FORMS

FORMS

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MEMBERSHIP

MEMBERSHIP APPLICATION

HPPU 109 MEMBERSHIP BENEFIT PACKAGE

CITY OF HOUSTON PAYROLL DEDUCTION FORM

CITY OF HOUSTON DONATION OF ACCUMULATED LEAVE

PAYROLL DEDUCTION FORMS - INSURANCE

HPPU PAYROLL DEDUCTION - INSURANCE

HPPU RETIRED PAYROLL DEDUCTION - INSURANCE

MEMBERSHIP ASSISTANCE PROGRAM - M.A.P.

M.A.P. PLAN DOCUMENT

M.A.P. SUMMARY

M.A.P. APPLICATION

LIFE INSURANCE

SHENANDOAH LIFE INSURANCE BENEFITS

SHENANDOAH LIFE INSURANCE ENROLLMENT FORM

SHENANDOAH LIFE INSURANCE CHANGE REQUEST FORM

DISABILITY / ACCIDENTAL DEATH AND DISMEMBERMENT

HARTFORD ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS

HARTFORD SHORT TERM DISABILITY BENEFITS

HARTFORD SHORT TERM DISABILITY APPLICATION

DENTAL

EPSI DENTAL PLAN

EPSI DENTAL SCHEDULE OF BENEFITS

EPSI DENTAL BENEFITS APPLICATION

VISION

AVESIS VISION PLAN

TEXAS FOP SCHOLARSHIP

TEXAS FOP SCHOLARSHIP PROGRAM

TEXAS FOP SCHOLARSHIP APPLICATION

TEXAS POLICE TRUST

TEXAS POLICE TRUST CONTRACT BENEFITS

TEXAS POLICE TRUST DISABILITY BENEFITS APPLICATION

TEXAS POLICE TRUST MEDICAL CLAIM FORM

For more information please contact:

info@houstonfop.com

713-864-2925

Houston Police Patrolmen's Union - Fraternal Order of Police Lodge 109
4713 Tidwell Road- Houston, Texas 77016 - Phone: 713-864-2925 - Fax: 713-864-9265

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