#734 Winter 2011.indd - Bakery Drivers Local 734

Transcription

#734 Winter 2011.indd - Bakery Drivers Local 734
TEAMSTERS
734
734
NEWS
WINTER, 2011 — Vol 11 - No 1
Official newsletter of International Brotherhood of Teamsters Local 734
Local 734 Wins Unjust Discharge Grievance
Gonnella Members Win
$52,000 Backpay Award
P
LEFT: Pictured (left to right)
are Local 734 Recording
Secretary Joe Sanchez, Gonnella
members Felipe Cerdas, Arnulfo
Velazco and Secretary-Treasurer
Scott Kunz following the Gonnella grievance victory.
roving, once again, that a Teamsters Local 734 contract
gives members tremendous power to fight back against
workplace injustice, members at Gonnella Baking are
celebrating the conclusion of their unjust discharge
grievance which resulted in a backpay award of $52,000.
On November 9, 2009 the company unjustly terminated 6 members for alleged rule and procedure violations. Once informed about
the firing, Local 734 Business Agent Joe Sanchez filed a grievance
stating that the company acted improperly in firing the members.
“From our perspective the company managers and supervisors
were aware of and/or condoned the procedures our members were
directed to follow,” Sanchez said.
BELOW: Gonnella member
Ed Aghajan was also ordered
returned to his job.
Arbitrator Sides With Local 734 In Dispute
The grievance went to arbitration, where both sides were allowed
to present their case. After hearing from Local 734 and the company,
an arbitrator ruled that Gonnella did violate the contract in wrongfully firing the members. The arbitrator ruled that the members must
be reinstated to their jobs with partial backpay and benefits. Since
these members were without jobs for six months before a final decision was reached, the arbitrator set the backpay award at $52,000.
“This is a terrific victory for these Gonnella members who were
treated unfairly and yet prevailed thanks to Local 734,” said President
Brian Meidel. “Our Union has a long history of standing up against
injustice at the workplace, and this is just the latest example of how
we will use our grievance and arbitration procedure to make sure our
members’ rights and dignity are fully protected.”
Meidel Team Elected
To Represent Local 734
Members at the 2011
IBT Convention
Local 734 members voted by acclamation to elect
the MEIDEL TEAM as their voice at the 2011 IBT
Convention. President Brian Meidel and SecretaryTreasurer Scott Kunz were elected Delegates, while
Vice President Gordon Nisbet was elected an Alternate.
The IBT’s Constitutional Convention will be held
this June in Las Vegas, Nevada.
President
Brian Meidel
CONVENTION
DELEGATE
Sec-Treasurer
Scott Kunz
CONVENTION
DELEGATE
Vice President
Gordon Nisbet
ALTERNATE
DELEGATE
PReport
resident’s
By
BRIAN MEIDEL
Local 734 Delegates Prepare
For Important IBT Convention
A
s I sat down to write this month’s
President’s column, the muchanticipated 2011 International
Brotherhood of Teamsters’ Constitutional Convention is about five months
away. Preparations are already ongoing,
both here in Local 734 and at
Local Unions across the country, for what
will be another historic and important gathering for our International Union and for
rank-and-file members.
The first step for Local 734 took place on
January 8, 2011 when members elected
Delegates to serve as their voice and vote
at this Convention. I want to thank all the
members for electing Scott Kunz and I as
your Delegates, and electing Gordon Nisbet
as your Alternate. We graciously thank
the members for their unanimous vote of
confidence in us, and each pledges to do
our level best to make sure that the voices,
ideas and vision of Local 734 members is
heard loud and clear at this convention.
Local 734 Delegates Prepare
For Historic IBT Convention
When Teamster delegates from through
the U.S. and Canada gather in Las Vegas
this coming June, we will have plenty of
important work to do. For years Local 734
has played an important role in the IBT
and I want you to know that our intent is
to keep this tradition alive this year. As
your elected Delegates, we will be present,
active and vocal on issues that you care
about. Issues that impact your jobs, your
family and your future. Count on it!
Decisions made at this convention will
determine the future progress of the IBT
during the coming years, while outlining a
road map of priorities and programs to help
build a 21st Century Union. This is why
your Delegates and Alternate Delegate are
busy familiarizing ourselves with the many
resolutions and issues that will surely come
up for discussion, and why we have been
out speaking one-on-one with members to
find out what’s on your minds and
what issues you think should be
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talked about at this year’s Convention.
