Employer Name is a required field.
 Address 1 is a required field
 City is a required field
 State is a required field
 Zip is a required field
 Phone is a required field
 Email is a required field
 Social Security Numbers must be in the format 000-00-0000
 Hours Worked must be a numeric value in the format 0.00
 Gross Wages must be a numeric value in the format $0.00

SSN Last Name First Name Hours Worked Gross Wages
  Totals
%
Employeer Contributions 
Fund Factor Rates Total Hours Amount Due
Welfare Per Hour Worked X =
Local 31 Pension Per Hour Worked X =
Bldg Trades Pension Per Hour Worked X =
Apprentice Per Hour Worked X =
CAP Fund Per Hour Worked X =
Total Employer Contributions Due
Payroll Deductions 
Fund Factor Rates Amount Due
Advancement Per Hour Worked X =
Local 31 Dues 6% Gross Wages X =
International Dues (A) 1% Gross Wages X =
International Dues (B) 1% Benefit Contribution X =
Total Payroll Deductions Due
  Total Employer Contributions Due
  Total Payroll Deductions Due
  Total Payment Due

By utilizing this form, I certify this report to be a true and correct representation of hours worked by employees working under the Collective Bargaining Agreement with Plasterers' Local Union No. 31 and agree to abide by the terms and provisions of the Collective Bargaining Agreement with Plasterers' Local Union No. 31 and the Declarations of Trust affiliated with the Benefits outlined on this Transmittal Form.