Common use of IN WITNESSETH WHEREOF Clause in Contracts

IN WITNESSETH WHEREOF. the Union and the University have signed this Agreement this 24th day of August 2022. 1199SEIU UNITED HEALTHCARE THE TRUSTEES OF WORKERS EAST COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK By: By: Xxxxxxxxxx Xxxxxxx Xxxxx Xxxxxx Executive Vice-President Executive Director Labor & Employee Relations BLANK PAGE EXHIBIT A CHECKOFF AUTHORIZATION DATE: TO: You are hereby authorized and directed to deduct an initiation fee from my wages or salary as required by 1199SEIU United Healthcare Workers East, as a condition of my membership and in addition thereto, to deduct each month my monthly membership dues from my wages or salary; and to remit all such deductions so made to 1199SEIU United Healthcare Workers East, 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, no later than the tenth day of each month immediately following the date of deduction or following the date provided in the Collective Bargaining Agreement for such deductions. This authorization is a voluntary act on my part and shall be irrevocable for a period of one (1) year or until the termination date of the Collective Bargaining Agreement, which ever is sooner, and shall, however, renew itself from year to year unless the employee gives written notice addressed to the l 1199 Finance Department at 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, xx least fifteen (15) days prior to any termination date of the revocation of this authorization. SOC. SEC. NO. Signature DEPT. Address EXHIBIT B 1199 SEIU FEDERAL CREDIT UNION CHECKOFF AUTHORIZATION 1199 SEIU Federal Credit Union CHECKOFF AUTHORIZATION Effective Date TO: You are hereby authorized and directed to deduct from my wages or salary the sum of $ each pay period and to remit such deductions to the 1199 SEIU Federal Credit Union, no later than the 10th day of each month following the month in which the deductions are made. This authorization may be revoked by a 30 day written notice sent to 1199 SEIU Federal Credit Union, unless this authorization is executed as security for or as a manner or method of the repayment of a loan from the 1199 SEIU Federal Credit Union doing business in New York and in such latter event the same shall be in full force and effect until the loan from the 1199 SEIU Federal Credit Union has been paid in full. Print Name Signature Home Address _ Number Street City/Town State Zip Employed At: Address Social Security Number EXHIBIT C

IN WITNESSETH WHEREOF. the Union and the University have signed this Agreement this 24th 7th day of August 2022May 2015. 1199SEIU 1199 SEIU, UNITED HEALTHCARE THE TRUSTEES OF WORKERS EAST COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK By: By: Xxxxxxxxxx Xxxxxx Xxxxxxx Xxxxx Xxxxxx Executive Vice-Xxxxxxxx President Executive Director Assistant Vice President – Labor & Employee Relations BLANK PAGE EXHIBIT A CHECKOFF AUTHORIZATION DATE: TO: You are hereby authorized and directed to deduct an initiation fee from my wages or salary as required by 1199SEIU 1199 SEIU, United Healthcare Workers East, as a condition of my membership and in addition thereto, to deduct each month my monthly membership dues from my wages or salary; and to remit all such deductions so made to 1199SEIU 1199 SEIU, United Healthcare Workers East, 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, no later than the tenth day of each month immediately following the date of deduction or following the date provided in the Collective Bargaining Agreement for such deductions. This authorization is a voluntary act on my part and shall be irrevocable for a period of one (1) year or until the termination date of the Collective Bargaining Agreement, which ever is sooner, and shall, however, renew itself from year to year unless the employee gives written notice addressed to the l 1199 Finance Department at 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, xx at least fifteen (15) days prior to any termination date of the revocation of this authorization. SOC. SEC. NO. Signature DEPT. Address EXHIBIT B 1199 SEIU FEDERAL CREDIT UNION CHECKOFF AUTHORIZATION 1199 SEIU Federal Credit Union CHECKOFF AUTHORIZATION Effective Date TO: You are hereby authorized