While there will be plenty of events and
activities taking place during the week-long
Convention, by and large the priority item
on the Convention’s “to do list” will be the
nomination of candidates for IBT General
President, General Secretary-Treasurer
and IBT General Executive Board. This is a
duty that all Delegates take very seriously,
because we understand what this means
to our Union today — and for decades to
come. Once nominated at the Convention,
rank-and-file members will get the opportunity to vote for IBT officers in a direct-mail
election this November.
We need strong leadership guiding the
IBT during these difficult times. I want you
to know that your Delegates will support
the election and re-election of candidates
who understand our challenges and have
a vision to move our Union forward. As
Teamsters we know what it will take to
keep our Union on a positive track, and
we will be voting for those individuals who
have the best interests of rank-and-file
members at heart not just at election time
— but every day throughout the year.
Important Challenges Ahead
For All Teamster Members
The IBT Constitutional Convention, held
every five years, is the IBT‘s highest governing body. The decision made at this convention will help guide the IBT from now
until the year 2016. That may seem like a
long way off, but when you consider how
fast the last five years have gone, you can
see why the Convention is a vital part of the
overall IBT structure. The Convention will
also provide a forum from which the IBT‘s
General Executive Board takes its orders, as
expressed by the collective voice of Local
Union Delegates, about which direction the
Teamsters Union should go.
As one of your Delegates to this year’s
Convention, I fully expect that there will
be a lively and healthy discussion on a wide
range of issues. These will undoubtedly
include organizing, health care, health
and safety, jobs, workplace rights, and pension reform. The pension issue is one which
Local 734 members are following very closely. The loss of retirement savings over the
last two years, as our economy fell apart,
has been on the minds of all Americans.
The devastating decline in the U.S. stock
market hit pension plans hard. Many,
including Local 734’s Pension Plan, had to
enter Rehabilitation Plans to survive. Our
plan has fared better than most during these
times and as our economy improves we
remain hopeful. I want you to know that we
will keep working to get our Pension back
to where it was before the meltdown. It will
take time, but we will keep working on this.
Charting Our Union’s Future
The 2011 Teamsters Convention will be
one of the most dramatic gatherings for our
Union in years. This Convention is a test of
our democracy, a time for us to open up,
stand up, and debate issues and direction
of our Union. The key point is for us to do
so respectfully — understanding that while
we may disagree on ideas, we agree on the
larger mission of our great Union: promoting dignity and justice for Teamsters and all
working men and women.
Sure we can disagree on specific issues
or candidates, and we likely will. However,
the bottom line is that we are all Teamsters
who are committed to the cause of our
Union and who are fighting everyday to
stand up for working families. This is why
our Delegate team will do everything we can
to stress unity and teamwork.
Once again, a sincere “thank you” to all
members for their unanimous support of our
Delegate team. We head to this convention with a strong feeling of purpose and an
understanding that we will work everyday
to make you proud to be Teamsters — and
even prouder to be Local 734 members.
TEAMSTERS
734
734
NEWS
EXECUTIVE BOARD
Brian Meidel .........................President
Scott Kunz ........... Secretary-Treasurer
Gordon Nisbet ..............Vice President
Joe Sanchez ........ Recording Secretary
Mark Mizera ............................ Trustee
Filip Covic ................................ Trustee
Joe Lanski................................. Trustee
Teamsters Local 734 News • Winter, 2011
Teamsters Local 734
6643 N. Northwest Highway
Chicago, Illinois 60631
Union Hall (773) 594-2820
Fax (773) 631-3907
Local 734 Welfare Fund News
SCHOLARSHIP NEWS
IBT’s James R. Hoffa
Memorial Scholarship
Local 734 members are
advised that the IBT’s James R.
Hoffa Memorial Scholarship
Fund are available on the IBT’s
website: www.teamster.org.
A total of 100 scholarships
will be awarded. Thirty-one
total $10,000 each, while 69
are one-time $1,000 grants.
ELIGIBILITY CRITERIA
Information About
Your Health Benefits
Fund Announces Upcoming
Plan Enhancements for
Benefit Fund Participants
Several significant improvements will be made to the
Local 734 Welfare Fund’s benefit plan on May 1, 2011.
