Defined Benefit Request for information - CIC-TOC Pension Plan

SSN :
532-64-4477   Date:  8/24/2019
Last Name:
Nollan   First Name :   Tom Middle Initial:  W
Mailing Address : 1022 East 35th Street
City :
Tacoma   State :   Washington   Zip Code :   98404
Contact Phone :
257-257-1257   Work Phone :   257-257-1257
Date of Birth :
09/09/1955   Email ID :   [email protected]
Sex :
Male   Marital Status :   Married
Will this information be used for divorce purposes:  No
Spouse's Name:
Melissa I Nollan   Spouse's Date of Birth :   04/26/1950 Date of Marriage :   11/26/1977

Are you currently Employed:
Yes   Local Union :  
Employer Name :(Present or Most Recent Covered Employer) LeMay Family Collection  
Date of Hire :
06/DD/2008   Date of Termination :  
Previous Employer : Portac Inc.
Date of Hire :
07/02/1979   Date of Termination :   04/DD/2008

Have you ever been disabled:
No   From Date :     To Date :      
Are you receiving Social Security Disability Benefits ? No         Entitlement Date :

I am requesting an Estimate of Benefits for Retirement at Age(s) :   65
I am requesting an Estimate of Death Benefits:  No 

Have you previously requested pension information : Yes                Year :   2019