and directed to deduct from my wages or salary the sum of $ each pay period and to remit such deductions to the 1199 SEIU Federal Credit Union, no later than the 10th day of each month following the month in which the deductions are made. This authorization may be revoked by a 30 day written notice sent to 1199 SEIU Federal Credit Union, unless this authorization is executed as security for or as a manner or method of the repayment of a loan from the 1199 SEIU Federal Credit Union doing business in New York and in such latter event the same shall be in full force and effect until the loan from the 1199 SEIU Federal Credit Union has been paid in full. Print Name Signature Home Address _ Number Street City/Town State Zip Employed At: Address Social Security Number EXHIBIT C

IN WITNESSETH WHEREOF. the Union and the University have signed this Agreement this 24th 7th day of August 2022May 2015. 1199SEIU 1199 SEIU, UNITED HEALTHCARE THE TRUSTEES OF WORKERS EAST COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK By: By: Xxxxxxxxxx Xxxxxx Xxxxxxx Xxxxx Xxxxxx Executive Vice-Xxxxxxxx President Executive Director Assistant Vice President – Labor & Employee Relations BLANK PAGE EXHIBIT A CHECKOFF AUTHORIZATION DATE: TO: You are hereby authorized and directed to deduct an initiation fee from my wages or salary as required by 1199SEIU 1199 SEIU, United Healthcare Workers East, as a condition of my membership and in addition thereto, to deduct each month my monthly membership dues from my wages or salary; and to remit all such deductions so made to 1199SEIU 1199 SEIU, United Healthcare Workers East, 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, no later than the tenth day of each month immediately following the date of deduction or following the date provided in the Collective Bargaining Agreement for such deductions. This authorization is a voluntary act on my part and shall be irrevocable for a period of one (1) year or until the termination date of the Collective Bargaining Agreement, which ever is sooner, and shall, however, renew itself from year to year unless the employee gives written notice addressed to the l 1199 Finance Department at 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, xx at least fifteen (15) days prior to any termination date of the revocation of this authorization. SOC. SEC. NO. Signature DEPT. Address EXHIBIT B 1199 SEIU FEDERAL CREDIT UNION CHECKOFF AUTHORIZATION 1199 SEIU Federal Credit Union CHECKOFF AUTHORIZATION Effective Date TO: You are hereby authorized and directed to deduct from my wages or salary the sum of $ each pay period and to remit such deductions to the 1199 SEIU Federal Credit Union, no later than the 10th day of each month following the month in which the deductions are made. This authorization may be revoked by a 30 day written notice sent to 1199 SEIU Federal Credit Union, unless this authorization is executed as security for or as a manner or method of the repayment of a loan from the 1199 SEIU Federal Credit Union doing business in New York and in such latter event the same shall be in full force and effect until the loan from the 1199 SEIU Federal Credit Union has been paid in full. Print Name Signature Home Address _ Number Street City/Town State Zip Employed At: Address Social Security Number EXHIBIT CC POLITICAL ACTION FUND CHECK-OFF AUTHORIZATION I hereby authorize 1199 SEIU, New York’s Health and Human Service Union, AFL-CIO, to file this payroll deduction card on my behalf with my employer, to withhold $10 per month and to forward that amount to the l 1199 Political Action Fund. This authorization is voluntarily made based on my specific understanding that (1) The signing of this authorization form and the making of these voluntary contributions are not conditions of my employment by my Employer or membership in any Union; (2) That I may refuse to contribute without reprisal; and (3) That the 1199 Political Action Fund uses the money it received for political purposes including but not limited to making contributions to and expenditures for candidates for federal, state, and local offices and addressing the political issues of public importance. This authorization shall remain in full force and effect until revoked by me in