Change of Address form IUOE 139

Change of Address Form

IUOE LOCAL 139 PO BOX 130 PEWAUKEE, WI 53072
Questions? Call Christina at (262) 896-0139
Reg#*
Name*

First NameLast Name
NEW ADDRESS
Address*

Street Address

Street Address Line 2

CityState

Zip Code
New Phone Number
Winmill

Yes
UltraX

Yes
OLD ADDRESS
Address

Street Address

Street Address Line 2

CityState

Zip Code
Should be Empty: