401K Documents, Forms & Notices

The Local One 401K Plan retains a third party administrator, Employee Benefit Solutions (EBS), as a record keeper for participant accounts.   Several Forms are available for you to download and return to the Fund Office by mail at the Oriskany address below or Fax to (315) 797-9664.   You may also call Kristin Owen, 1-800-959-9497, Ext. 2582 to request forms.

To download a file, click the corresponding red download arrow.



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Title Type Description
2011 Deferral Limits
application/pdf icon2011 Deferral Limits.pdf
401k (SMM) Summary of Material Modifications
application/pdf iconSMM_2008_amend_3.pdf
401K Beneficiary Form
application/pdf icon401K Beneficiary FORM.pdf
401K Benefit Distribution Request Form
application/pdf iconUFCW Benefit Distribution Forms-EMAILED.pdf
This form is for Distributions due to Termination, Death, Disability and Retirement
401k Loan Policy
application/pdf iconLoan_Policy 2007.pdf
401k Rollover Notice
application/pdf iconRollover_Notice_revised 2007.pdf
401K Summary Annual Report
application/pdf iconLocOne401kSAR07.pdf
401k Summary Plan Description (SPD)
application/pdf iconFinal March 2007_401K_SPD_0.pdf
EBS-RMSCO Retirement Account Voice Response System
application/pdf iconweb_vru_instructions1.pdf
Investing In Your Retirement
application/pdf icon401k flyer black and white.pdf