writing. Last Name First Name Middle Init. Social Sec. # Home Address City State Zip Code Department in which you work Home Phone (include area code) Work Phone (extension) Date Signature EXHIBIT D Clerical Effective 6/1/2015 Effective 6/6/2016 Effective 6/5/2017 Effective 6/4/2018 Labor Grade Job Title 2.00% 3.00% 3.00% 3.25% I Eliminated as of July 1, 2002 Entry Rate Min Rate Entry Rate Min Rate Entry Rate Min Rate Entry Rate Min Rate Clerk CO (TRAINEE) CO $ 601.95 $ 620.57 $ 620.01 $ 639.19 $ 638.61 $ 658.36 $ 659.37 $ 679.76 Duplicating Machine Op SSW $ 608.15 $ 626.40 $ 645.19 $ 666.16 File Clerk SSW,CO $ 605.05 $ 623.21 $ 641.90 $ 662.76 Mail Clerk SSW,CMR Messenger CUIT II Receptionist CO, CUIT Asst. Clerk CUIT Clerk Typist CO, SSW Receptionist–Typ CO, SSW Clerical Asst. CUIT Mail Clerk CUIT Clerical Asst SSW, CO $ 611.68 $ 630.60 $ 630.03 $ 649.52 $ 648.94 $ 669.01 $ 670.03 $ 690.75 III Jr. Acctg Clk CO $ 618.00 $ 636.54 $ 655.63 $ 676.94 Jr Secretary SSW $ 614.84 $ 633.28 $ 652.28 $ 673.48 File Clerk CO Dispatcher CUIT $ 631.14 $ 650.66 $ 650.07 $ 670.18 $ 669.57 $ 690.28 $ 691.33 $ 712.72 Accounting Clk CO $ 637.64 $ 656.77 $ 676.48 $ 698.46 IV Encumbrance $ 634.39 $ 653.42 $ 673.02 $ 694.90 Processing Clk CO Clerical Asst CO Mail Clerk PS $ 656.45 $ 676.75 $ 676.15 $ 697.05 $ 696.43 $ 717.96 $ 719.06 $ 741.30 Field Secy SSW $ 663.21 $ 683.11 $ 703.60 $ 726.47 V Office Asst Driver/Mail Clk SSW $ 659.83 $ 679.62 $ 700.01 $ 722.76 Sr Acctg Clerk CO

IN WITNESSETH WHEREOF. the Union and the University have signed this Agreement this 24th 22nd day of August 20222019. 1199SEIU UNITED HEALTHCARE THE TRUSTEES OF WORKERS EAST COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK By: By: Xxxxxxxxxx Xxxxxx Xxxxxxx Xxxxx Xxxxxx Executive Vice-Xxxxxxxx President Executive Director Labor & Employee Relations Vice President – Human Resources BLANK PAGE EXHIBIT A CHECKOFF AUTHORIZATION DATE: TO: You are hereby authorized and directed to deduct an initiation fee from my wages or salary as required by 1199SEIU United Healthcare Workers East, as a condition of my membership and in addition thereto, to deduct each month my monthly membership dues from my wages or salary; and to remit all such deductions so made to 1199SEIU United Healthcare Workers East, 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, no later than the tenth day of each month immediately following the date of deduction or following the date provided in the Collective Bargaining Agreement for such deductions. This authorization is a voluntary act on my part and shall be irrevocable for a period of one (1) year or until the termination date of the Collective Bargaining Agreement, which ever is sooner, and shall, however, renew itself from year to year unless the employee gives written notice addressed to the l 1199 Finance Department at 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, xx at least fifteen (15) days prior to any termination date of the revocation of this authorization. SOC. SEC. NO. Signature DEPT. Address EXHIBIT B 1199 SEIU FEDERAL CREDIT UNION CHECKOFF AUTHORIZATION 1199 SEIU Federal Credit Union CHECKOFF AUTHORIZATION Effective Date TO: You are hereby authorized and directed to deduct from my wages or salary the sum of $ each pay period and to remit such deductions to the 1199 SEIU Federal Credit Union, no later than the 10th day of each month following the month in which the deductions are made. This authorization may be revoked by a 30 day written notice sent to 1199 SEIU Federal Credit Union, unless this authorization is executed as security for or as a manner or method of the repayment of a loan from the 1199 SEIU Federal Credit Union doing business in New York and in such latter event the same shall be in full force and effect until the loan from the 1199 SEIU Federal Credit Union has been paid in full. Print Name Signature Home Address _ Number Street City/Town State Zip Employed At: Address Social Security Number EXHIBIT C

