%PDF-1.6
%
2 0 obj
<>
endobj
19 0 obj
<>stream
2019-05-02T11:18:30-07:00
Canon
2019-05-02T11:18:34-06:00
2019-05-02T11:18:34-06:00
uuid:788ce852-60b7-47f2-884f-2c4b19238f49
uuid:6485d51d-605b-4f06-859e-70b87de0b848
application/pdf
endstream
endobj
3 0 obj
<>
endobj
11 0 obj
<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/Subtype 7 0 R/XObject<>>>/Type/Page>>
endobj
7 0 obj
<>stream
CWA / ITU Nesotiated Pension Plan
DIRECT DEPOSIT SIGI\.UP FORM
1323 Aeroplaza Dr.Colorado Springs, CO 80916Phone: (719) 473-3862Fax: (719) 473-3134Email : info@cwaitunpp.org
Name:
Address:
Social Security #:Email:
Telephone :SecondaryTelephone :Telephone:
Emergency Contact Person:(other than your spouse)
Bank Name:
Bank Telephone:
Bank Address:
Bank Account Number:(Not Debit Card #1
Bank ABA Routing Number (9 digits):
PLEASE ATTACH A VOIDED CHBCK (or preprinted deposit slip if savings account)TO ENSURE YOUR PENSION IS PAID TO THE CORRECT ACCOUNT. IF YOUARE UNSURE AND DO NOT HAVE A CHECK TO ATTACH, PLEASE CONTACTYOUR BANK FOR THE NECESSARY INFORMATION. AS THEY WILL ONLYGIVE THAT INFORMATION TO THE ACCOUNT HOLDER.NON-U.S. DOLLAR BANK ACCOUNTS CANNOT BE USED.I hereby authorize my NPP pension to be deposited into my account named above.This authorizationshall remain in effect until the Plan Otfice is notified. in writing. that it has been cancelled. [f the accountis a joint account, I hereby affirm that I have notified all joint account holders to notify the Plan Officeimmediately upon my death. By signing below. I further affirm that all joint account holders consent tothe reversal of any deposits that may be made into the account after my death, and all joint accountholders have been notified that if the account is closed without reversal of ineligible deposits, the personclosin-q the account will be held liable for any overpayment of benefits and must reimburse same to thePlan Office within 30 days.
SIGNATURE(lf POA or guardian. please attach docurnentation)
DATE
Pleuse return this completed.frtrm to the Plan OlJice ttt the above uddress. Direct tleposit canbegin w'ith the next pension povmettt if the Plan receives rolff form b-v the 20th ot'the month.To change banks or accounts, please complete a new sign-up form, vvhiclt con be dow'nloacled .fiontwtttt,.t'vr,tritunpp.org. Othenu'ise, please contoct the Plan Of ice iJ'your bank intormation or home udclressc'honges. It is importunt that the Plan Office hus your curuent otldress so lhut yolt con receiv,e v-ourcrnnuoltuxJorm(1099R)undotheru)rrespotl(lence. Yountulcull (719)473-3862forussistonce.
E Checking
E Savings
(Renrcntlrcr tu uttuch u v,oitletl check)
endstream
endobj
4 0 obj
<>/Filter/CCITTFaxDecode/Height 3315/Length 59884/Name/Obj4/Subtype/Image/Type/XObject/Width 2567>>stream
d7*Ql0XU"$z z0U?{v!r;;]#r$Q0bqjS1:?3N`wšgA2אBDlA֕qN_@@d!Az թ)TFnQ
T @:rJ$"4
I[&GB6-'k@vH²~ݤt}=ZNC$ɶT%pudrev
m ~X4_xaa0Ng| ߮KKӣjM5kK:]ZuO8Y!馽~Z]hy;^KRJ%'Ki
%=jC"fE=DyתI/].j|46aBBd9.ztM+Z*R/A*jָKItOvJI ZnNމ^FIIImizx*nk '{zUJ0#O M9} /w
iRm"
ӆd#`B\kbi^)tMIu꿄v 0PL!@iV b> ONBjK!2R:U xI蘆UN@BatPi%*
vu?AI-%KZDq%p
UL(A4OA wPR7ޗKW|BH'd&$AGpB"Bk@*IZZIUuҦ%KZMDw I%
/pUUO-RiRV--BU]t)-%TUZ"Iv90|5^ZT/J*B$g/G N)O
S5K
jI'IPK
%Uoq}О
It]%I%zUZUA%V
Rh4TS{¯t$˥^A*U$U!RR/чTD0NȣEO_~8#JKTT]<TDhDDqa*
@kU_IRV=c"3ҬDDDDwzU]uJ *T[z%UXK*DAzUO
mU/^%UT"ZWU@.PI.Ku^Ik.k_-}k{JMKJA%_T섪]k:Z~_n_m{ZUKKZVIRTatZ-$iiu_~'TZ~in%MU#9Ҫkޠ˂RIi}e
M#~r[^몭V*U{M'NZ
䅄]uK$ڪ
*
Ҏ8V])%vPPI}HVK˦r|U.d_ &R$$qdҥF$1jmy](Zj0"# IBb.><(-eAaU}Zmna*JJ$T%>0wl%l!"w6",)9TI(lT(UU
CuZ]UU*H?A@T d6Dx :p UM 4 BC@0iRIU"Ӳ0"at4leЈ (L*a0$$ ,$T
=04iӮ00
l%PD4( JuNm]}]xLDXB"(E)8":a5 TF*VLGvN$;DQooDDAP yBCq#q
'A7ਝADX@V
zP1hZqhEzkADDDEݦP;ǂzw
}zڊf_(^hPA6J+m% GD|0Gˢ:1|84[OpCl:#'ݵV[DDDDDDDDHX&9&Q糹
VRU
B]8o~_9E[r3gVTjiaRy
O.<qArC#S4D YB#>ÿ|׆""""""$6 C98:.D|mь.8"/CwuzwY4"89#dp 0tG":.:#jtJG[d>xڪ$2:#p6iL2>hhӯIV~X7~Z