Ancillary Benefits Forms

This page provides a description of and links to National IAM Benefit Trust Fund forms related to Fund ancillary benefits. Click the form titles below to review or download copies.

Enrollment Form

Enrollment Form (PDF)

Disabled Dependent Certification Form

Disabled Dependent Certification Form (PDF)

Eligible Dependent Certification Form

Eligible Dependent Certification Form (PDF)

Waiver Form

Waiver Form (PDF)