IN WITNESSETH WHEREOF. the Union and the University have signed this Agreement this 24th day of August 2022. 1199SEIU UNITED HEALTHCARE THE TRUSTEES OF WORKERS EAST COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK By: By: Xxxxxxxxxx Xxxxxxx Xxxxx Xxxxxx Executive Vice-President Executive Director Labor & Employee Relations BLANK PAGE EXHIBIT A CHECKOFF CHECK-OFF AUTHORIZATION DATE: TO: You are hereby authorized and directed to deduct an initiation fee from my wages or salary as required by 1199SEIU United Healthcare Workers East, as a condition of my membership and in addition thereto, to deduct each month my monthly membership dues from my wages or salary; and to remit all such deductions so made to 1199SEIU United Healthcare Workers East, 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, no later than the tenth day of each month immediately following the date of deduction or following the date provided in the Collective Bargaining Agreement for such deductions. This authorization is a voluntary act on my part and shall be irrevocable for a period of one (1) year or until the termination date fate of the Collective Bargaining Agreement, which ever is sooner, and shall, however, renew itself from year to year unless the employee gives written notice addressed to the l 1199 Finance Department at 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, xx at least fifteen (15) days prior to any termination date of the revocation of this authorization. SOC. SEC. NO. Signature DEPT. Address EXHIBIT B 1199 SEIU 1199SEIU FEDERAL CREDIT UNION CHECKOFF CHECK-OFF AUTHORIZATION 1199 SEIU 1199SEIU Federal Credit Union CHECKOFF CHECK-OFF AUTHORIZATION Effective Date TO: You are hereby authorized and directed to deduct from my wages or salary the sum of $ each pay period and to remit such deductions to the 1199 SEIU 1199SEIU Federal Credit Union, no later than the 10th day of each month following the month in which the deductions are made. This authorization may be revoked by a 30 day written notice sent to 1199 SEIU 1199SEIU Federal Credit Union, unless this authorization is executed as security for or as a manner or method of the repayment of a loan from the 1199 SEIU 1199SEIU Federal Credit Union doing business in New York and in such latter event the same shall be in full force and effect until the loan from the 1199 SEIU 1199SEIU Federal Credit Union has been paid in full. Print Name Signature Home Address _ Number Street City/Town State Zip Employed At: Address Social Security Number EXHIBIT CC POLITICAL ACTION FUND CHECKOFF AUTHORIZATION I hereby authorize 1199SEIU, United Healthcare Workers East, to file this payroll deduction card on my behalf with my employer, to withhold $10 per month and to forward that amount to the 1199 Political Action Fund. This authorization is voluntarily made based on my specific understanding that (1) The signing of this authorization form and the making of these voluntary contributions are not conditions of my employment by my Employer or membership in any Union; (2) That I may refuse to contribute without reprisal; and (3) That the 1199 Political Action Fund uses the money it received for political purposes including but not limited to making contributions to and expenditures for candidates for federal, state, and local offices and addressing the political issues of public importance. This authorization shall remain in full force and effect until revoked by me in writing. Last Name First Name Middle Init. Social Sec. # Home Address City State Zip Code Department in which you work Home Phone (include area code) Work Phone (extension) Date Signature EXHIBIT D The cafeteria workers employed at all of the cafeteria locations of the University, which are as follows: Xxxx Xxx Xxxx Xxxxxx Xxxx Uris Deli Xxxxxxx Cafe Carelton Lounge Blue Java Coffee Bars Faculty Club EXHIBIT E HOLIDAYS

IN WITNESSETH WHEREOF. the Union and the University have signed this Agreement this 24th 22nd day of August 20222019. 