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Application Package
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Download, complete, and mail these forms to begin your application process.
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Temporary Return to Work Amendment Notice and Retiree Notification Letter
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Temporary Return to Work Notification Letter (File size - 376 K)
If you would like to return to work under this notice temporary amendment, download, complete and mail the third page of this letter to NEBF.
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Change of Address
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Change your address by downloading, completing, and mailing this form.
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Direct Deposit
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Direct Deposit Authorization Form ( File size - 64 K)
Benefit payments are sent via direct deposit--a safe, fast and confidential way to receive payments. Download, complete and mail this direct deposit authorization form to the Fund office.
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Social Security Authorization
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Download, complete, and mail this form to give the Fund authorization to obtain your earnings data from the Social Security Administration.
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Tax withholding (W-4P)
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Change your tax withholdings by downloading, completing, and mailing this form. Note that if you are not a US Citizen or resident alien of the United States, you may be subject to different withholding rules.
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Status Request
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Download, complete, and mail this form to find out your current status with the NEBF.
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Work History Information
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This form allows you to provide NEBF with information about your work history in the electrical industry.
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National Electrical Benefit Fund
2400 Research Blvd, Suite 500
Rockville, MD 20850-3266
Telephone number: (301) 556-4300
Fax number: (301)869-4322
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In order to download, view, and print these forms, you need to have Adobe Reader installed on your system. Click on the Adobe icon to download the latest version.
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