Forms – Teamsters Local 222

Membership Forms

Q: What is a withdrawal card and why is it so important?
A: If a member does not work any days in the bargaining unit during the current calendar month the member shall be issued an honorable withdrawal card upon request. All financial obligations including dues must be paid current at the time of the request. It is very important to request a withdrawal card in a timely manner as dues can accrue until a withdrawal card is requested. Upon returning to bargaining unit work, you, are required to contact the Local Union immediately to deposit your withdrawal card and return to “active” member status.

Q: What happens if I don’t request an honorable withdrawal card?
A: If a member does not request a withdrawal card, he/she shall stand suspended at the end of the third month, and shall not be entitled to any rights or privileges of membership. Upon returning to employment at the craft a re-initiation fee plus back dues will be required for entitlement to the rights and privileges of membership.

Life with Dues Beneficiary Form

Update Personal Information with Local 222 – This form will only update your information at the Local Union Hall. If you need to update information with your insurance and/or pension that must be done separately.

WCTP Pensi on Change of Address Form

Utah Idaho Teamsters/Southwest Service Administrators Change of Address – The most efficient way to update your address with the insurance is to log in to your ssaportal at www.ssatpa.com.

Log into ssaportal and click on the “My Account” application then click on the the “Change Address” button. Click on Apps. Select change address. Select update my information & enter current info. Make sure to select update.

Utah Idaho Teamsters/Southwest Service Administrators Change of Address Form

TWR177 Change of Address Form

Grievance Forms

Grievance Form – For members working at ABF, American Airlines, DHL, MV Transportation, NCS-EML, Rail Terminal Services, Reddaway, or YRC

Grievance Form for Members Represented by Marty Cowin – For members working at Albertons, ALSCO, Bimbo Bakeries, Dean Dairy’s, Gold Cross Ambulance, Integrated Facility Services, Magna Water, MTC, Ryder, or Univar

Grievance Form for Members Represented by Grant Edwards – For members working at Forterra, Geneva Rock, Granite Construction, Hertz, Praxair, or W.W. Clyde

UPS Grievance Form

UPS 9.5 Grievance Form

Insurance Forms

Utah Idaho Teamsters/Southwest Service Administrators Enrollment Form

Utah Idaho Teamsters/Southwest Service Administrators Change of Address Form

Utah Idaho Teamsters/Southwest Service Administrators Change of Address – The most efficient way to update your address with the insurance is to log in to your ssaportal at www.ssatpa.com.

Utah Idaho Teamsters/Southwest Service Administrators HRA Claim Form – Q&A HERE

Teamsters Western Region & Local 177 Health Care Plan Enrollment Form

TWR177 Change of Address Form

WTWT Enrollment Form – For members who are employed at ABF, DHL, UPS Cartage, Reddaway, or YRC

WTWT Disability Form

UPS Part Time Short Term Disability Form – Directions HERE

UPS Full Time Short Term Disability Form – Directions HERE