1199SEIU UNITED HEALTHCARE THE TRUSTEES OF WORKERS EAST COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK By: By: Xxxxxxxxxx Xxxxxx Xxxxxxx Xxxxx Xxxxxx Executive Vice-Xxxxxxxx President Executive Director Labor & Employee Relations BLANK PAGE Vice President – Human Resources EXHIBIT A CHECKOFF CHECK-OFF AUTHORIZATION DATE: TO: You are hereby authorized and directed to deduct an initiation fee from my wages or salary as required by 1199SEIU United Healthcare Workers East, as a condition of my membership and in addition thereto, to deduct each month my monthly membership dues from my wages or salary; and to remit all such deductions so made to 1199SEIU United Healthcare Workers East, 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, no later than the tenth day of each month immediately following the date of deduction or following the date provided in the Collective Bargaining Agreement for such deductions. This authorization is a voluntary act on my part and shall be irrevocable for a period of one (1) year or until the termination date fate of the Collective Bargaining Agreement, which ever is sooner, and shall, however, renew itself from year to year unless the employee gives written notice addressed to the l 1199 Finance Department at 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, xx at least fifteen (15) days prior to any termination date of the revocation of this authorization. SOC. SEC. NO. Signature DEPT. Address EXHIBIT B 1199 SEIU 1199SEIU FEDERAL CREDIT UNION CHECKOFF CHECK-OFF AUTHORIZATION 1199 SEIU Federal 0000XXXX Xxxxxxx Credit Union CHECKOFF CHECK-OFF AUTHORIZATION Effective Date TO: You are hereby authorized and directed to deduct from my wages or salary the sum of $ each pay period and to remit such deductions to the 1199 SEIU Federal 0000XXXX Xxxxxxx Credit Union, no later than the 10th day of each month following the month in which the deductions are made. This authorization may be revoked by a 30 day written notice sent to 1199 SEIU Federal 0000XXXX Xxxxxxx Credit Union, unless this authorization is executed as security for or as a manner or method of the repayment of a loan from the 1199 SEIU Federal 0000XXXX Xxxxxxx Credit Union doing business in New York and in such latter event the same shall be in full force and effect until the loan from the 1199 SEIU Federal 0000XXXX Xxxxxxx Credit Union has been paid in full. Print Name Signature Home Address _ Number Street City/Town State Zip Employed At: Address Social Security Number EXHIBIT CC POLITICAL ACTION FUND CHECKOFF AUTHORIZATION I hereby authorize 1199SEIU, United Healthcare Workers East, to file this payroll deduction card on my behalf with my employer, to withhold $10 per month and to forward that amount to the 1199 Political Action Fund. This authorization is voluntarily made based on my specific understanding that (1) The signing of this authorization form and the making of these voluntary contributions are not conditions of my employment by my Employer or membership in any Union; (2) That I may refuse to contribute without reprisal; and (3) That the 1199 Political Action Fund uses the money it received for political purposes including but not limited to making contributions to and expenditures for candidates for federal, state, and local offices and addressing the political issues of public importance. This authorization shall remain in full force and effect until revoked by me in writing. Last Name First Name Middle Init. Social Sec. # Home Address City State Zip Code Department in which you work Home Phone (include area code) Work Phone (extension) Date Signature EXHIBIT D The cafeteria workers employed at all of the cafeteria locations of the University, which are as follows: Xxxx Xxx Xxxx Xxxxxx Xxxx Uris Deli Xxxxxxx Cafe Carelton Lounge Blue Java Coffee Bars Faculty Club EXHIBIT E HOLIDAYS

IN WITNESSETH WHEREOF. the Union and the University have signed this Agreement this 24th 22nd day of August 20222019. 1199SEIU UNITED HEALTHCARE THE TRUSTEES OF WORKERS EAST COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK By: By: Xxxxxxxxxx Xxxxxx Xxxxxxx Xxxxx Xxxxxx Executive Vice-Xxxxxxxx President Executive Director Assistant Vice President – Labor & Employee Relations BLANK PAGE EXHIBIT A CHECKOFF AUTHORIZATION DATE: TO: You are hereby authorized and directed to deduct an initiation fee from my wages or salary as required by 1199SEIU United Healthcare Workers East, as a condition of my membership and in addition thereto, to deduct each month my monthly membership dues from my wages or salary; and to remit all such deductions so made to 1199SEIU United Healthcare Workers East, 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, no later than the tenth day of each month immediately following the date of deduction