IBEW LOCAL UNION 890 PORTABILITY REPORT
LOCAL UNION NO.  WHERE  WORK  IS  PERFORMED ..............
890
NAME___________________________________________
ADDRESS________________________________________  _
EMPLOYERS FEDERAL REGISTRATION NO.
 ______________________
TOTAL NUMBER THIS PERIOD
 ______________________
CITY, STATE_____________________________________
This Transmittal Covers ALL Payroll Weeks From:
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APPRENTICESHIP AND TRAINING FUND ........................................................................$                                   .95%
UNION DUES DEDUCTED ...................................................................................................$                                     4%
MAKE CHECK PAYABLE TO:
IBEW Local Union 890                  TOTAL ..............................................................$                                        
MAIL CHECK TO: 17 S. River Street        
Janesville  Wisconsin 53548
Phone (608) 752-0321     www.ibew890.org
First report in this Local Union area                         
Final report in this Local Union area                        
When more forms are needed                                

FIRM NAME
SIGNATURE & TITLE
DATE
 
COLUMN 1 COLUMN 2 COL.  3 COL. 4 COL. 5 COL. 6 COL. 7 COL. 8

SOCIAL SECURITY NUMBER

 NAME OF EMPLOYEE
LAST NAME & INITIALS		 CLOCK HOURS GROSS EARNINGS HOURLY WAGE RATE UNION DUES AP FUND TOTAL DUE
               
               
               
               
               
               
               
               
               
               
               
               
               

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