Survivor Benefit Form

Our local has setup a fund to help the families of our fallen siblings.  Local 7011 will pay out $1,500 to the beneficiary on file in the event of the death of an active member. This is not a life insurance policy, and you do not need to buy into it.

Please note - We can only pay out if the form is completed and verified.   Once we have received the completed form you will receive a phone call to the number provided on the form to verify.