Withdrawal Card Application

It is very important that you obtain a withdrawal card from Local 804 when you will not be at your job for more than a calendar month. This includes FMLA, retirement, layoff, resignation, discharge, military leave, disability or workers' compensation. 

A withdrawal has two important functions:

(1) It stops your liability for back dues from the date that you leave your job, until you are reinstated in your current job, or until you are hired at another Teamster job.

(2) Once issued, the withdrawal card establishes your status as a member in good standing. You will not be required to pay union dues for the time you are out or pay another initiation fee.

There is no charge for a withdrawal card. In order for your card to be processed, your dues must be paid up to date. 

Failure to obtain a withdrawal card will result in you continuing to accrue a monthly dues obligation.

Be advised that the issuance of that withdrawal card may result in a break in your twenty-four month continuous good standing requirement for eligibility to:

          -Be a candidate to run for Local or International Union office

          -Be a Delegate/Alternate Delegate to the next International Convention.

          -Nominate or vote in the election of Union officers;the election of Delegates/Alternates; or, in the election of International Union Officers.

          -Any other continuous good standing requirements of Local 804 as stated in the Local Union By-Laws.

Important: It is entirely the member's responsibility to inform Local 804 when you will be out of work and to either obtain a withdrawal card or to continue to pay dues. Your obligation to pay dues will not be suspended, and you will owe back dues, unless you fill out a withdrawal card.  

To apply for a withdrawal card, fill out the form below.