Teamsters Local 962
Withdrawal Card Form

A withdrawal card is issued to Teamster members who are leaving their job for an extended amount of time for a leave of absence from work, or because of a resignation or termination. If you are going to be off work for an extended period of time, you should request a withdrawal card.  You must be paid up on your dues through the month that you last worked four days or more to go on withdrawal.

A withdrawal card lets the Local Union know that you are not going to be working and therefore not remitting union dues. When you return to work you must notify the local to avoid owing back dues or re-initiation fees. If you return to work at other Teamster-represented employment, you can deposit your withdrawal card and avoid initiation fees.

When you are on withdrawal, you are considered to have an “inactive” status and are therefore ineligible to exercise the rights of union membership, such as voting in elections or on contracts.

You may request a withdrawal card by filling out the form below.

Please note that we no longer issue physical withdrawal cards.  If you would like, we can mail or email you a confirmation at your request.

First name:
Last name:
Social Security #:
Last Day Worked:
Reason For Requesting Withdrawal:
Date Requested:
Member's Signature:

Use your mouse, finger, or touch device to write your signature.