Reciprocal
IRONWORKERS LOCAL387 PENSION / HEALTH & WELFARE FUNDS IRONWORKERS INTERNATIONAL RECIPROCAL AGREEMENT AUTHORIZATION OF CONTRIBUTIONS TRANSFER

I understand that the Cooperating Fund(s) will act solely as the agent of the noted Home Fund(s) and as such, I shall be subject to the eligibility rules of said Home Fund(s) upon the transfer of contributions. I hereby release (on behalf of myself as well as on the behalf of anyone claiming through me) and further discharge the Cooperating Fund(s) and their Trustees of and from all claims, demands, actions, causes of actions or suits with respect to any contributions so transferred and for any benefits or credits which would have accrued or become payable to me had I not authorized this transfer of contributions. I further recognize that the transfer of contributions to the noted Home Fund(s) may or may not ultimately prove to be to the advantage of myself and / or beneficiaries

Email address *
NAME *
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Home Local # *
Your answer
ADDRESS *
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Last four digits of Social # *
Your answer
MEMBERSHIP # *
Your answer
DATE OF BIRTH *
Your answer
TELEPHONE *
Your answer
HOME PENSION FUND NAME / ADDRESS *
Your answer
HOME ANNUITY FUND NAME / ADDRESS *
Your answer
HOME WELFARE FUND NAME / ADDRESS *
Your answer
DATE *
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I hereby elect do not elect, to the extent that the Trustees of these above-noted Cooperating Fund(s) and the Trustees of my home Pension, Annuity and/or Welfare Funds (as noted below) have executed agreements between them permitting the transfer of contributions, to have Pension and Welfare contributions paid on my behalf to the above noted Funds remitted to my Home Pension, Annuity and/or Welfare Fund(s) as now stated by me. *
By selecting below I acknowledge that my benefits will be forwarded to the appropriate fund.
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