The TelCo Retirees Association. Inc. Membership Application

Yes I want to join the TelCo Retirees Association, Inc. I support you in your effort to protect the pension and benefit rights of both management and non-management retirees.

Enclosed is the suggested annual membership fee of $34.

In addition I would like to include my, voluntary, personal, contribution to the TelCo Retirees Association, Inc. in the amount of_____ to assist with expenses incurred conducting Association business.

Name: ____________________________________________________

Address: ________________________________________________________

City/State/Zip Code:________________________________________________

Telephone: _________________________e-mail:________________________

Job Title: (At Retirement) ____________________________________________

I Retired in: (Year)______________ From (Company)_______________________

SBC Stock Owner?: Yes___ No___

TelCo Retirement Association, Inc. is a 501 C (4) IRS Tax-exempt Corporation. Membership is open to all Pacific Bell and Bell of Nevada Retirees and their dependents. Former Pacific Bell / Bell of Nevada Employees who retire from SBC or any former Bell System employees are also eligible for membership.

Please print and mail this form to:

The TelCo Retirees Association, Inc.

P.O. Box 600067
San Diego, CA 92160-0067


*Membership fee is not tax deductible. If you have additional question regarding tax deductions you should contact your tax consultant.

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