CEMENT MASONS AND PLASTERERS 401(K) TRUST 2026-2027 ELECTION FOR 401(K) DEFERRAL CONTRIBUTIONS

CEMENT MASONS AND PLASTERERS 401(K) TRUST 2026-2027 ELECTION FOR 401(K) DEFERRAL CONTRIBUTIONS

Use this form to elect or terminate 401(k) deferral contributions for the 2026–2027 plan year. Please read the instructions carefully and provide all required information.
Basic Information
Employee’s Name – First
Employee Name
Employee’s Name – Middle
Employee’s Name – Last
Social Security Number / WPAS ID Number
Home Address
Employee Home Address
Apartment #
City
State
ZIP
Date of Birth

MonthDayYear
Date
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
E-mail
example@example.com
Current Employer #1
Current Employer #2
401(k) Deferral Election
I elect to make 401(k) deferral contributions from my hourly wage on a pre-tax basis.
Hourly 401(k) deferral amount
Month/Year began working in Local Union 528 jurisdiction
Current participant with employer contributions to this Plan
Month/Year first hours worked when newly eligible to participate
Employee Signature - Deferral Election
Date - Deferral Election

MonthDayYear
Date
Termination of Deferrals
I elect to terminate wage or salary deferral contributions.
Employee Signature - Termination of Deferrals
Date - Termination of Deferrals

MonthDayYear
Date
After review by the Administration Office, your employer will be notified of your election deferral. Please keep a copy of the completed form for your own records.
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