(1) Be the son, daughter, or grandchild of an active,
retired, disabled, deceased or laid-off Teamster member
who has or had at least 12 months of consecutive membership in good-standing in the Teamsters.
(2) Be in his/her last year of high school and may not apply if he/she has already graduated from high school.
(3) Be in the top 15% of his/her high school class.
(4) Plan to submit excellent SAT or ACT scores.
(5) Plan to attend an accredited college or university.
Those who plan to attend non-academic or certificate
programs may not apply.
Applicants should complete the application and
mail it back to Local 734. Secretary-Treasurer Scott
Kunz will then complete the form and forward it to
the Fund. Applications not being sent from a local
union office will be returned to the applicant.
CFL’s William Lee
Memorial Scholarship
Applications for the 2011 William A. Lee Memorial Scholarship offered by the Chicago Federation
of Labor are now available online at the website:
www.chicagolabor.org.
Five academic-based scholarships and five random-drawing scholarships in the amount of $2,000
are offered to students graduating from a Chicago
or suburban-area high school. Students may only
apply in one of the two categories.
To be eligible, either the student or one of his or
her parents must be a member of a local union affiliated with the Chicago Federation of Labor.
All applications must be signed by either of the top
two officers of the local union to which the student
or his or her parent belong. Applications signed
by Union representatives or Union Stewards will
be disqualified.
Completed applications must be returned to
the Chicago Federation of Labor, William A. Lee
Memorial Scholarship Committee, 130 E. Randolph
St., Suite 2600, Chicago, IL 60601. All applications
must be postmarked no later than March 1, 2011.
1. Coverage for Children Until Age 26
Your children will remain covered under
the Plan until their 26th birthday, provided
you remain eligible. The Plan will not require
that children be students, nor will it cover only
children who are unmarried and financially
supported by you.
If an adult child of yours is eligible to enroll
in another group health plan, other than a plan
through a parent, he or she will not be eligible
for coverage under this Plan.
Prior to May 1 the Fund will send you information about how to add your
eligible adult children to the Plan.
2. Lifetime Dollar Limit Removed
The overall benefit maximum under the medical plan will be changed
from a lifetime limit to an every-12-months limit. The 12-month limit will
be $1,000,000 starting May 1, 2011.
3. Mental Health and Chemical Dependency/Substance Abuse
The limits on the number of days and treatments provided under the Plan
for covered mental health and substance abuse treatment will be eliminated May 1. At that time, mental health and substance abuse treatment will
be paid the same as other medical conditions.
4. Additional Benefits Available
Some of the Plan’s other dollar limits will also be removed effective May 1,
2011. For example, there will no longer be a $300 limit for adult preventive
exams or a $100 limit on immunizations for children age 6 and over.
You will receive more information about these benefit enhancements at
a later date. Note that the changes described above will NOT apply to the
Basic 65 Plan (the limited benefit plan for retirees over age 65).
Teamsters Local 734 News • Winter, 2011
5
Saluting Our
Retirees
Steven Abbott, East Balt
Edward Aghanjan, Gonnella
John Albrecht, IBC Hostess
Eugene Allen, Rosen’s
Roberto Almanza, Alpha Baking
Jerry Anderson, Continental
Frank J. Biernat, Butternut
Jeffrey Bobo, Wonder Bread
Felczak Bogdan, Metz Baking
William Borgens, IBC
Marvin D. Boulware, Alpha Baking
Robert Breen, IBC
Terry Bronke, Hostess
Oscar Brown, Rosen’s
Dennis Burmeister, Continental
Frank Cacci, Jr. , IBC Hostess
Thomas M. Casa, Sara Lee
Ross Cobb, IBC
Thomas Corso, Olympic Freight
Michael Criddell, Continental
Charles A. Crumble, Interstate
Lyle Dobrowski, Sara Lee
John C. Draver, IBC
Nabil Elddine, IBC
Paul J. Flynn, Alpha Baking
William Garrigan, New Process
Anthony Giadonato, Entenmann’s
