IUOE Benefit Funds of Eastern PA and DE

Forms

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• Annuity Roll In Contributions Form – Use this form to Roll In contributions from another Qualified Plan, ie 401(k).
• Beneficiary Form – All Benefits
• Beneficiary Form – Welfare Only
• Census Card
• Change of Address Form
• Dental Claim Form
• Direct Deposit – Retired Members Only
• Disability – Weekly Disability Claim Form
• Disability – Continued Disability Form
• Express Scripts Mail Order Form
• Hour Complaint Form
• International Reciprocity Form
• Pension Application
• PPO Out-of-Network Claim
• Transfer Authorization Form – This form is for Non Local 542 members to transfer their contributions back to their home local.