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Upon taking this Withdrawal Card, I do hereby certify under penalty of perjury that I have no pending claims under the Grievance Procedure of my Collective Bargaining Agreement and that I further have no claims to be asserted under the Grievance Procedure of my Collective Bargaining Agreement.
 

Your Email Address (username@server.com)
Last Name First Name

Social Security Number (enter numbers only) 

Employer
Job Classification

Daytime Telephone Evening Telephone

Street Address (123 StreetName)

City, State & Zip Code

Enter the LAST day you worked 
Enter as 00/00/00):


Click the Reason for Withdrawal:

  Disability
Terminated
Resigned
Changed to a Non-Union Position
Other
 
To be eligible for a withdrawal card, your initiation fees must be paid and your monthly dues must be current.  Are your dues current and initiation/transfer fees paid? YES
It is your responsibility to notify the Union immediately upon your return to a Teamster capacity.  Click here   to indicate you understand your responsibility:

 NOTE: If you do not receive a confirmation page after submitting, please print and mail the form to:

TEAMSTERS LOCAL 315
P.O. BOX 3010
Martinez, CA  94553