Edward Gronowski, Alpha Baking
Percy Groves, Jr., Entenmann’s
Dennis Hahn, Butternut
Percy Hall, Continental Baking
Yvette Hankerson, Entenmann’s
Sam Harris, IBC
James Harwell, Interstate
Athanasios Hatzaras, Alpha Baking
Neil Humphrey, Interstate
Patrick Iwatiw, Rosen’s
Marc Jacobs, Alpha Baking
Jessie Jarred, Salerno
Jimmy Jenkins, IBC Hostess
Larry Jones, Continental
Constantin Kakoliri, Alpha Baking
Robert T. Kane, IBC
John LaPorte, Entenmann’s
Elmer Lemmer, New Process
Richard Longoria, Hostess
IN MEMORIAM
Our thoughts and prayers to the families and
friends of our recently-departed members
Howard C. Murphy, Heinemann’s Bakery
Harry D. Andritsi, Eagle Baking
Andrew D. Nisbet, Interstate Brands
Billy Bartlett, Chicago Baking
Neil Ortt, Interstate Brands
George Bliss, Interstate Brands
Georgios Palaskonis, Alpha Baking
Joseph Bowden, Interstate Brands
Edward Paolicchi, Keebler
Daniel Busa, Alpha Baking
Richard P. Parker, Chicago Baking
Robert Busse, Lewis Bakeries
William J. Pokin, Continental Baking
Mary Cimino, Best Foods Baking
Carl Porto, Gonnella
Thomas Corbin, Entenmann’s
William W. Purvis, Continental Baking
James Dillman, Interstate Brands
Albert Rossi, Busch Products
Alfred Durnin, Butternut
Larry D. Rowell, Sr., Interstate Brands
Eugenio Fantozzi, Gonnella
Ronald Schroeder, Wonder Bread
Charles Folino, Gonnella
Stavos Selas, Interstate Brands
Robert Fulghum, Hostess
Walter Setzke, Transervice Lease
Konstantinos Goufas, Alpha Baking
Emil Sileo, Interstate Brands
Folco Grimaldi, Alpha Baking
Joseph H. Simms, Continental Baking
Madonna Grimaldi, GMG Distributors
Louis Stauter, Wayco Food
Jesus Gutierrez, Interstate Brands
William Svec, New Process Baking
Raymond Hasse, Gonnella
Howard Thirus, Interstate Brands
Donald Hull, George Weston
David Thompson, Interstate Brands
Robert Hull, New Process Baking
Frank Urban Keebler
Hedrick Humphries, New Process Baking
John Villapiano, Keebler
Warren Jackson, Wards Baking Co.
Rocco Vitucci, Lloyd J. Harriss Pie
Thomas Jareczek, Colonial Bread
Billy J. Walker, Interstate Brands
Joseph Kania, Lloyd J. Harriss Pie
Willie L. Ware, Chicago Baking Co.
George Kroeger, Universal Foods
Kurt M. Wenzel, Clyde’s Donuts
Robert Laszczak, Alpha Baking
Melvin Wiewal, Wonder Bread
Robert J. Lucchesi, Chicago Baking
Allan J. Witt, Salerno
Robert N. Meidel, Teamsters Local 734
Ivo Zanardo, Gonnella
Efrain Montanez, Burny Bros.
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James McKee, IBC
George Maldonado, Sara Lee
Gregory Manijak, IBC
Robert E. Martin, Chicago Baking
P. Mihalopoulos, Alpha Baking
Michael Moravick, Lewis Baking
Ioannis Nikolakakis, MaryAnn Baking
Robert E. Nowak, Holsum Bread
Gilberto Olivares, IBC
Thomas K. Page, Entenmann’s
Robert Pagni, Bimbo Bakery
Giovanni Peri, Gonnella
Mario Perez, Chicago Baking
Miguel Perez, Alpha Baking
Vito Perniciaro, Bimbo Bakery
John C. Pistorius, Gonnella
Victor Pizano, Sara Lee
George Porter, Interstate
Virgil Puczylowski, Chicago Baking
Gregory Quarles, Alpha Baking
Steven Ripstein, Sara Lee
Thomas Rusnak, Hostess
Henry Sajpel, Alpha Baking
Theodore Schmidt, Continental
Richard C. Schuit, Chicago Baking
Porfiro Serrano, Entenmann’s
Russell Sliwa, Hostess
Michael Smith, IBC Hostess
David S. Somo, IBC
Calvin Steward, Interstate
Matthew Stiffend, Interstate
James Stringham, Butternut
Wayne Swart, Chicago Baking
Mark Syputa, Bimbo Bakeries
Leonard Szot, Bimbo Bakeries
Arthur Tevenan, IBC Hostess
P. Theodosopoulos, East Balt
Fred Thomas, Interstate
James L. Thomas, Alpha Baking
Thomas Vassiliou, East Balt
Robert J. Veleta, Gonnella
Jerome E. Vicha, Bimbo Bakeries
Louis Vlahos, East Balt
Mark A. Walters, Heinemann’s
William Weed, Interstate
John Wilson, Alpha Baking
Marian Zagata, Alpha Baking
Wayne Zaehler, IBC Hostess
WELCOME New Local 734 Members
Alpha Baking
Mustafa Mohammad Alshaikh
Ulises Delgado Ramirez
Omar Lara
Michael Gregory Leveston
Fabian Lopez
Michel Lopez
Ciro Macedo
Jeremie Meade
Edgar Melecio
Cristian Morales/Figueroa
Jose Maria Munoz
John Edward Nosek
Christopher Joseph O’Connor
Sara Parra
Santos Marcelo Rodriguez
Stephen Scott Salsman
Cecil Thomas White
Interstate Brands
Kevin Peter Bartlett
Carnell Bonne, Jr.
