FORMS

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General Forms

 Name Address Telephone Change Form

Annuity Fund
Rules for Loans to Participants + Application for Loan (Rev 8/2016)
Benefit Application Form
(Qualified Joint And Survivor Annuity Election/Rejection Form)
(Tax Withholding/Transfer Election Form)
Special Tax Notice (Rev 12/2009)
Election to Defer Payment
Hardship Distribution Application (Rev 8/2016)

Health & Welfare Fund
Spouse/Dependent Questionnaire
 VSP Member Reimbursement Form
 Claim for Physical Examination Expenses
 CVS Caremark Prescription Reimbursement Claim Form
 Special Enrollment Form For Extension of Coverage For Adult Children Up to Age 26
 CMS 1500 Claim Form

Supplementary Unemployment Benefit Fund
Application for Sub Benefits

Training Fund
 Hawaii Electricians Training Fund - Wireperson Daily Progress Report
 Hawaii Training Fund - Telecommunication/CATV Installer Technician Daily Progress Report

Federal Credit Union
Name/Address Change Form – FCU accounts only


Local Union 1186 IBEW
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