This form is used to provide instructions for payment of a benefit if you have 5 or more years of contributory service. fr
Please complete and submit either page 1 or pages 2 & 3 (
Do not submit all the 3 completed pages to the Fund).
If you submit all the 3 completed pages, the Fund will not able to determine your election of benefit, therefore, the process will be delayed.
Page 1 is only to be completed if you elect the
DEFERMENT of your choice or payment of benefit under Art. 32.
Pages 2 and 3 are for those who want to make their
BENEFIT election. (You do not need to complete page 1).