Common use of Excluded Clause in Contracts

Excluded. C1 - chairpersons, deans, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. APPENDIX B United Faculty of Florida-Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall). Signature (for payroll deduction authorization) Today’s Date Please print, fill out, & give this form to a UFF-FIU Representative or mail to: United Faculty of Florida-FIU XX-000 Xxxxx, XX 00000 United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unit. Signature of Member Date Department Panther ID Effective date if later than above: Return to the United Faculty of Xxxxxxx-XXX Xxxxxx, XX 000, Xxxxx, XX 00000 Or to the XXX Xxxxx Xxxxxx, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME : SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE:

Excluded. C1 - chairpersons, deans, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. Ratified by the Board of Trustees on 09/14/2021 Ratified by the United Faculty of Florida-FIU on 09/14/2021 APPENDIX B United Faculty of Florida-Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall). Signature (for payroll deduction authorization) Today’s Date Please print, fill out, & give this form to a UFF-FIU Representative or mail to: United Faculty of Florida-FIU XX-000 Xxxxx, XX 00000 United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unit. Signature of Member Date Department Panther ID Effective date if later than above: Return to the United Faculty of Xxxxxxx-XXX Xxxxxx, XX 000, Xxxxx, XX 00000 Or to the XXX Xxxxx Xxxxxx, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ C GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME NAME: SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE:

Excluded. C1 - chairpersons, deansxxxxx, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. APPENDIX B United Faculty of Florida-Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall). Signature (for payroll deduction authorization) Today’s Date Please print, fill out, & give this form to a UFF-FIU Representative or mail to: United Faculty of Florida-FIU XX-000 XxxxxPC-111 Miami, XX 00000 FL 33199 United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unit. Signature of Member Date Department Panther ID Effective date if later than above: Return to the United Faculty of XxxxxxxFlorida-XXX XxxxxxFIU Office, XX PC 000, Xxxxx, XX 00000 Or to the XXX Xxxxx XxxxxxUFF State Office, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME : SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE:

Excluded. C1 - chairpersons, deans, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. APPENDIX B As ratified by the Board of Trustees on March 24, 0000 XXXXXXXX X United Faculty of Florida-Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall). Signature (for payroll deduction authorization) Today’s Date Please print, fill out, & give this form to a UFF-FIU Representative or mail to: United Faculty of Florida-FIU XX-000 Xxxxx, XX 00000 United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unit. Signature of Member Date Department Panther ID Effective date if later than above: Return to the United Faculty of Xxxxxxx-XXX Xxxxxx, XX 000, Xxxxx, XX 00000 Or to the XXX Xxxxx Xxxxxx, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ C GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME : SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE:

Excluded. C1 - chairpersons, deansxxxxx, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. APPENDIX B United Faculty of Florida-Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL APPENDIX B I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall). Signature (for payroll deduction authorization) Today’s Date Please print, fill out, & give this form to a UFF-FIU Representative or mail to: United Faculty of Florida-FIU XX-000 XxxxxPC-111 Miami, XX 00000 FL 33199 United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unitbargainingunit. Signature of Member Date Department Panther ID Effective date if later than above: Return to the United Faculty of XxxxxxxFlorida-XXX XxxxxxFIU Office, XX PC 000, Xxxxx, XX 00000 Or to the XXX Xxxxx XxxxxxUFF State Office, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ C GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME : SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE:

Excluded. C1 - chairpersons, deans, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. APPENDIX B United Faculty of Florida-Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL APPENDIX B I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall). Signature (for payroll deduction authorization) Today’s Date Please print, fill out, & give this form to a UFF-FIU Representative or mail to: United Faculty of Florida-FIU XX-000 Xxxxx, XX 00000 United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unitbargainingunit. Signature of Member Date Department Panther ID Effective date if later than above: Return to the United Faculty of Xxxxxxx-XXX Xxxxxx, XX 000, Xxxxx, XX 00000 Or to the XXX Xxxxx Xxxxxx, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ C GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME : SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE:

Excluded. C1 - chairpersons, deans, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. Ratified by the Board of Trustees on 09/14/2021 Ratified by the United Faculty of Florida-FIU on 09/14/2021 APPENDIX B United Faculty of Florida-Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall). Signature (for payroll deduction authorization) Today’s Date Please print, fill out, & give this form to a UFF-FIU Representative or mail to: United Faculty of Florida-FIU XX-000 XxxxxPC-111 Miami, XX 00000 FL 33199 United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unit. Signature of Member Date Department Panther ID Effective date if later than above: Return to the United Faculty of XxxxxxxFlorida-XXX XxxxxxFIU Office, XX PC 000, Xxxxx, XX 00000 Or to the XXX Xxxxx XxxxxxUFF State Office, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ C GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME NAME: SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE:

Excluded. C1 - chairpersons, deansxxxxx, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. APPENDIX B United Faculty of Florida-Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL APPENDIX B I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall). Signature (for payroll deduction authorization) Today’s Date Please print, fill out, & give this form to a UFF-FIU Representative or mail to: United Faculty of Florida-FIU XX-000 Xxxxx, XX 00000 United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unitbargainingunit. Signature of Member Date Department Panther ID Effective date if later than above: Return to the United Faculty of Xxxxxxx-XXX Xxxxxx, XX 000, Xxxxx, XX 00000 Or to the XXX Xxxxx Xxxxxx, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ C GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME : SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE:

