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             Please email your change of address and/or withdrawal request to or                                                                                                        



March 19, 2009  Contract

Local 72 By Laws


We now have two forms that relate to your Personal History File. 

The first form lets request of copy of your PH file.     

The second will let you list the items that you would like removed from you file. 

To view and print these forms you'll need Adobe's Acrobat Reader. 



Click here for the first form. (Use this form to request a copy of your PH Folder) 

Click here for the second form. (Use this form to request the removal of items from your PH Folder)

                             EMAIL  Change of Address Form                    (PDF) Change of Address Form    

Local 72 Schedule of Allowances for Dental Plan. (effective 2012)

                                        Upstate Area   Lower New York Area   Out of network

Dental Form   Group # GG 258

Davis Vision Reimbursement Claim Form for non participating providers

                                                              Disability Form for Part Time Members                                

       Please call the NY office for a Employee /Dependents Enrollment Form.  One will be mailed to mailed to you with a          postage paid return envelope.

Life Insurance Form (Please contact our NY Office or your Business Agent)

Omnibus General Information

Omnibus Violations

     Vision Care Summary Booklet


Union members please be advised as to your right and responsibility to request a  union withdrawal card if you are going out of work for an extended period of time.

If you are going to be out of work for an extended period of time, you MUST call the Local 72 office at 212 691 4228 or fill out the on line application to request a withdrawal.  The withdrawal will relieve you of your obligation to pay union dues during the withdrawal period.  Failure to request a withdrawal will continue your obligation to pay union dues, even though you are not working and may not be receiving pay from the NYSTA.

Failure to pay these dues may affect your union status and lead to suspension.  You are responsible for paying all dues in arrears to obtain "good standing status".  If you have any questions, please contact the office.

                         EMAIL Withdrawal Form          (PDF)  Withdrawal Form           


Union Privilege scholarships click here