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Electrical Workers Benefit Trust Fund IBEW Local Union No. 481 Supplemental Unemployment Benefit Plan 1828 N. Meridian St. Ste. Https //uplink. in.gov/CSS/CSSLogon.htm III. APPLICATION FOR WAGE REPLACEMENT BENEFITS Medical Leave will cause the applicant to miss at least one full week of work and the applicant s employer will not provide compensation for the period of missed work. DEATH BENEFIT The undersigned applicant hereby applies for the supplemental death benefit provided by the IBEW...
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