Forms

If you need us to update your information, or you wish to submit a claim to Canada Life, please see the list of forms below. Simply send the completed form to TEIBAS and/or Canada Life where noted on the forms below.

Privacy Warning: Please return your completed and signed forms to TEIBAS via mail or fax. If you wish to scan or provide your completed and signed form by email, please contact TEIBAS for assistance so that a secure encryption portal can be provided to you to safely return the form. Please be advised that if you return the form or provide any other sensitive or personal information to us by regular email, the information is not secure and may be vulnerable to unauthorized use. Neither TEIBAS nor the Board of Trustees of the Local 353, IBEW Trust Funds will be responsible for any unauthorized use, disclosure, interception or other privacy breach where personal information or other sensitive information is provided by you to TEIBAS through the use of email.

Authorization & Direction Form

Change/Update of Information Form

Change/Update of Beneficiary For Life & Accident Insurance Form

Change/Update of Beneficiary for Pension Plan Form

Change & Update Form for Retiree Death Benefit & Accident Insurance Form

Declaration of Attendance at Post-Secondary Institution Form

Declaration of Marital Status Form

Canada Life Dental Expense Claim Form

Canada Life Healthcare Expense Claim Form

Canada Life Over-Age Dependent Application Form

SUB Plan Claim Form

Your Guide for SUB Payment E-Transfers

Leave of Absence Form

Keep up with TEIBAS! Update us if:

• You change your address, phone number, or email address,
• You have children, or otherwise have a change or need to add dependents,
• Your spouse loses or gains benefits under their own benefit plan,
• You want to change your beneficiary(ies) for your pension and/or benefits, or
• You get married, separated, or divorced.

Make sure you log into myteibas.com for the information we have for you on file and to check to see if your contact and beneficiary information is up to date!

Contact the IBEW Local 353 Union Hall office regarding beneficiaries update forms related to your International Pension and Disability applications forms.