On-line Resign Form

On-line Resign Form

ATTENTION: Referral Agent

I am currently registered on of the Local Union 124 Out-of-Work list. Please resign my name for the month of .

First Name M.I. Last Name

Member of Local Union No. Card No. OR Last 4 digits of Social Security No.

Phone Number Alternate Phone Number

E-Mail Address

Print the following page as your receipt.

Resigns must be date / time stamped between the 1st and the 10th of the month following (Example: A resign for the month of August must be date stamped between 12:01 AM August 1st and midnight August 10th.

Resigns may also be completed by fax (816) 942-8805 or by phone to (816) 942-7500.