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Member Documents

General Member Forms


Disability Pension Application
Pension Appeal Form
Pension Application
W-4P Form 2018
Retirement and Pension Plan Officers and Employees of NYCDCC Beneficiary Form


Stop Payment Request Form
Change of Address Form
Direct Deposit Authorization Form
Medicare and You 2018
Private Health Information Authorization Form
Active City Carpenters Reimbursement Claim Form 2018
Retired City Carpenters Reimbursement Claim Form 2018
ASO/SIDS Dental Claim Form
Paid Family Leave- Bonding Application
Paid Family Leave- Care for Family Member Application
Paid Family Leave- Military Application
Benefit Shortage Form
Benefits Opt In Form
Disqualifying Employment Questionnaire
Health Plan Enrollment Form
NYCDCC Beneficiary Designation Form
Prudential Beneficiary Form
Short-Term Disability Form
Reciprocal Authorization Form
Required Documents for Eligible Dependents
Health Insurance Claim Form- Empire
Prescription Mail Order Form- English
Prescription Mail Order Form- Spanish
SBC Uniform Glossary


To request any forms or documents that you do not see available on the website, please call the Benefit Funds Call Center at (800) 529-FUND (3863) or (212) 366-7373.