TEAMSTERS LOCAL 72
FORMS
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We now have two forms that relate to your Personal History File. The first form lets request of copy of your PH file. The second will let you list the items that you would like removed from you file. To view and print these forms you'll need Adobe's Acrobat Reader.
Click here for the first form. (Use this form to request a copy of your PH Folder) Click here for the second form. (Use this form to request the removal of items from your PH Folder) (PDF) Change of Address Form (Email) Change of Address Form Local 72 Schedule of Allowances for Dental Plan. (effective Jan 09) Dental Form Group # GG 258 Davis Vision Reimbursement Claim Form for non participating providers
Important : When filling out the employee enrollment form you must send a birth certificate for you children and a marriage certificate for your spouse (PDF) Employee / Dependents Enrollment Form Please call the NY office for a Employee /Dependents Enrollment Form. One will be mailed to mailed to you with a postage paid return envelope. Life Insurance Form (Please contact our NY Office or your Business Agent)
Union members please be advised as to your right and responsibility to request a union withdrawal card if you are going out of work for an extended period of time. If you are going to be out of work for an extended period of time, you MUST call the Local 72 office at 212 691 4228 or fill out the on line application to request a withdrawal. The withdrawal will relieve you of your obligation to pay union dues during the withdrawal period. Failure to request a withdrawal will continue your obligation to pay union dues, even though you are not working and may not be receiving pay from the NYSTA. Failure to pay these dues may affect your union status and lead to suspension. You are responsible for paying all dues in arrears to obtain "good standing status". If you have any questions, please contact the office. (PDF) Withdrawal Form (Email) Withdrawal Form
Union Privilege scholarships click here |
