Teamsters Local 492
Teamsters Local 492

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Withdrawal Request Form

Withdrawal Request Forms

In the event that you leave your current job for any reason (short/long term disability or absence, termination/resignation, or any other reason, you must contact the local union and request a withdrawal card in writing by filling out a “Withdrawal Form” so that you are no longer obligated to pay monthly dues. If a member does not fill out a withdrawal form after leaving their job, Membership is automatically suspended if the Union does not receive payment on or before close of business on the last business day of the 3rd month due. After that date, Members are subject to a re-initiation fee equal to seven times (7x) their dues rate, in addition to any back dues, in order to return to good standing. “Any member who has been automatically suspended for failure to pay dues and or other charges shall be under a continuing obligation to pay dues during the period of his suspension.”

Please fill out the form in its entirety

First Name and Middle Initial:
Last Name:
City, State:
,  *
Postal Code:
- *    


E-Mail Address:

Last Four SS# 


Last Teamster Employer


Last Day Worked (If you can't remember, put the Last MONTH worked) 


Reason For Requesting Withdrawal (Terminated, Quit, Medical, ETC) 


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Teamsters Local 492
4269 Balloon Park Road NE
Albuquerque, New Mexico 87109

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