Card - All Benefits - This can be filled out online.
Click Here for Instructions for completing this form.

Direct Deposit - Retired Members Only - This can be filled out online.

Hour Complaint Form

Weekly Disability - Employee Claim Form

Continued Disability Form

Vision Claim Form

Dental Claim Form

Pension Application

Death Benefit Application

Transfer Authorization Form - this form is for Non Local 542 members to transfer their contributions back to their home local.

Annuity Roll In Contributions Form - Use this form to Roll In contributions from another Qualified Plan, ie 401(k).

These forms can be filled out online, but please remember  to mail in the signed copy of the form.