AUTHORIZATION FOR PAYROLL DEDUCTION. BY: (Last Name) (First Name) (Middle Name) TO: (Employer) (Department) EFFECTIVE: (Date) I hereby request and authorize you to deduct from my earnings the Union membership initiation fee, assessments and once each month, an amount established by the Union as monthly dues. The amount deducted shall be paid to the Treasurer of the Union. This authorization shall be irrevocable during my current contract year.
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