Applications & Forms for Participants


Click on the headers below to expand the document lists.

All forms in this section allow you to enter your information directly on to the form.  You will need to print the form, sign it and mail it to the Fund Office for processing.  Receipt of your form will be acknowledged.

Participant, Beneficiary & Payee Forms
Pre-retirement Death Benefit Beneficiary Designation Form
Complete this form to name the primary and alternate beneficiaries for the Pre-retirement or the additional benefit earned before Normal Retirement Age (generally age 65 – referred to as Re-retirement Benefit). This form includes the form to name a custodian if you name a minor child as a beneficiary.
Pension Application - Part 1: Preliminary Information Form
Complete this application to apply for a regular or disability pension.
Attending Physician's Statement
The form must accompany the Pension Application - Part 1 when applying for a disability pension to determine eligibility.
Death Benefit Application
Complete this application for a death benefit.
Covered Employment Correction Claim Form and Instructions
Complete this form if you believe the covered employment reported on your Annual or Interim Covered Earnings Statement does not properly report all of your covered employment.
Authorization to Release Information to a Third-Party
Complete this form to authorize another person to receive information from the Fund on your behalf.
Direct Deposit Authorization Form and Instructions
A pensioner or beneficiary should complete this form to establish or change information for the direct deposit of monthly benefit payments.
Tax-Related Forms
W-4P Federal Withholding Certificate
IRS instructions and withholding certificate for pension or death benefit payments.
W-4P State Withholding Certificate
Withholding certificate for pension or death benefit payments applicable to the state of residence.
Notice for Foreign Resident Payee
Requirements for U.S. Federal Income Tax Withholding for Pensioners and Beneficiaries receiving benefits and residing in a foreign country.
W-8BEN Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding and Reporting (Individuals)
A Non-Resident Alien receiving pension benefits is required to file this form with the Fund.
W-9 Request for Taxpayer Identification & Certification
A U.S. citizen residing in a foreign country and receiving pension benefits is required to file this form with the Fund.