Request a Withdrawal Card if you are laid off, going on leave of absence, on a lengthy medical leave, or terminating your employment. It is your responsibility to obtain a withdrawal card in order to avoid being suspended from the Union and subject to paying back dues and/or a reinitiation fee.

A withdrawal card must be requested within 90 days of your last day worked. Dues must be paid current through the last month you were employed.

Please complete the attached form and fax or mail it to:

Fax: 714.978.0576

TEAMSTERS LOCAL 952
140 S. Marks Way
Orange, CA 92868

PLEASE NOTE THAT ALL WITHDRAWAL CARDS MUST BE SIGNED BEFORE SENDING.

Request for Withdrawal Card_English.doc

Request for Withdrawal Card_Spanish.doc