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215-633-9200 800-848-1953 Steelworkers Pension Trust Daniel A. Bosh Seven Neshaminy Interplex Suite 301 P. O. Box 660 Trevose Pennsylvania 19053-0660 Gary W* Gordon CPA www. steelworkerspension*com Benefits Manager Chairman of the Board of Trustees/Director of Operations Fax 215-633-0607 Accounting Manager Lisa Kapral All Fields are required in order to process either an Estimate or an Application Request Request Estimate Request Normal/Rule of 85 Pension Application Disability I plan to continue working after my retirement date. Today s Date Intended Date of Retirement Last day of work/vacation Participant s Name - - - - - - - - - - - - - --- --- --- -- Date of Birth - - - - - Phone ----- Social Security Employer Mailing Address Marital Status Married Divorced Widowed Single/Never Married Name of Spouse Date of Birth - - - - - - - - - - - Phone Address Please allow a minimum of 15 business days to receive a response to your requests. Applications cannot be processed any earlier than 30 clays prior to your retirement date. A Jointly Administered Defined Benefit Plan Since 1953 Providing Accurate Dependable and Timely Service to our Participants. O. Box 660 Trevose Pennsylvania 19053-0660 Gary W* Gordon CPA www. steelworkerspension*com Benefits Manager Chairman of the Board of Trustees/Director of Operations Fax 215-633-0607 Accounting Manager Lisa Kapral All Fields are required in order to process either an Estimate or an Application Request Request Estimate Request Normal/Rule of 85 Pension Application Disability I plan to continue working after my retirement date. Today s Date Intended Date of Retirement Last day of work/vacation Participant s Name - - - - - - - - - - - - - --- --- --- -- Date of Birth - - - - - Phone ----- Social Security Employer Mailing Address Marital Status Married Divorced Widowed Single/Never Married Name of Spouse Date of Birth - - - - - - - - - - - Phone Address Please allow a minimum of 15 business days to receive a response to your requests. Today s Date Intended Date of Retirement Last day of work/vacation Participant s Name - - - - - - - - - - - - - --- --- --- -- Date of Birth - - - - - Phone ----- Social Security Employer Mailing Address Marital Status Married Divorced Widowed Single/Never Married Name of Spouse Date of Birth - - - - - - - - - - - Phone Address Please allow a minimum of 15 business days to receive a response to your requests. Applications cannot be processed any earlier than 30 clays prior to your retirement date. A Jointly Administered Defined Benefit Plan Since 1953 Providing Accurate Dependable and Timely Service to our Participants. O. Box 660 Trevose Pennsylvania 19053-0660 Gary W* Gordon CPA www. steelworkerspension*com Benefits Manager Chairman of the Board of Trustees/Director of Operations Fax 215-633-0607 Accounting Manager Lisa Kapral All Fields are required in order to process either an Estimate or an Application Request Request Estimate Request Normal/Rule of 85 Pension Application Disability I plan to continue working after my retirement date. Today s Date Intended Date of Retirement Last day of work/vacation Participant s Name - - - - - - - - - - - - - --- --- --- -- Date of Birth - - - - - Phone ----- Social Security Employer Mailing Address Marital Status Married Divorced Widowed Single/Never Married Name of Spouse Date of Birth - - - - - - - - - - - Phone Address Please allow a minimum of 15 business days to receive a response to your requests. Applications cannot be processed any earlier than 30 clays prior to your retirement date. A Jointly Administered Defined Benefit Plan Since 1953 Providing Accurate Dependable and Timely Service to our Participants.

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