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RETURN TO: Administrative Services Only, Inc. PO Box 9011 Department 146 Benbrook, NY 11563 (877) 322-5385 (516) 394-9485 BUILDING SERVICE 32BJ HEALTH FUND DENTAL CLAIM FORM PRE-TREATMENT ESTIMATE
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How to fill out 32bj claim form fund?

01
Obtain the 32bj claim form fund from the appropriate source, such as the 32bj website or the human resources department of your employer.
02
Carefully read through the instructions provided on the form to ensure you understand the requirements and the information you need to provide.
03
Fill in personal information, including your full name, address, phone number, and social security number. Make sure to double-check the accuracy of this information.
04
Provide details about your employment, such as the name of your employer, your job title, and your hire date. Include any additional information that may be requested, such as union membership details.
05
Indicate the type of claim you are making by selecting the appropriate option or providing a brief explanation in the designated field.
06
Clearly describe the details of your claim, providing any relevant information, dates, and supporting documentation if required.
07
Review the completed form to ensure all sections are filled accurately and completely. Make any necessary corrections or additions.
08
Sign and date the form in the designated areas to certify the accuracy of the information provided.
09
Make copies of the completed form for your records before submitting it to the designated recipient according to the instructions provided.

Who needs 32bj claim form fund?

01
Employees who are members of the 32bj union and wish to file a claim for benefits or financial assistance.
02
Individuals who have experienced workplace-related incidents or events that may qualify them for compensation or assistance under the 32bj claim form fund.
03
Employees who need to document their eligibility for specific benefits or programs offered by the 32bj union or their employer.

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32BJ Claim Form Fund is a benefit fund established by the 32BJ SEIU (Service Employees International Union) for its members. It provides various benefits and services to eligible individuals, including healthcare coverage, dental benefits, retirement benefits, and disability benefits. The claim form is a document that members need to fill out and submit when they seek reimbursement or assistance from the fund for covered expenses or services.
Employees who are members of 32BJ SEIU (Service Employees International Union) and have experienced a violation of their rights under the collective bargaining agreements are required to file a claim with the 32BJ Benefits Fund. This includes janitors, building services workers, doormen, security officers, and other property service workers who are part of the 32BJ SEIU union.
To fill out the 32BJ claim form fund, follow these steps: 1. Obtain the claim form: You can download the claim form from the 32BJ website or request a physical copy from the 32BJ union office. 2. Provide personal information: Fill in your personal details such as name, address, phone number, email address, and social security number. 3. Employer information: Enter the name and address of your employer, along with any additional details required, such as the name of the building where you worked. 4. Employment details: Describe your job title, department, and the dates of your employment. Include any relevant information, such as the number of hours worked per week or your hourly wage. 5. Reason for claim: Specify the reason for your claim, such as unpaid wages, overtime, or improper deductions. Provide a detailed explanation of the issue, including dates, amounts, and any supporting documents or evidence. 6. Sign and date the form: Read the declaration carefully and sign and date the form to certify the accuracy of the information provided. 7. Attach supporting documents: Gather any necessary supporting documents, such as pay stubs, timesheets, employment contracts, or other evidence related to your claim. Make copies of these documents and attach them to the claim form. 8. Submission: Once you have completed the form and attached all required documents, submit the claim form to the 32BJ union office. You can either mail it or deliver it in person according to the instructions provided on the form. Remember to keep copies of all submitted documents for your reference. It is also advisable to follow up with the 32BJ union office to ensure that your claim is being processed and to address any additional information they may require.
The purpose of the 32BJ Claim Form Fund is to provide financial assistance and compensation to members of the Service Employees International Union (SEIU) Local 32BJ who may have experienced workplace-related injuries, illnesses, or accidents. Members can file claims through this fund to seek reimbursement for medical expenses, lost wages, disability benefits, and other financial hardships resulting from their employment. The fund exists to support and protect the rights and welfare of the union's members by providing a mechanism for seeking compensation for work-related issues.
The information that must be reported on a 32BJ claim form fund may include: 1. Claimant's personal information: Name, address, phone number, email address, and social security number. 2. Employer information: Name of the employer, address, and contact information. 3. Claim details: Type of claim being filed (e.g., medical, vacation pay, maternity leave), date of occurrence, description of the incident or reason for the claim, and any supporting documentation. 4. Work-related details: Start and end date of employment, job title, and hours worked per week. 5. Supporting documents: Attach any relevant supporting documents such as medical reports, invoices, or pay stubs. 6. Declaration: The claimant may need to sign a declaration asserting the truthfulness of the information provided. It is important to note that the specific requirements may vary depending on the 32BJ claim form's instructions or any additional information requested by the fund.
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