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ROSEVILLE FIREFIGHTERS RELIEF ASSOCIATION Application for Disability Benefits Name: Address:Date: Date disability began: Date returned to regular employment:: Name of your attending Physician: Address:Phone:

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How to fill out roseville firefighters relief association

01

Obtain the Roseville Firefighters Relief Association application form.

02

Fill out the personal information section, including your name, address, contact information, and social security number.

03

Provide details about your employment as a firefighter in Roseville, including your hire date, rank, and department.

04

Include information about any prior membership or contributions to the relief association.

05

Fill out the beneficiary section, indicating who will receive your benefits in case of your death.

06

Sign and date the application form.

07

Submit the completed form to the Roseville Firefighters Relief Association.

Who needs roseville firefighters relief association?

01

Roseville firefighters who belong to the Roseville Fire Department and want to ensure financial protection and benefits in case of injury, illness, or death.

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What is roseville firefighters relief association?

The Roseville Firefighters Relief Association is a fund established to provide benefits to firefighters and their families in times of need.

Who is required to file roseville firefighters relief association?

All firefighters and fire departments in Roseville are required to file the relief association.

How to fill out roseville firefighters relief association?

To fill out the Roseville Firefighters Relief Association, firefighters need to provide information about their personal details, years of service, and beneficiaries.

What is the purpose of roseville firefighters relief association?

The purpose of the Roseville Firefighters Relief Association is to provide financial assistance to firefighters and their families during emergencies or times of need.

What information must be reported on roseville firefighters relief association?

Information such as personal details, years of service, beneficiaries, and any claims for benefits must be reported on the Roseville Firefighters Relief Association.

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