CARPENTERS' VACATION TRUST FUND OF ST. LOUIS .

STATEMENT OF VACATION BENEFIT CREDITS

PLAN YEAR: 2020

JACOB M CLARK
Checks will be mailed to the current address on file

Z REDEMPTION STATUS

YOUR AUTHORIZATION IS COMPLETE

Expected Payment Dates

A Direct Deposit will be made into your account on or around May 29, 2020.

Employer May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr Benefit Rate Dollar
Credits Value

WIES 159.50 160.00 170.00 197.50 153.50 158.00 188.00 152.00 168.00 212.00 160.00 111.00 1989.50 $1.00 $1,989.50
DRYWALL
& CONSTR
CO

Total Credits: 1989.50 $1,989.50

VACATION BENEFIT PAYABLE

Total Dollar Value

$1,989.50
Benevolent Fund
-$5.00
Scholarship Donation
-$0.00
Dues Deduction
-$288.00
Net Vacation Benefit Payable
$1,696.50

STATEMENT TRANSACTION DETAIL

Redemption ID
20160614-01N
Amount Payable
$1,696.50
Payment Type
Direct Deposit
Routing Number
********0019
Account Number
********8827
Status(es)
5/21/2020 3:35:12 PM: Member authorized
AUTHORIZATION

By Authorizing/Signing this Statement of Vacation Benefit Credits, I, the Member or Authorized Representative, have reviewed
the accounting of Vacation Benefit Credits for the Plan Year and agree that I am entitled to the Vacation Benefit Credits
contained on this Statement. I also acknowledge and authorize any and all deductions included in the Vacation Benefit Payable
section of this Statement. If a Vacation Benefit is not deposited or a check is not cashed within three years after payment is
due to me, you will forfeit the right to receive such benefit.

Signature
Jacob M Clark
On-line Authorization
5/21/2020

If you do not agree with the Vacation Benefit Credits listed above:

1. Bring all of your check stubs for the Plan Year to the Regional Council Collections Accounting Office, 1401 Hampton
Avenue, Lower Level.
2. We will determine any additional vacation benefit credits you may be entitled to.

You may also contact the CDC Collections Accounting Office at 314.951.0909 or toll free at 800.332.7188.

Note to All Vacation Fund Participants Regarding Unclaimed Benefits: In accordance with the Vacation Fund Plan, if a
Vacation Benefit is not redeemed within three years after the benefit year in which contributions were paid into the Fund, said
benefits will be deemed forfeited.

1401 Hampton Ave

St. Louis MO, 63139

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• 800.332.7188

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