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  • Forms

    DUES DEDUCTION AUTHORIZATION FORM

    As per the Inside Construction Agreement , the working assessments are 4% of your gross wages and are deducted from your weekly paycheck and submitted to Local 112 monthly by your employer.  However, it is your responsibility to pay your basic dues each month.  

    VACATION SAVINGS AUTHORIZATION FORM

    If you would like to participate in the Vacation Savings Program, you will need to complete the authorization form to give to your employer.   You can obtain an enrollment form for the Tri-Cities Community Credit Union  at the hall or at their office at 2626 W. Kennewick Ave., Kennewick, WA   99336.  You can also get more information about the Credit Union and the savings accounts and forms  at Tri-Cities Community Credit Union

    FAX FORM TO CONFIRM MONTHLY  ON THE

    OUT-OF-WORK BOOK

    If you are currently registered on the out-of-work book, you need to confirm your registration monthly to remain on the book. You can confirm at the monthly unit meetings, in person at the hall, by postcard supplied by the hall or by faxing in a form.  If you fax, it must be received in the hall no later than 5:00 p.m. on the last business day of the month.

     SUPPLEMENTAL BENEFIT ACCOUNT (SBA)

    (Claim Form)

     The Supplement Benefit Account is part of our Health & Welfare Program through the IEEW Health & Welfare Trust.  It is a fund that can be used to cover medical or dental issues not covered by the Plan. Submit the completed form to Rehn & Associates at P. O. Box 5433, Spokane, WA  99205.  Be sure to incude the required documentation.

    AUTOMATIC PREMIUM REIMBURSEMENT FORM 

      

    HEALTH & WELARE PARTICIPANT DATA FORM

      If you need to make changes to your Health & Welfare enrollment to add or delete the names of those covered or to change your beneficiary, you can complete this form and submit it to Rehn & Associates in Spokane.

    HEALTH & WELFARE DISABILITY FORM

    $400 per week for weeks 1 - 4 and $500 per week for the 5th - 26th week. Not eligible if under a Labor & Industries Claim. 

    112 / 73 RETIREMENT FUND - NECA -IBEW

    If you have retired or meet the criteria to withdraw your funds from the 112/73 Retirement Fund, you can submit a withdrawal form to Rehn & Associates in Spokane.  Early withdrawal can result in additional penalties, so be sure to know all the information concerning taxes and penalties before withdrawing these funds. If you choose to withdraw your funds and meet the requirements, contact Rehn & Associates at 1 -800-872-8979.

    CHANGE OF BENEFICIARY FORM

    NATIONAL 401K PLAN

    Your participation in this plan is optional.  As of June, 2018, the contribution rate is 5% of your gross wages.  It is your responsibility to complete the form and send a copy to the IBEW Investment Department and also a copy to your employer.   PRINT AN ENROLLMENT FORM

    IBEW PENSION - ELECTRONIC DEPOSIT 

    Bank Account Change Form

    NATIONAL ELECTRICAL BENEFIT FUND PENSION APPLICATION

    N.E.B.F.

    REQUEST FOR STATUS

     





    Page Last Updated: Oct 19, 2018 (09:32:48)
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