I hereby certify that I have been or will be performing work covered by the Collective Bargaining Agreement negotiated by Plumbers and Pipefitters' Local No. 118, located in Kenosha, Wisconsin. I understand that contributions will be made on my behalf, pursuant to the Collective bargaining Agreement with Plumbers and Pipefitters' Local Union No. 118 to the Pension, 401(K) and Welfare Funds specified in that Collective Bargaining Agreement (the "Transferring Funds"). I also understand that the Pension, 401(K) and Welfare Funds to which contributions are required by collective bargaining agreements with my home local and with which I have been principally associated (the "Home Fund"), may be parties, together with the Transferring Funds, to the following reciprocal agreements: The Midwestern States-United Association Reciprocal Pension Agreement, the Wisconsin Pipe Trades 401(K) Plan Reciprocal Agreement and the Midwestern States-United Association Reciprocal Welfare Agreement (collectively, the "Reciprocal Agreements").
I hereby consent to and agree that all contributions made on my behalf to each Transferring Fund be transferred to the corresponding Home Fund in accordance with the provisions of the applicable Reciprocal Agreement but only to the extent that the Transferring Fund and the Home Fund are parties to the Reciprocal Agreement. I further understand and agree that the Pension Trust Fund which is my Home Fund shall determine what portion, if any, of the contributions transferred to that Fund pursuant to this Request shall be forwarded to any other Pension Fund, including but not limited to the Building Trades United Pension Trust Fund, Milwaukee and Vicinity, and the Plumbers and Pipefitters' National Pension Fund. I hereby certify that the "Home Funds" for purposes of the Reciprocal Agreements.
I understand and agree that the Trustees of each Transferring Fund shall have no obligation to me other than to transfer the contributions made to the Transferring Fund on my behalf to the corresponding Home Fund in accordance with the Request. Therefore, I hereby release and agree to hold harmless the Trustees of each Transferring Fund from any liability or claim that I or anyone claiming through me may have based, in whole or in part, on the contributions which are transferred from the Transferring Fund to the corresponding Home Fund pursuant to this Request, including but not limited to any claim that the transfer of contributions was not in my best interests.
I, the undersigned, hereby authorize my current and any future employer to deduct from my wages each and every week a service fee in an amount equal to the working dues of Plumbers & Steamfitters Local 118, irrespective of my Local 118 membership, and direct such amounts so deducted to be turned over to the Secretary-Treasurer of Plumbers & Steamfitters Local 118 on my behalf.
This authorization and assignment shall be irrevocable for the term of the applicable contract between Plumbers & Steamfitters Local 118 and my employer or for one year, whichever is the lesser, and shall automatically renew itself for the successive yearly or contract periods thereafter, whichever is lesser, unless I give written notice to my employer and the Union at least sixty (60) days and not more than seventy-five (75) days before any periodic renewal date of this authorization and assignment of my desire to revoke same.
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