Transcription of Association Incorporated Under Section 21: Reg. No 94 ...
1 metal Industries Benefits Funds Administrators Association Incorporated Under Section 21: Reg. No 94 01481/08 engineering INDUSTRIES pension fund / metal INDUSTRIES PROVIDENT fund BENEFIT STATEMENT QUERY FORM Form to be completed where identity details and service records are incorrect. Please return to: metal Industries Benefit fund Administrators, P O Box 7507, JOHANNESBURG, 2001 or Fax: (011) 870-2397. Details per Benefit Statement: NAME: ID NO: COMPANY: I wish to advise the following correction / additional information:- NAME DATE OF BIRTH NEW ID NUMBER ATTACH COPY OF IDENTITY DOCUMENT AS CONFIRMATION OF THE ABOVE. PREVIOUS ID / PASSPORT NUMBERS SERVICE RECORD QUERY NOTE: LIST ONLY SERVICE PERIODS IN THE INDUSTRY FOR WHICH YOU HAVE NOT PREVIOUSLY CLAIMED BENEFITS. The following service periods are wrong or missing (attach a copy of your card as confirmation): NOTE: THE fund MAY NOT BE ABLE TO ATTEND TO THE QUERY WITHOUT A COPY OF THE CARD.
2 DATES FROM TO COMPANY ID NUMBER WORK NO. Additional comments: _____ _____ SIGNED: _____ DATE: _____ DAY MONTH YEAR metal Industries House POSTAL ADDRESS: Tel. no.: 011 870 2000 42 Anderson Street P O Box 7507 Fax no.: 011 870 2380 JOHANNESBURG JOHANNESBURG 2001 2000
