Member/Dependent Registration
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 Account Details
 User Name*  
 Security Question 1*     
 Security Answer*     
 Security Question 2*     
 Security Answer*     
 Security Question 3*     
 Security Answer*     
 Security Question 4*     
 Security Answer*     
 Security Question  5*     
 Security Answer*     
 Secure Image*
 User Details
 Are you a member or dependent?  
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 First Name*          MI    
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 Terms & Conditions 
  I have read and agree to all of the Terms of Use for receiving Plan Materials electronically from the Local 804 Funds*  
Local 804 Welfare Trust Fund / Annuity Fund / Pension Fund,34-21 Review Avenue, Long Island City, NY 11101
Phone: (718) 786-5410, Fax: (718) 786-6176 (9:00 am to 5:00 pm Mon - Fri).

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