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The form collects member details including date, phone number, name, SS#, and address, along with the date of separation. It explains that benefit payment options require review of the summary plan description and that, per bylaws, applicable state and federal taxes will be withheld. The applicant completes tax withholding using a TA W-4 form, selects cash payout, and signs with date.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/withdrawal-application-ibew-local-294-cash-payout-election/302992/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/withdrawal-application-ibew-local-294-cash-payout-election/302992.png","ImageObject",442,249,{"name":88,"@type":89},"Levi","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-27","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":73},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"Who should complete this withdrawal election form?","Question",{"text":108,"@type":109},"A member of IBEW Local #294 who is electing to withdraw from the Supplemental Unemployment Fund after separation from service and future employment with employers obligated to contribute to the fund.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What does selecting cash payout mean?",{"text":113,"@type":109},"Selecting cash payout indicates the member’s election to receive a cash payment of the supplemental unemployment benefit, based on eligibility and options described in the summary plan description.",{"name":115,"@type":106,"acceptedAnswer":116},"How are taxes handled for the benefit payment?",{"text":117,"@type":109},"Per bylaws, all applicable state and federal taxes will be withheld from the benefit, and the applicant must complete a TA W-4 form for tax withholding.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},302992,1790507647,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":79,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":4},7971461740909,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","WITHDRAWAL APPLICATION  \nIBEW LOCAL \\#294  \nSUPPLEMENTAL UNEMPLOYMENT FUND PAYMENT OF INACTIVE ACCOUNT  \nI AM ELECTING TO WITHDRAW FROM MY IBEW LOCAL \\#294 SUPPLEMENTAL UNEMPLOYMENT FUND.  \nDATE   PHONE \\#    \nNAME   SS\\#    \nADDRESS   CITY, STATE, ZIP   DATE OF SEPARATION    \nUPON YOUR SEPARATION FROM SERVICE FROM THE LOCAL 294 ELECTRICAL INDUSTRY AND FUTURE EMPLOYMENT WITH EMPLOYERS OBLIGATED TO CONTRIBUTE TO THIS FUND, YOU CAN ELECT TO RECEIVE A CASH PAYOUT OF YOUR SUPPLEMENTAL UNEMPLOYMENT BENEFIT.  \nSEE SUMMARY PLAN DESCRIPTION FOR PAYMENT ELIGIBLITY AND OPTIONS.  \nAS REQUIRED BYLAW, ALL APPLICABLE STATE AND FEDERAL TAXES WILL BE WITHHELD FROM THIS BENEFIT. COMPLETE TA W4 FORM FOR TAX WITHHOLDING (W4 can be found at: [https://www.irs.gov/pub/irs-pdf/fw4.pdf](https://www.irs.gov/pub/irs-pdf/fw4.pdf)).  \nPLEASE SELECT YOUR ELECTION BELOW:  \n  CASH PAYOUT  \nSIGNATURE   DATE","cbCaibagwZdlSoCX","https://ap.wps.com/l/cbCaibagwZdlSoCX","pdf",91510,"English","# Withdrawal Election\n## Member Information\n## Separation and Eligibility Notice\n## Tax Withholding Requirements\n## Election Selection and Signature","[{\"question\":\"Who should complete this withdrawal election form?\",\"answer\":\"A member of IBEW Local #294 who is electing to withdraw from the Supplemental Unemployment Fund after separation from service and future employment with employers obligated to contribute to the fund.\"},{\"question\":\"What does selecting cash payout mean?\",\"answer\":\"Selecting cash payout indicates the member’s election to receive a cash payment of the supplemental unemployment benefit, based on eligibility and options described in the summary plan description.\"},{\"question\":\"How are taxes handled for the benefit payment?\",\"answer\":\"Per bylaws, all applicable state and federal taxes will be withheld from the benefit, and the applicant must complete a TA W-4 form for tax withholding.\"}]","Withdrawal Application - IBEW Local 294 - Cash Payout Election | PDF",1789799390]