Buffalo Laborer's Local 210

Security Fund

Forms

Security Fund Summary Plan Description

Security Fund Annual Funding Report for June 30, 2021

Security Fund Form 5500 Annual Report for June 30, 2021

Withdrawal Application and Benefit Election **

IRS W-4P 2022 Form

2022 NYS Estimate Tax Form

 

NOTE:  This pertains to the Security Fund Withdrawal

If you intend to apply for a Security Fund withdrawal, select item 4 above. The Withdrawal Application will download as a PDF to your computer. Fill-in the form fields and save the file. You can then print the completed forms and mail them to the Fund Office.

** If you intend to have Federal Income Tax withheld on your Security Fund withdrawal, check box 2 on the Withdrawal Application page 6.

THEN, click on item 5 above to download IRS Form W-4P. Complete Form W-4P by filling-in the form fields and saving the file on your computer. Print Form W4-P and include it with your application.

The NYS Estimate Tax Form is provided for you to send to NY State for estimated taxes to be paid. Consult with your tax advisor.

You must have PDF reader installed onto your computer, such as Adobe Acrobat Reader.
Click here to get Adobe Acrobat Reader.

You may download any of these forms pertinent to your situation, fill them out and print them from your computer.

Mail:
Buffalo Laborers’ Benefit Funds
25 Tyrol Drive, Suite 200
Cheektowaga, NY 14227

Fax:                          Phone:
(716) 668-8589            (716) 894-8061     

Email:
 local210members@laborerslocal210.com

Click on the form you want and you can input your information on it. After you complete the information, print the form out and mail it to the Fund Office.