Be sure to request a withdrawal when being LAID-OFF, GOING ON LEAVE OFABSENCE, LENGTHY MEDICAL LEAVE, WORKER’S COMPENSATION ORTERMINATING YOUR EMPLOYMENT. The charge for the withdrawal card is fifty-cents ($.50). However, all initiation fees and back dues must be paid before thewithdrawal can be issued.
Stop by the Local Union office or complete this form and mail it to the Local Union,along with your check, cash or money order for fifty-cents ($.50). It is your responsibility to obtain a withdrawal card, so take care of it as soon as possibleafter leaving the company so that you will not be obligated to pay back dues. Failure torequest and obtain a withdrawal card may cause you to pay back dues.