1199 Seiu Form PDF Details

For members of the 1199SEIU Benefit Funds, maintaining updated personal information is crucial to ensuring continued access to benefits and important communications. Among the essential administrative tasks they must manage is the submission of the 1199SEIU Change of Address Form whenever there is a change in their residential or contact information. Located at 330 West 42nd Street, New York, NY, with a comprehensive website and contact numbers for both local and outside NYC area codes, the Benefit Funds make this process accessible and straightforward. Members are instructed to fill out the form using either blue or black ink, providing their full name, member ID, both old and new addresses, telephone numbers, and email addresses, then sign and date the document. This form, once completed, must be mailed to the 1199SEIU Benefit and Pension Funds Member Eligibility Department, with a reminder for members to also update their address with their local Post Office using Change of Address Form #3575. This simple yet essential document ensures that members remain in good standing with their benefits and receive all necessary correspondence from the 1199SEIU Benefit Funds.

Form Name1199 Seiu Form
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesE-mail, NYC, CAM01, org

Form Preview Example

1199SEIU Benefit Funds



Change of Address Form

Print Clearly in Blue or Black Ink

Full Name:

Member ID:

Old Address:










Zip Code:


Old Telephone: (











Old E-mail:











New Address:




















Zip Code:


New Telephone: (











New E-mail:











Member’s Signature X









Complete and mail to:

1199SEIU Benefit and Pension Funds

Member Eligibility Department

PO Box 1035

New York, NY 10108-1035

Note: You should also complete Change of Address Form #3575 at your local Post Office.


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Writing part 2 of 1199change address

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