Defined Contribution Request for information - Pacific Coast Benefits Trust

546-75-1493   Date:  3/27/2022
Last Name:
Siapno   First Name :   Paul Middle Initial: 
Mailing Address : 696 Tantaros Lane
City :
Tracy   State :   California   Zip Code :   95376
Contact Phone :
650-302-1675   Work Phone :  
Date of Birth :
10/07/1977   Email ID :   [email protected]
Sex :
Male   Marital Status :   Married
Will this information be used for divorce purposes:  No
Spouse's Name:
Christina Siapno   Spouse's Date of Birth :   11/06/1979 Date of Marriage :   03/19/2005

Are you currently Employed:
Yes   Local Union :   I was rehired in the Lathrop hub. I was a driver in the San Bruno hub.
Employer Name :(Present or Most Recent Covered Employer) United Parcel Service, Inc.  
Date of Hire :
05/06/2021   Date of Termination :  
Previous Employer : PS Yogurt Inc. dba Menchie's Frozen Yogurt 438
Date of Hire :
09/DD/2016   Date of Termination :   03/19/2020

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

I would like a quote for a Monthly Annuity Benefit based on the elected retirement date of:   05/06/2042

Have you previously requested pension information : Yes                Year :   2014