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Get Steelworkers Pension Trust Direct Deposit Authorization

STEELWORKERS PENSION TRUST Fund Office GEMGroup Administrator 3 Gateway Center 401 Liberty Ave. Ste. 1200 Pittsburgh PA 15222-1024 DIRECT DEPOSIT AUTHORIZATION MEMBER INFORMATION Name Social Security Number Address City State Zip Code Phone Number ACCOUNT INFORMATION Financial Institution Name Name s of account holder Bank Routing ABA Number Account Number Account Type Savings Checking If using a checking account please attach a voided check This direct deposit will take TWO 2 pay cycles to complete. 1200 Pittsburgh PA 15222-1024 DIRECT DEPOSIT AUTHORIZATION MEMBER INFORMATION Name Social Security Number Address City State Zip Code Phone Number ACCOUNT INFORMATION Financial Institution Name Name s of account holder Bank Routing ABA Number Account Number Account Type Savings Checking If using a checking account please attach a voided check This direct deposit will take TWO 2 pay cycles to complete. On the 1st of the month following receipt of this form your account will be set-up and tested you will receive a paper check then on the 1st business day of every month thereafter your pension payment will be sent electronically into the account provided above. I we hereby authorize Steelworkers Pension Trust to deposit my benefit payment into the account provided above and for the would like to terminate this method of payment. STEELWORKERS PENSION TRUST Fund Office GEMGroup Administrator 3 Gateway Center 401 Liberty Ave. Ste. 1200 Pittsburgh PA 15222-1024 DIRECT DEPOSIT AUTHORIZATION MEMBER INFORMATION Name Social Security Number Address City State Zip Code Phone Number ACCOUNT INFORMATION Financial Institution Name Name s of account holder Bank Routing ABA Number Account Number Account Type Savings Checking If using a checking account please attach a voided check This direct deposit will take TWO 2 pay cycles to complete. On the 1st of the month following receipt of this form your account will be set-up and tested you will receive a paper check then on the 1st business day of every month thereafter your pension payment will be sent electronically into the account provided above. I we hereby authorize Steelworkers Pension Trust to deposit my benefit payment into the account provided above and for the would like to terminate this method of payment. In the event that the Trust notifies the financial institution that funds to which I was not entitled to were sent inadvertently I we authorize that the funds are to be returned to the Trust as soon as possible. PLEASE RETURN THE COMPLETED FORM TO THE TRUST USING THE ADDRESS ABOVE OR FAX IT TO 412-471-2891. Signature Date Signature Member If a joint account both parties must sign. 1200 Pittsburgh PA 15222-1024 DIRECT DEPOSIT AUTHORIZATION MEMBER INFORMATION Name Social Security Number Address City State Zip Code Phone Number ACCOUNT INFORMATION Financial Institution Name Name s of account holder Bank Routing ABA Number Account Number Account Type Savings Checking If using a checking account please attach a voided check This direct deposit will take TWO 2 pay cycles to complete. On the 1st of the month following receipt of this form your account will be set-up and tested you will receive a paper check then on the 1st business day of every month thereafter your pension payment will be sent electronically into the account provided above. .

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