Pension Benefits Forms

For FAQs regarding Fidelity Retirement Plan please see PDF above



Change of Address Form:

It is important that you keep us advised of changes of address. Any mail sent to you and returned to us will result in suspension of your pension benefit. All changes of address must be sent to the Fund Office in writing and notarized. A copy of the change of address form can be obtained by visiting or by contacting Jill Dalton at 1-800-251-4107.


Pension Applications, Estimates, Report a Death:

You may download a copy of the application from the website at If you have a question or need assistance in completing the forms please contact your Claims Processor as listed below.

For PIUMPF Benefits

Last names beginning with A – G
Nelda Drake
[one_third_last] 1-800-251-4109

Last names beginning with H – K
Juan Cavallini

Last names beginning with L – O
Pam Eaton

Last names beginning with P – Z
Barbara Mathis
1-800-251-4108 [/one_third_last]


For OCAW Plan Benefits

Last names beginning with A – L
Juan Cavallini
[one_third_last] 1-800-412-5388

Last names beginning with M – Z
Pam Eaton
1-800-423-8743 [/one_third_last]

Pension Cost Calculation/Fund Information: Call Lisa Ellis at 1-615-333-5786

QDRO’s, Claims Information & Denials: Call Beverly Langley at 1-615-333-5796

Education, Training & Appeals: Call Connie Cornelius at 1-615-333-5764

Please visit for a copy of the Fund’s Summary Annual Report and Summary Plan Description.