Letter of Assent - Information Request Form

IBEW Local 51 - Letter of Assent Request

Please complete the information below so we may generate the letter of assent. Please note - this is not the letter of assent, this is the information necessary to complete the letter of assent. If you have any questions about this form, please call 217-726-8481 or email ibew51@ibew51.org.
Company Name*
Address*
City*
State*
Zip*
Phone*
Fax
Email*
Please provide the email address for the individual that will be handling the letter of assent information (this may or may not be the authorized signatory).
FEIN*
Are you a member of NECA?

YesNo
Contact Name and Title*
Contact Phone*
Email to send referrals*
example@example.com
Are you interested in remitting working dues via ACH?*

YesNo
If yes, who should we contact to set up ACH payments?
Name*
Email Address*
example@example.com
Nature of the business (please note if you do storm work)
Printed Name of Authorized Signatory*
Title of Authorized Signatory*
Phone # of Authorized Signatory*
PLEASE READ BEFORE SUBMITTING

When you complete this form you will be automatically redirected to the Local 51 website which contains helpful links such as the 6-51-A Agreement, wage/fringe summary, and an explanation of fund contributions.

If we need any additional information we will contact you directly. Otherwise, we we will generate the letter of assent and send it to the email address provided. If you need further assistance, please call the Hall at 217-726-8481 or email ibew51@ibew51.org.
Should be Empty:

IBEW Local 51 - Letter of Assent Request