Excluded. C1 - chairpersons, deans, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. APPENDIX B As ratified by the Board of Trustees on June 16, 0000 XXXXXXXX X United Faculty of Florida-Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall). Signature (for payroll deduction authorization) Today’s Date Please print, fill out, & give this form to a UFF-FIU Representative or mail to: United Faculty of Florida-FIU XX-000 Xxxxx, XX 00000 United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unit. Signature of Member Date Department Panther ID Effective date if later than above: Return to the United Faculty of Xxxxxxx-XXX Xxxxxx, XX 000, Xxxxx, XX 00000 Or to the XXX Xxxxx Xxxxxx, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ C GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME : SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE:

Excluded. C1 - chairpersons, deans, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. APPENDIX B United Faculty of FloridaUNITED FACULTY OF FLORIDA UFF DUES CHECK-OFF AUTHORIZATION FORM I, , authorize Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full biweekly pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. UFF dues payments are not tax deductible as charitable contributions for federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office, and to UFF, or (2) my transfer or promotion out of this bargaining unit. Unless this Dues Check-off Authorization is revoked in the manner heretofore stated, this authorization shall remain in full force and effect in accordance with the provisions of Section 447.007 Florida Statutes. Date Employee's Signature Social Security Number Name (printed) Department Effective date if later than above: Please return to your Chapter President or to the UFF State Office, 000 X. Xxxxxx Street, Tallahassee, Florida 32301. Please PRINT complete information where necessary. Check One Dr. Mr. Ms. Mrs. Social Security Number Last Name, First Name Home Address Campus Address Department City, State, Zip Code Office Phone Home Phone = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = == = = = = == Please enroll me as a member of the United Faculty of Florida (UFF). All UFF members are also members of the Florida Education Association, National Education Association, American Federation of Teachers and the AFL-CIO. UFF dues are 1 percent of total salary* for members for which the United Faculty of Florida is the bargaining agent. UFF dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked *Total salary for purposes of dues deductions includes any money received by me at any time upon thirty (30) days written notice to the employee for in-unit work. If insufficient funds remain after mandatory deductions, the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall)has no obligation to process dues deductions. Signature (for payroll deduction authorization) Today’s of Member Date Please print, fill out, & give this Return your completed membership form to a UFF-FIU Representative your Chapter President or mail to: United Faculty of Florida-FIU XX-000 XxxxxUFF State Office,000 Xxxxx Xxxxxx Xxxxxx, XX 00000 Xxxxxxxxxxx, Xxxxxxx 00000. United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first full biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of $1.00 per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unit. Date Signature of Member Date Department Panther ID Effective date if later than above: Return to your Chapter President or the United Faculty of Xxxxxxx-XXX Xxxxxx, XX 000, Xxxxx, XX 00000 Or to the XXX Xxxxx XxxxxxUFF State Office, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6X. Xxxxxx Street, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ C GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME : SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE:

Excluded. C1 - chairpersons, deansxxxxx, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. APPENDIX B United Faculty of Florida-Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall). Signature (for payroll deduction authorization) Today’s Date Please print, fill out, & give this form to a UFF-FIU Representative or mail to: United Faculty of Florida-FIU XX-000 Xxxxx, XX 00000 United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unit. Signature of Member Date Department Panther ID Effective date if later than above: Return to the United Faculty of Xxxxxxx-XXX Xxxxxx, XX 000, Xxxxx, XX 00000 Or to the XXX Xxxxx Xxxxxx, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME : SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE:

Excluded. C1 - chairpersons, deans, associate deans, assistant deans, directors, and all administrators above them, all employees of the school of law, all employees of the College of Medicine, chairman of the faculty senate serving on the board of trustees, managerial and confidential employees, and all other employees of The Board of Trustees of the Florida International University. APPENDIX B As ratified by the Board of Trustees on June 16, 0000 XXXXXXXX X United Faculty of Florida-Florida International University UFF Membership and Dues Deduction Authorization Form NAME (Last, First MI) Panther ID Department TITLE (ie, Assistant Professor, Professor, Lecturer, Assoc In, University Librarian, Instructor) CAMPUS LOCATION OFFICE HOURS HOME ADDRESS CITY/STATE ZIP PHONE: Work Home E-MAIL I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida International University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF. Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall). Signature (for payroll deduction authorization) Today’s Date Please print, fill out, & give this form to a UFF-FIU Representative or mail to: United Faculty of Florida-FIU XX-000 Xxxxx, XX 00000 United Faculty of Florida UFF-PAC Payroll Deduction Authorization Form I, authorize Florida International University to deduct from my pay, starting with the first biweekly pay period commencing not earlier than seven days from the date this authorization is received by the University, contributions to the UFF Political Action Committee in the amount of per pay period, and I direct that the sum so deducted be paid over to the UFF. Contributions to UFF-PAC are not deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. The above deduction authorization shall continue until either (1) revoked by me at any time upon thirty days written notice to the University Human Resources Office and to the UFF, or (2) my transfer or promotion out of this bargaining unit. Signature of Member Date Department Panther ID Effective date if later than above: Return to the United Faculty of Xxxxxxx-XXX Xxxxxx, XX 000, Xxxxx, XX 00000 Or to the XXX Xxxxx Xxxxxx, 000 Xxxxx Xxxxxxx Xxxxxx, Suite 6, Tallahassee, Florida 32301. Florida International University/United Faculty of Florida APPENDIX C‌ GRIEVANCE Date Received by Xxxxxxx or Designee: GRIEVANT STEP 1 GRIEVANCE REPRESENTATIVE NAME : SCHOOL/COLLEGE: DEPT : NAME: MAILING ADDRESS: OFFICE PHONE: OFFICE PHONE: