This page is provided as a ready reference tool for Foremen of our Local.

Monthly Job Report

Download the Excel file here or the PDF file. You can also fill in the blanks below and click the ‘submit’ button to send your form to IBEW Local 5.

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Date / Time *

Date

Time

Name of Employer *

Name of Job *

Type of Job *

County *

Job Site Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Job Phone *

Thru Time on

List any electrical contractors/subcontractors on site.

Estimated Job Completion Date

Estimated Number of Layoffs

Employees on Jobsite

Please complete the fields below for each member, including full name, Local Union number, card number, and dues-paid-through dates. You may submit up to twenty entries using the “Add Another Member” button.

Employees

Name *

First

Last

Local Union #

Card #

Dues Paid Thru –

Add Remove

File Upload

Drag & Drop Files, Choose Files to Upload

You may also upload your list of employee names using an excel spreadsheet.

Name of person submitting form. *

First

Last

Signature *

Clear Signature

Draw your signature into the box above. I understand this is a legal representation of my signature.

Your Email Address *

Date / Time

Submit