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CHANGE OF ADDRESS Unless otherwise instructed, this change (Carpenter Funds Administrative Office)

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CHANGE OF ADDRESS
Unless otherwise instructed, this change of address will be applied to ALL records of the Carpenters Union, Apprenticeship
Training Committee and the Carpenters Trust Funds including Health & Welfare, Vacation/Sick Leave, Pension and
Annuity records and payments.
Complete the section below only if you require a different mailing address for your Trust Fund Office
Correspondence regarding Health & Welfare, Vacation/Sick Leave, Pension, Annuity, statement mailings, benefit
payments, and benefit notices.
Mail, Fax or Email this Form to:
Carpenter Funds Administrative Office of Northern California, Inc.
P.O. Box 2280
Oakland, CA 94614
PHONE (510) 633-0333 or (888) 547-2054
FAX (510) 633-0215
If you’ve provided your UBC# or CFAO ID#, you may email your form to:
benefitservices@carpenterfunds.com
We do not encourage electronic transmittal of documents containing your SSN.
opeiu 29 af
l-cio 4/2020
Name (Please Print): Active Retired
UBC#, SSN or CFAO ID#: Phone #:
Street Address:
City: State: Zip Code:
Effective Date of Change: Local Union:
Email address for the receipt of Mandatory Disclosures:
If y
ou provide your email address, mandatory disclosures will be sent via email.
Signature: Date Signed:
Name (Please Print): Active Retired
UBC#, SSN or CFAO ID#:
Phone #:
Street Address:
City: State: Zip Code:
Effective Date of Change: Local Union:
Email address for the receipt of Mandatory Disclosures:
If y
ou provide your email address, mandatory disclosures will be sent via email.
Signature: Date Signed:
Reset Form
To Change Your Address: Complete the form below, print it, sign it and return it via email, fax or mail.
DELIVERY OF PLAN DOCUMENTS IS FAST, CONVENIENT, AND EFFICIENT!
• Providing your email address for the receipt of mandatory disclosures is voluntary.
• Electronic materials are emailed, typically in Portable Document Format (PDF), and are identical to t
he
paper v
ersions you've been receiving. There is no charge for accepting materials online.
• You will need an internet connection and a computer with an operating system capable of receiving,
accessing and displaying and either printing or storing the electronic documents received. You should have
Adobe Reader to access PDF files. Learn more and download Adobe Reader directly from Adobe's web site,
www.adobe.com.
• Change your email address at any time by contacting the Fund Office at
benefitservices@carpenterfunds.com, (510) 633-0333, or Toll-Free (888) 547-2054. The change must be in
writing, with your signature.
• Some example documents that may be sent electronically include: Summary Plan Descriptions, Notices of
Plan changes, Explanations of Benefits, Benefit and Claim Department letters, Prohibited Employment
Committee letters, and Fund Trustee memos.
• Your consent to electronic delivery of Plan documents is valid unless and until you withdraw your consent.
You can withdraw your consent and reset your preference to mail at any time by contacting the Fund Offi
ce
at
benefitservices@carpenterfunds.com, (510) 633-0333, or Toll-Free (888) 547-2054. The change must be
in writing, with your signature.
• While e-Delivery may significantly reduce the amount of mail we send you, certain documents and service-
related correspondence will continue to be sent via U.S. Mail. Additionally, you may request a paper copy of
any documents received electronically.
• Unless otherwise instructed, your email address will be shared with the Carpenters Union, Apprenticeship
Training Committee and the Carpenters Trust Funds.
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CHANGE OF ADDRESS Unless otherwise instructed, this change (Carpenter Funds Administrative Office)

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Completed 13 January 2021

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