WISCONSIN IBEW/NECA PORTABILITY REPORT
LOCAL UNION NO. WHERE WORK IS PERFORMED
NAME
ADDRESS
EMPLOYERS FEDERAL
REGISTRATION NO.
TOTAL NUMBER EMPLOYED THIS PERIOD
CITY, STATE
This Transmittal Covers ALL Payroll Weeks From:
/ /20
CLASSIFICATIONS
TO BE USED IN COLUMN NO.3
1 INSIDE JOURNEYMAN
4
COMMUNICATIONS
6 APPRENTICE
MH MATERIAL HANDLER
22 RESIDENTIAL WIREMAN
APPRENTICESHIP AND TRAINING FUND
........................................................................$
.45%
APPRENTICESHIP COORDINATOR TRAINING FUND
..................................................$ .50%
UNION DUES DEDUCTED
...................................................................................................$
4%
L.M.C.C. FUND
.........................................................................................................................$
.20%Contract Administration Fund.................................................................................................$ .20%
MAKE CHECK PAYABLE TO:
WISCONSIN ELECTRICAL EMPLOYEES BENEFIT FUNDS (WEEBF) TOTAL ...........$
MAIL CHECK TO: 2730 Dairy Drive, Suite 101
Madison, Wisconsin 53713
1-800-422-2128 or (608) 276-9111
First report in this Local Union area
Final report in this Local Union area
When more forms are needed
FIRM NAME
SIGNATURE & TITLE
DATE
