Central Laborers' Pension Welfare & Annuity Funds
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Pension Forms

IRS 2012 Form W-4P

Affidavit in Support of Claim for Death Benefits

Application for Pre-Retirement Surviving Spouse Option

Beneficiary Designation Form

Cancellation of Pre-Retirement Surviving Spouse Option

Deduction of Union Dues Form

Direct Deposit Form

Disability Pension or Occupational Disability Benefit Application

Medical Release Form

Pension Application

Pension Death Benefit Application

Proof of Age Form

Proof of Disability Form

Return to Retirement Form

Suspend Pension Benefits Form

General Forms

Change of Address

Employer Forms

Remittance Report Form		 Welfare Forms

Accident Report Form

Appeal Procedure

Application for Welfare Non-Work Disability Credit

Beneficiary Designation Form

Dental Claim Form

Proof of Adult Child Relationship Form

Life Insurance / Accidental Death Application

Loss of Time Application

2011 Open Enrollment Form

2012 Open Enrollment Form

Open Enrollment Coverage Change Form

Release of PHI (Personal Health Information)

Vision Care Claim Form

Release of Personal Health Information Authorization Form

Annuity Forms

Affidavit in Support of Claim for Death Benefits

Annuity Application

Beneficiary Designation Form

Death Benefit Application

Direct Deposit Form

First or Second Hardship Application

Third Hardship Application

Tax Notice Regarding Plan Payments

 

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