Get Ufcw 247

This guide provides a clear, step-by-step approach to filling out the Ufcw 247 Benefit Trust Fund Drug & Vision Expenses Form online. It is designed to help users understand each section of the form and ensure that all necessary information is accurately provided.

Follow the steps to fill out your Ufcw 247 form effectively.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
2. Begin by providing your employer or store number in the designated field. This identifies your workplace and is crucial for processing your claim.
3. Next, enter your employee number, ensuring accuracy as this helps link your claim to your employment record.
4. Fill in your Social Insurance Number in the ID section. This serves as a key identifier for processing your claim, and it will be kept confidential.
5. Provide your date of birth by selecting the month, day, and year in the respective fields.
6. Enter your complete address, including number and street, city, province, and postal code. This information ensures that any correspondence regarding your claim reaches you.
7. Indicate if you have any other coverage that may pay benefits for your claim by circling 'yes' or 'no.' Fill in the name of your employer and insurance company if you have indicated 'yes.'
8. For each expense, enter the date of the claim, the type of vision expense or drug name, the provider (pharmacy or vision care provider), and the total charge in the respective fields. If additional space is needed, attach a separate sheet.
9. Calculate the total of all charges and enter this amount in the designated field.
10. Complete the certification and consent section by reading the statement carefully. Sign and date where indicated to confirm the accuracy of the information provided.
11. Finally, save your changes, download a copy of the completed form, and either print it for mailing or share it as needed.

Start filling out your Ufcw 247 form online today to ensure timely processing of your benefits.