Grievance Forms
PPA Forms
PPA Membership Application & Payroll Deduction
Verizon Forms
Anticipated Disability Form Verizon
Dependent Care Reimbursement Fund Application 2022
Dependent Care Reimbursement Fund Monthly Form 2022
Defensive Driving Program 2022
Health and Wellness Flier 2022 (including gym reimbursement)
Pendant Program Application 2022
Pendant Program Quarterly Reimbursement Form 2022
Sedgwick Attending Physician Statement Behavioral Health
Sedgwick Attending Physician Statement
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
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)