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Revised 05/10 (Please typewrite or print) CONNECTICUT CARPENTERS BENEFIT FUNDS Tel. (203) 281-5511 Fax (203) 407-0147 MILLWRIGHT LOCAL 1121 Fringe Benefits Pension $7.70 Health 5.52 Annuity WEEKLY
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Start by entering the date at the top of the form, ensuring it is accurate and up to date.
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Fill in your personal information, such as your name, contact details, and any relevant identification numbers.
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Proceed to the section labeled "Job Details" and input the necessary information pertaining to the millwright job you are undertaking.
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Make sure to provide accurate details regarding the location, date, and duration of the job.
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Next, move on to the section titled "Work Performed" where you will document the specific tasks and services you have performed as a millwright.
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Millwright technicians or professionals who perform installation, maintenance, and repair work in industrial settings may need to fill out the 05_02_10 millwright formxls.
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Organizations or regulatory bodies that oversee millwright work or require records of millwright activities may also require the use of 05_02_10 millwright formxls.

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