Defined Contribution Request for information - Pacific Coast Benefits Trust

SSN :
539-70-3488   Date:  2/4/2020
Last Name:
nix   First Name :   LINDA Middle Initial:  A
Mailing Address : 28617 194 AV SE
City :
KENT   State :   Washington   Zip Code :   98042
Contact Phone :
206-300-4500   Work Phone :  
Date of Birth :
12/29/1958   Email ID :   [email protected]
Sex :
Female   Marital Status :   Married
Will this information be used for divorce purposes:  No
Spouse's Name:
ROBERT NIX   Spouse's Date of Birth :   11/27/1960 Date of Marriage :   08/19/1995

Are you currently Employed:
Yes   Local Union :   117
Employer Name :(Present or Most Recent Covered Employer) PORT OF SEATTLE POLICE  
Date of Hire :
01/03/2002   Date of Termination :  
Previous Employer :
Date of Hire :
  Date of Termination :  

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

Have you previously requested pension information : No                Year :