Health & We
lfare and Pension Funds
of Philadelphia and Vicinity

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Click on the particular form you need.  You must have Adobe Acrobat Reader to access these documents.  To download a free copy of Adobe Acrobat Reader, click here.

Application for Normal or Early Retirement Benefits
Application for Disability Retirement Benefits
Benefit Statement Request Form
Direct Deposit Request Form
Form W-4P (for monthly tax withholding)
Form W-9 (for Death Benefit payment)
Census Card
Change of Address
Death Benefit Beneficiary Change Form

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 Last Date Updated :  10/16/08