Christopher Lee Johnson
Douglas Karwatka
Michael Pearson
Mark John Tynski
Thomas Vansickle
Lewis Bakeries
Brian Czarney
Jeffrey John Kreutzer
Kyle Martino
William Nash
Scott Waddick
Sara Lee Bakery
Jerome Applewhite
Michael Bagnall
Svengali Banks
Eric Bartelt
Jonathan Cook
Dorian Duhart
Darren Hoeppner
Gregory Jacobs
Alexandros Klementos
Graham Paul Manges
Larry Moffitt
David Pierzchalsk
Catalina Rivera
Mark Siegel
Olympic Freightways
David Eugene Edge
Dominic Tyler
George Weston
Brian Bronson
David Iverson
Brian Kaczmarek
Teamsters Local 734 News • Winter, 2011
Roger Lajewski
Alex Willert
David Alan Wolter
IBC Bread
Retail Outlet
Jkeandra Lashawn Jackson
East Balt
Commissary
Michael James Gross
Michael Kubistal
Dimitri Lacombe
Randy Potempa
Thomas Rosy
Ryan Santos
Steven Sellis
Gonnella Baking
Andres Hernandez
Enrique Reyes
Reinaldo Rodriguez
Luis Vera
Sergio Vossah
Kellogg Company
Paul Edwin Klemm
Local 734 Members
Mourn Death of
Former President
Robert Meidel
A
true giant of Chicago labor, and a dedicated and trusted
leader of Teamsters Local 734, Robert (Bob) Meidel passed
away last May leaving behind a proud legacy that lives on.
Bob Meidel joined Local 734 in August, 1948 when he became
employed as a route man for the Sunkist Pie Co. His love for, and appreciation of, the Teamsters Union started early and shaped his long
47-year career as a fighter for Teamster members.
Meidel drove for both Sunkist and Burny Bros. until 1963 when he
was elected Secretary Treasurer of Local 734, a position he held for
20 years. Determined to broaden his efforts on behalf of the rankand-file membership, Bob Meidel was elected Local 734 President in
1983 and held that position until his retirement in 1995. He was also
heavily involved in charitable work, volunteering his time on activities
and causes that he truly believed in.
“One of the guiding principles that I learned early on in life is
that there is no better way to fight for what you believe in than by
organizing a union,” Meidel said upon his he retirement. “And when
it comes to labor unions, there is no better fighting force for workers
than the Teamsters Union.”
Saluting Robert Meidel’s Lifetime of
Service to Teamsters Local 734 Members
Local 734 members benefited greatly by the work that Bob did for
the Local all those years. During his tenure with Local 734, Robert
Meidel made improvements in all areas of the union. He helped
enhance the Health & Welfare and Pension Fund, negotiated strong
contracts for members, and encouraged members to stand together
during the toughest of times to achieve victory.
“We were constantly being tested by employers who thought they
could get away with something, or who figured we wouldn’t do
anything to fight back,” he said. ”Each time they decided to take
us on we gave them a battle they never expected. Each battle, each
bargaining session or each political campaign gave us the strength to
carry on and fulfill our ultimate goal: progress for working families.”
In addition to his work with Local 734, Bob was a renowned
leader of the Teamsters, both statewide and nationally. He served
as Secretary-Treasuer of Teamsters Joint Council 25 and was Director
of the Bakery & Laundry Conference U.S.A. and Canada.
