LENGTH OF SERVICE AWARD PROGRAM
PARTICIPANT PORTAL
Forms
Forms can be accessed and completed in two ways:
DocuSign: This will allow you to complete the form fully online using an e-signature. Pressing this button will bring you to the DocuSign website and the online form. By completing the form this way, Hometown Firefighters and the Sponsor will be provided with an electronically signed form at the time of completion. You will also be able to download and save a copy.
PDF File: This will open a PDF version of the form that you can print and complete. The PDF file does have fillable fields, but you must hand-sign the form. If you choose this option, you can scan and send the completed form to service@hometownfirefighters.com, or you can mail it to Hometown Firefighters At 5 Orville Drive, Bohemia NY 11716
Please complete this form to designate your LOSAP beneficiaries. It applies only to LOSAP death benefits, not other death benefits. You may name up to 2 primary and 3 contingent beneficiaries. For additional beneficiaries, please submit an addendum with the required information. If you have any questions, contact us at service@hometownfirefighters.com
Complete this form to designate beneficiaries for your life insurance policy. It is for life insurance beneficiaries only and does not apply to other death benefits. You may name up to 2 primary and 3 contingent beneficiaries. For additional beneficiaries, submit an addendum with the required details. For any questions, contact us at service@hometownfirefighters.com.
complete this form as you near the Entitlement Age to initiate your LOSAP benefit payments. When using the DocuSign form, you will need to upload supporting documents (proof of birthdate and bank account verification) as images, screenshots, or scans. If you’re unsure how to do this, we recommend completing the PDF form. The DocuSign form also includes sections for Beneficiary and Direct Deposit information.
If you’ve recently moved or need to update your mailing address, please complete the Change of Address form. This ensures all important communications, including LOSAP payments, benefits information, and other notices, are sent to your current address.
To update your direct deposit information for LOSAP payments, you can use either the PDF form or the DocuSign option, based on your preference. Keeping your direct deposit details current ensures timely and secure payment transfers, reducing the risk of lost or delayed checks.
For assistance, contact our support team at Service@hometownfirefighters.com. We’re here to help.
As part of managing your benefits, you may be required to complete a W-9 form. This form is essential for ensuring that your benefits are processed correctly and that any payments or tax-related information is accurately reported to the IRS.
