Application Packet (File size - 316 K) Download, complete, and mail these forms to begin your application process. Click here for a video of the Application Instructions
Click here to View Application Instructions

Temporary Return to Work Notification Letter (File size - 376 K) If you would like to return to work under this notice temporary amendment, download, complete and mail the third page of this letter to NEBF.

Change of Address

Change of Address Form (File size - 47 K) Change your address by downloading, completing, and mailing this form.

Direct Deposit

Direct Deposit Authorization Form (File size - 52 K)
Benefit payments are sent via direct deposit--a safe, fast and confidential way to receive payments. Download, complete and mail this direct deposit authorization form to the Fund office.

Social Security Authorization

Social Security Authorization Form (File size - 55 K) Version # 41908 Download, complete, and mail this form to give the Fund authorization to obtain your earnings data from the Social Security Administration.

Tax withholding (W-4P)

Federal Tax Withholding Form (File size - 37 K) Change your tax withholdings by downloading, completing, and mailing this form. Note that if you are not a US Citizen or resident alien of the United States, you may be subject to different withholding rules.

Status Request

Request for Status Information (File size - 35 K) Version #7711 Download, complete, and mail this form to find out your current status with the NEBF.

Work History Information

Work History Inquiry (File size - 132 K) Version #36115 This form allows you to provide NEBF with information about your work history in the electrical industry.

National Electrical Benefit Fund
2400 Research Blvd, Suite 500
Rockville, MD 20850-3266
Telephone number: (301) 556-4300
Fax number: (301)869-4322