If you would like your benefit payment electronically deposited to your bank account, please READ AND COMPLETE all portions of this form and return the original signature document totheTrustFundOffice.
I request, until further notice, that disbursements be deposited for each appropriate pay period, to the account with the Financial Institution described on this form and understand that the account cannot be in the name of a living trust or trustee account.
IMPORTANT REMINDER: You must always notify the Trust Fund Office in writing of any change in your mailing address, even though your benefit payment is electronically deposited. The Trust Fund Office does not allow our mail to be forwarded at any time!