Umwa, the United Mine Workers of America, is a labor union that was founded in 1890. The Umwa address form is an important document for members of the Umwa, as it allows them to update their contact information and stay up-to-date with the latest news and events. The form is available on the Umwa website, and members are urged to fill out and submit the form as soon as possible. The form can be filled out online or downloaded and printed out.
The table features details about the umwa address. You can look at it prior to completing the gaps.
| Question | Answer |
|---|---|
| Form Name | Umwa Address |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | umwa change pdf, umwa address, umwa request, umwa health request online |
UMWA HEALTH AND RETIREMENT FUNDS CALL CENTER
2121 K Street, Suite 350 Washington, DC 20037 Telephone: (800)
Change of Address Request
Effective October 1, 2003, all address changes must be requested in writing and signed by the miner/widow or the legal representative. Please complete this form and return it to:
UMWA Health and Retirement Funds
Attn: Call Center
2121 K Street, NW Suite 350
Washington, DC 20037
Please print clearly and provide all information requested.
Mineworker/Widow Name: _______________________________________________________
(Last, First, Middle)
Social Security Number:
Telephone Number:
List All dependents currently living with you:_________________________________________
______________________________________________________________________________
Current Address:
Street Address: _________________________________________________________________
City or Town, State and Zip Code: _________________________________________________
Old Address:
Street Address: _________________________________________________________________
City or Town, State and Zip Code: _________________________________________________
Signature: __________________________________________________Date: ______________
∙If signing for a beneficiary, you must include legal proof of your power of attorney or guardianship status or relationship.
∙If witnessing a beneficiary's mark, write out both the full name of the beneficiary for whom you are witnessing and your full name.
∙If the beneficiary is unable to make a mark, and has not granted you power of attorney or guardianship, please describe the circumstances on the back and provide your telephone number.