Forms

Grievance Forms

Statement of Occurrence

Information Request Form

Grievance Form AT&T Mobility

Grievance Form IGT

Grievance Form PPA

Grievance Form USIC

Grievance Form Verizon

PPA Forms

PPA Membership Application & Payroll Deduction

PPA Steps to Verify Days

Verizon Forms

For Verizon Regional Work and Family update and forms click here
 

Anticipated Disability Form Verizon

Payroll Action Form Verizon

Sedgwick Attending Physician Statement Behavioral Health

Sedgwick Attending Physician Statement

Sedgwick Appeal Request Form

NOTE: FMLA forms are now sent directly from Sedgwick, upon initiation of a claim.  The reporting process remains the same, beginning with a call out to your supervisor or absence administrator. 

CWA LOCAL 1101 FORMS

Change of Address

Employer Unfair Labor Practices

Prudential Beneficiary Form Jan 5, 2022

(please fill out, sign and return to CWA Local 1101, Atten: Kevin Condy, 350 West 31 St, 2nd Fl, NY NY 10001)

Payroll Voucher CWA Local 1101

CWA District 1 PAF Card fillable (fill out and return to CWA Local 1101, 350 W 31 St, 2nd Fl, NY NY 10001)

Retirement Trust Application

Retirement Trust Application (2024)

Retirement Trust Instructions 

Steward Certification