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Withdrawal Card Request Form
Updated On: Feb 03, 2010

 

 

 Name ________________________________________________________
Address ______________________________________________________
  _____________________________________________________________
 Phone (_____) _________________________________________________
 Company you worked for _________________________________________
   Last Day Worked _______________________________________________
 
 
 
Your Dues and Initiation must be paid up to date. You have 60 days from your last day worked to submit this form. There is a fee of 50 cents.
 
 
 
 
Print out and Mail completed form with 50 cents to:
Teamsters Local 436
6051 Carey Drive
Valley View, Ohio 44125
Phone: 216-328-1833 or 800-506-4360
Fax: 216-328-1513
 
 
 

 


 
 
Teamsters Local Union No. 436
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