TEAMSTERS
LOCAL UNION NO. 783

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Insurance and Pension Forms

Health & Welfare Forms

Loss of Time Form (Disability) Loss of Time Continuation Form
Enrollment Information Change Form Student Verification Form
Prescription Drug Form Dental Claim Form
Dental Claim Form (Ortho) Vision Claim Form
Designation of Beneficiary Card Request for Extension of Basic or Major Medical Benefits
Health & Welfare General Appeals  


Pension Forms

Application for Pension Benefit Retirement Declaration Form
Joint & 50% Surviving Spouse Federal Tax Withholding Letter (W4-P)
Direct Deposit of your Pension Benefit (EFT) Reemployment Questionnaire
Application for Disability Benefit  




Teamsters Local 783
7711 Beulah Church Road Louisville, KY 40228
(502) 231-9596 (800) 248-6936