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Get CA Vacation Request Form 2012-2024

If your bank rejects your direct deposit information you will receive a physical check at the address listed at the bottom of this form. NAME OF BANK OR FINANCIAL INSTITUTION ACCOUNT TYPE CIRCLE ONE CITY STATE CHECKING BANK ABA/TRANSIT ROUTING NUMBER or SAVINGS ZIP CODE ACCOUNT NUMBER The undersigned hereby authorizes the Southwest Carpenters Vacation Trust to make credit entries and if necessary to make debit entries as adjustments for any credit in error to my bank account indicated. SOCIAL SECURITY NUMBER OR MEMBER NUMBER NAME Please Print DATE SIGNATURE OF PARTICIPANT REQUIRED X REQUEST FOR VACATION BENEFITS 12/12 MEMBER NUMBER OR SOUTHWEST CARPENTERS MEMBER S BIRTH DATE LOCAL UNION NO. VACATION REQUEST FORM IMPORTANT YOU MUST COMPLETE SIGN AND RETURN THE REQUEST FOR VACATION BENEFITS PORTION OF THE FORM FOR EACH VACATION DISTRIBUTION PERIOD WHETHER OR NOT YOU CHO OSE TO HAVE YOUR CHECK ELECTRONICALLY DEPOSITED. Please check one of the following NEW BANKING INFORMATION - A voided check or deposit slip with the member s printed name MUST be included* USE THE SAME BANKING INFORMATION - We will use the banking information provided in the last distribution* SEND ME A PHYSICAL CHECK - We will cancel your direct deposit if you have one in place. AUTHORIZATION FOR ELECTRONIC DEPOSIT This authority is to remain in effect until the Southwest Carpenters Vacation Trust has received written notification from me. application for benefits is made in compliance with the terms and conditions of that certain Trust Agreement entitled Agreement Establishing the Southwest Carpenters Vacation Trust dated April 1 1962 and in compliance with the conditions outlined in Collective Bargaining Agreements defined in that certain Trust Agreement. The undersigned agrees that the vacation payment for which application is made is limited to and circumscribed by the above mentioned Trust Agreement and Collective Bargaining Agreements. IF ANY MEMBER S PHONE NUMBER IMPORTANT PLEASE PRINT LEGIBLY NAME FIRST MIDDLE INITIAL LAST MAILING ADDRESS CITY STATE RETURN TO TRUST OFFICE USE ONLY 9 DIGIT ZIP CODE REQUESTED 533 S* Fremont Avenue Los Angeles CA 90071-1706 www. carpenterssw. org You are authorized to mail my check or direct deposit voucher addressed to the undersigned at the address shown in the block on this application and I agree that if I am not the person entitled to the benefits I will reimburse and indemnify you therefor. Vacation Trust to make credit entries and if necessary to make debit entries as adjustments for any credit in error to my bank account indicated* SIGN HERE X APPLICANTS SIGNATURE USE INK. VACATION REQUEST FORM IMPORTANT YOU MUST COMPLETE SIGN AND RETURN THE REQUEST FOR VACATION BENEFITS PORTION OF THE FORM FOR EACH VACATION DISTRIBUTION PERIOD WHETHER OR NOT YOU CHO OSE TO HAVE YOUR CHECK ELECTRONICALLY DEPOSITED. Please check one of the following NEW BANKING INFORMATION - A voided check or deposit slip with the member s printed name MUST be included* USE THE SAME BANKING INFORMATION - We will use the banking information provided in the last distribution* SEND ME A PHYSICAL CHECK - We will cancel your direct deposit if you have one in place. .

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