Reflecting upon his father’s life and legacy in the Teamsters Union,
Local 734 President Brian Meidel said commitment to service and a
never-say-no approach to representation are two important aspects
of leadership that his father always taught to him.
“Those who knew my dad, and who spent their years in the Union
working with him, knew that when he said something he meant it,”
President Meidel said. “He would look at all aspects of an issue,
but once he made up his mind he would not be swayed from that
decision. Some called it stubborn, others saw it as determination.
He also said that whatever you do in life, remember that it is the
people that matter most. Every decision impacts a working family
in one way or another, and my father fought to make sure working
families were recognized as a valuable part of our society.”
Bob Meidel, a member of the Neer-Goudie American Legion Post 846,
spent much of his time volunteering to help others. He is pictured
above assisting with a program at the Hines V.A. Hospital. Local 734
members salute his service and mourn his passing.
Frito-Lay Contract
Talks Will Begin Soon
L
ocal 734 is preparing for negotiations
with Frito-Lay this year. The
current labor contract expires
this coming August.
Currently, Business Agents
are discussing bargaining
details with Stewards and other Committee members,
who will be a part of the negotiating process.
“This year, as we have done in the past, we will be
negotiating with a very experienced and dedicated
Bargaining Committee determined to secure a good
contract for the membership,” said Local 734 SecretaryTreasurer Scott C. Kunz. “Considering the state of our
economy we know these talks will be tough. But I also
know that the Bargaining Committee is determined
to stand their ground, address key issues facing the
membership, and come away with a new contract the
members will be proud to ratify.”
C.J. Vitner Members Ratify Agreement
Meanwhile, Local 734 members at C.J. Vitner have
overwhelmingly voted to ratify an extension of their
current contract. This will secure their current working
conditions through 2014.
Teamsters Local 734 News • Winter, 2011
4
International Brotherhood of Teamsters
LOCAL
734
734
6643 N. Northwest Hwy.
Chicago, Illinois 60631
Local 734 Contract Update
East Balt Commissary - Members unanimously ratified
their new four-year agreement. The contract includes increases in wages, Health & Welfare and Pension contributions.
Entenmanns - Members ratified a new four-year contract,
which includes wage hikes and increases in Health and
Welfare & Pension.
Food Service Professionals - Members have voted to
ratify a new three-year contract that includes wage increases.
Gonnella — R.S. R’s ratified their three-year agreement on
Nov. 20, 2010. The contract also includes increases in theHealth & Welfare and Pension
How Your
Weingarten
Rights Can
Protect You
If you are called into a meeting with management
that you believe could result in disciplinary action
being taken against you, make sure to read this
Weingarten Rights statement:
Sara Lee negotiations are continuing.
If this discussion could, in any way, lead
to my being disciplined or terminated, or
affect my personal working conditions, I
request that my Steward (or a union officer)
be present. Without representation,
I choose not to answer any questions.
Chicago Baking negotiations are also ongoing.
This is my right under the law.
BARGAINING TABLE NEWS
Make Sure You Get A Withdrawal
Card Whenever You Leave Your Job
Be sure you request a withdrawal
card when being laid-off or terminating
your employment. All initiation fees
and back dues must be paid before the
withdrawal card is issued. Stop by, or
call the union office for a withdrawal
card. It is your responsibility to obtain
a Withdrawal Card so please take care
of it as soon as possible after leaving
the company, so that you will not be
obligated to pay extra dues. Failure to
request a Withdrawal Card may cause
you to pay back dues.
In accordance with Article XVIII,
Section 6(i) of the IBT Constitution,
“it shall be compulsory for any active
member on withdrawal card to deposit
his withdrawal card immediately upon
return to employment at the craft.”
Mail to: TEAMSTERS LOCAL 734
6643 N. Northwest Hwy.
Chicago, Illinois 60631
WITHDRAWAL CARD REQUEST
NAME ________________________________________________
SOCIAL SECURITY # ____________________________________
DATE _________________________________________________
ADDRESS _____________________________________________
PHONE _______________________________________________
NAME OF EMPLOYER ___________________________________
REASON FOR LEAVING (quit, laid off, terminated, etc.)
______________________________________________________
Signature __________________________________________________
Changes to Local 734
Health and Welfare
Benefits take effect
on May 1, 2011.
~ Details on page 5