Reciprocity Forms - Transfer of Benefits

Find the Local for the area that you worked in below, click on the link, print, complete and mail to the address at the top of each form.  If you are not sure what the

Local number is for the jurisdiction you worked in, the following link found on the UBC Millwrights page is helpful to determine that.

External link opens in new tab or windowFIND A UBC MILLWRIGHT - This site brings up the United States map.  Click on the state to find out the Local and then find the forms below.

TRANSFER FORMS for Local #1076 Members Working Outside of our Jurisdiction

  • External link opens in new tab or windowLocal #443 - (Previously #1755) - West Virginia   Covering the counties of Barbour, Boone, Braxton, Brooke, Cabell, Calhoun, Clay, Doddridge, Fayette, Gilmer, Greenbrier, Hancock, Harrison, Jackson, Kanawha, Lewis, Lincoln, Logan, Marion, Marshall, Mason, McDowell, Mercer, Mingo, Monongalia, Monroe, Nicholas, Ohio, Pleasants, Pocahontas, Preston, Putnam, Raleigh, Randolph, Ritchie, Roane, Summers, Taylor, Tucker, Tyler, Upshur, Wayne, Webster, Wetzel,  Wirt, Wood and Wyoming  (Verified & Updated 08/25/22) 

  • External link opens in new tab or windowLocal #443 - (Previously #2235 & Local #2237) - Pennsylvania  Covering the counties of Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Cameron, Centre, Clarion, Clearfield, Clinton, Crawford, Elk, Erie, Fayette, Forest, Fulton, Greene, Huntington, Indiana, Jefferson, Lawrence, McKean, Mercer, Mifflin, Potter, Somerset, Venango, Warren, Washington and Westmoreland in Pennsylvania. 

  • External link opens in new tab or windowLocal #1090 - Northwest Ohio (Toledo/Lima) covering Allen, Auglaize, Crawford, Defiance, Fulton, Hancock, Hardin, Henry, Lucas, Mercer, Ottawa, Paulding, Putnam, Sandusky, Seneca, Van Wert, Williams, Wood and Wyandot Counties in Ohio

  • External link opens in new tab or windowLocal #1192 - Central Alabama covering the counties of Autauga, Bibb, Blount, Bullock, Calhoun, Cherokee, Chilton, Clay, Cleburne, Coosa, Cullman, Dallas, Elmore, Etowah, Fayette, Greene, Hale, Jefferson, Lamar, Lowndes, Macon, Marshall, Montgomery, Perry, Pickens, Pike, Randolph, Shelby, St. Clair, Sumter, Talladega, Tallapoosa, Tuscaloosa and Walker (Verified & Updated 04/18/19)

  • External link opens in new tab or windowLocal #1192 - North Alabama / Mississippi / Tennessee covering the following Counties in Alabama: Parts of Jackson and Marshall. Colbert, Fayette, Franklin, Lamar, Lauderdale, Lawrence, Limestone, Madison, Marion, Morgan and Winston; the following Counties in Mississippi: Alcorn, Benton  , Calhoun, Chickasaw, Choctaw, Clay, Itawamba, Lee, Lowndes, Monroe, Oktibbeha, Pontotoc, Prentiss, Tippah, Tishomingo, Union and Webster; the following Counties in Tennessee: parts of Franklin, Giles, Hardeman, Hardin, Lawrence, Lincoln, McNairy and Wayne (Verified & Updated 12/16/21)

  • External link opens in new tab or windowLocal #1192 - Gulf Coast - Alabama / Florida / Mississippi covering the following Counties in Alabama: Baldwin, Choctaw, Clarke, Conecuh, Covington, Escambia, Marengo, Mobile, Monroe, Washington and Wilcox; the following Counties in Florida:  Bay, Calhoun, Escambia, Franklin, Gulf,Holmes, Jackson, Liberty, Okaloosa, Santa Rosa, Walton and Washington; the following Counties in Mississippi:  Adams, Amite, Covington, Forrest, Franklin, George, Greene, Hancock, Harrison, Jackson, Jefferson Davis, Jones, Lamar, Lawrence, Lincoln, Marion, Pearl River, Perry, Pike, Stone, Wathall, Wayne and Wilkinson (Verified & Updated 04/18/19)

  • External link opens in new tab or windowLocal #1192 - Central Mississippi / Louisiana covering the following Counties in Mississipi: Attala, Carroll, Claiborne, Clarke, Copiah, Grenada, Hinds, Holmes, Humphreys, Issaquena, Jasper, Jefferson, Kemper, Lauderdale, Leake, Leflore, Madison, Montgomery, Neshoba, Newton, Noxubee, Rankin, Scott, Sharkey, Simpson, Smith, Sunflower, Winston, Warren, Washington and Yazoo; and the following Counties in Louisiana:  Catahoula, Concordia and Madison (Verified & Updated 10/05/21)