Line Construction Benefit Fund
LINECo
Forms
These printable forms are in PDF (Portable Document) format. To read and print them, you need the free Adobe Acrobat Reader (which is probably already installed in your system). If you do need to install it, click the "Get Acrobat Reader" logo.
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Enrollment
LINECO Family Enrollment Card - Use this form to enroll your family in the Plan. Death Beneficiary Card - Use this form to designate a beneficiary in case of participant's death (located on Family Enrollment Card). Authorization to Disclose Health Information - Participants may use this form to authorize the disclosure of health information in order to enable another person or organization to assist you in obtaining benefits from the Fund. Change of Address - Use this form to notify the Fund of a change of address. |