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Michiana Area Electrical Workers
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Forms
Please Note:  In order to view and print the following forms, you must have the Adobe Acrobat Reader installed on your computer.  If you do not have the Adobe Acrobat Reader Software and wish to download it, you may do so by clicking on the image below.

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  • Beneficiary Designation Form

  • Participant Data Card Form

  • Application for Direct Deposit Form

  • Physician's Medical Report Form

  • Application For Member Death Benefit Form

  • Request for Estimated Benefits Form

  • Request For Application Form

  • Application For Total And Permanent Disability Benefits Form

  • Change of Address Form

  • Qualified Domestic Relations Order Sample

  • Qualified Domestic Relations Order Procedures



    • Michiana Area Electrical Workers Benefits Web Site
    6525 Centurion Drive, Lansing, MI 48917-9275
    Phone 877.244.9473 • Fax 517.321.7508


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