Participant Forms

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  • 2011 Benefit Instructions and Benefit Application
  • Description Of The Consequences Of Failing To Defer Receipt Of A Distribution (Benefit Application Notice)
  • Special Tax Notice Regarding Plan Distributions (Benefit Application Notice)
  • Qualified Joint And Survivor Annuity Notice (Benefit Application Notice)
  • Change of Address and Beneficiary Designation




  • IBEW Local 855 Defined Contribution Plan    11590 North Meridian Street, Suite 600   Carmel, IN  46032
    PHONE:  866-855-7767    FAX:  317-580-8651