Teamsters Local 492
Teamsters Local 492
 

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Return To Membership Application 

Please fill out the form in its entirety as soon as you start back to work to avoid back dues payment. 

First Name and Middle Initial:
  
Last Name:
Address:
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City, State:
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Postal Code:
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Phone:
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E-Mail Address:

Last Four SS# 

 *

Employer & Location

 

Date Withdrawal Card Was Issued by 492 (If you can't remember, put your best guess) 

 

Date You Returned to Work 

 

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Teamsters Local 492
4269 Balloon Park Road NE
Albuquerque, New Mexico 87109
  505-344-1925

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