Scroll Top
924 Greenup Ave. Ashland, Ky 41101
+1 606-324-8401

Forms

Forms
P2482022PensionFunddeductionAuthorization.pdf application/pdf

Pension Trust Fund Deduction Authorization

Open Download Copy Link 202.58 KB January 13, 2023
2020-P248-Ann-Application-for-Benefits-New-Address.pdf application/pdf

Annuity Fund APPLICATION FOR BENEFITS

Open Download Copy Link 173.75 KB November 18, 2022
248-Local-CBA-Wage-Rate-Sheet-June-1-22-May-31-23.pdf application/pdf

Local 248 CBA Wage Rate Sheet for June 1 2022 through May 31 2023

Open Download Copy Link 81.21 KB October 7, 2022
248-Local-MES-Wage-Rate-Sheet-June-1-22-May-31-23.pdf application/pdf

MES Wage Rate Sheet for June 1 2022 to May 31 2023

Open Download Copy Link 82.59 KB October 7, 2022
Direct-Deposit-Form-with-adress-248.pdf application/pdf

Direct Deposit Form

Open Download Copy Link 40.01 KB October 7, 2022
Humana-Enrollment-Form.pdf application/pdf

Humana 2021 Enrollment Form

Open Download Copy Link 148.56 KB October 7, 2022
National-Pension-Application.pdf application/pdf

National Pension Application for Benefits

Open Download Copy Link 223.21 KB October 7, 2022
National-Pension-Direct-Deposit-Form.pdf application/pdf

NATIONAL PENSION FUND DIRECT DEPOSIT AUTHORIZATION FORM

Open Download Copy Link 15.08 KB October 7, 2022
P248-HW-Discontinue-Insurance-Coverage2022_1.pdf application/pdf

Health and Wellness - Discontinue Insurance Coverage

Open Download Copy Link 218.76 KB October 7, 2022
P248PENSIONAPP12-09Finalnewaddress.pdf application/pdf

APPLICATION FOR RETIREMENT BENEFITS

Open Download Copy Link 173.98 KB October 7, 2022
PL-248-Disability-HSM-Atttending-Physician-Stmt-11_22_21-1.pdf application/pdf

Medical Claim Form

Open Download Copy Link 277.51 KB October 7, 2022
Premium-Waiver.pdf application/pdf

Health and Welfare Premium Waiver Form

Open Download Copy Link 155.45 KB October 7, 2022
Vision-Coverage.pdf application/pdf

Vision Coverage informational sheet

Open Download Copy Link 55.65 KB October 7, 2022
Anthem-Change-Form-2022.pdf application/pdf

Anthem Employee Change Form

Open Download Copy Link 82.24 KB September 30, 2022
Anthem-Enrollment-Form-2022.pdf application/pdf

Anthem Enrollment Form for 2022

Open Download Copy Link 109.5 KB September 30, 2022
P248-HW-Discontinue-Insurance-Coverage2022.pdf application/pdf

Health and Welfare DISCONTINUE COVERAGE form

Open Download Copy Link 218.76 KB September 30, 2022
PL248-2022-Annuity-Beneficiary-Form.pdf application/pdf

Annuity BENEFICIARY DESIGNATION

Open Download Copy Link 200.29 KB September 30, 2022
PL248-2022-Pension-Beneficiary-Form.pdf application/pdf

Open Download Copy Link 188.14 KB September 30, 2022

18

Archive