or following the date provided in the Collective Bargaining Agreement for such deductions. This authorization is a voluntary act on my part and shall be irrevocable for a period of one (1) year or until the termination date of the Collective Bargaining Agreement, which ever is sooner, and shall, however, renew itself from year to year unless the employee gives written notice addressed to the l 1199 Finance Department at 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, xx at least fifteen (15) days prior to any termination date of the revocation of this authorization. SOC. SEC. NO. Signature DEPT. Address EXHIBIT B 1199 SEIU FEDERAL CREDIT UNION CHECKOFF AUTHORIZATION 1199 SEIU Federal Credit Union CHECKOFF AUTHORIZATION Effective Date TO: You are hereby authorized and directed to deduct from my wages or salary the sum of $ each pay period and to remit such deductions to the 1199 SEIU Federal Credit Union, no later than the 10th day of each month following the month in which the deductions are made. This authorization may be revoked by a 30 day written notice sent to 1199 SEIU Federal Credit Union, unless this authorization is executed as security for or as a manner or method of the repayment of a loan from the 1199 SEIU Federal Credit Union doing business in New York and in such latter event the same shall be in full force and effect until the loan from the 1199 SEIU Federal Credit Union has been paid in full. Print Name Signature Home Address _ Number Street City/Town State Zip Employed At: Address Social Security Number EXHIBIT C

IN WITNESSETH WHEREOF. the Union and the University have signed this Agreement this 24th 22nd day of August 20222019. 1199SEIU UNITED HEALTHCARE THE TRUSTEES OF WORKERS EAST COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK By: By: Xxxxxxxxxx Xxxxxx Xxxxxxx Xxxxx Xxxxxx Executive Vice-Xxxxxxxx President Executive Director Assistant Vice President – Labor & Employee Relations BLANK PAGE EXHIBIT A CHECKOFF CHECK-OFF AUTHORIZATION DATE: TO: You are hereby authorized and directed to deduct an initiation fee from my wages or salary as required by 1199SEIU United Healthcare Workers East, as a condition of my membership and in addition thereto, to deduct each month my monthly membership dues from my wages or salary; and to remit all such deductions so made to 1199SEIU United Healthcare Workers East, 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, no later than the tenth day of each month immediately following the date of deduction or following the date provided in the Collective Bargaining Agreement for such deductions. This authorization is a voluntary act on my part and shall be irrevocable for a period of one (1) year or until the termination date fate of the Collective Bargaining Agreement, which ever is sooner, and shall, however, renew itself from year to year unless the employee gives written notice addressed to the l 1199 Finance Department at 000 Xxxx 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, xx at least fifteen (15) days prior to any termination date of the revocation of this authorization. SOC. SEC. NO. Signature DEPT. Address EXHIBIT B 1199 SEIU 1199SEIU FEDERAL CREDIT UNION CHECKOFF CHECK-OFF AUTHORIZATION 1199 SEIU Federal 0000XXXX Xxxxxxx Credit Union CHECKOFF CHECK-OFF AUTHORIZATION Effective Date TO: You are hereby authorized and directed to deduct from my wages or salary the sum of $ each pay period and to remit such deductions to the 1199 SEIU Federal 0000XXXX Xxxxxxx Credit Union, no later than the 10th day of each month following the month in which the deductions are made. This authorization may be revoked by a 30 day written notice sent to 1199 SEIU Federal 0000XXXX Xxxxxxx Credit Union, unless this authorization is executed as security for or as a manner or method of the repayment of a loan from the 1199 SEIU Federal 0000XXXX Xxxxxxx Credit Union doing business in New York and in such latter event the same shall be in full force and effect until the loan from the 1199 SEIU Federal 0000XXXX Xxxxxxx Credit Union has been paid in full. Print Name Signature Home Address _ Number Street City/Town State Zip Employed At: Address Social Security Number EXHIBIT CC POLITICAL ACTION FUND CHECKOFF AUTHORIZATION I hereby authorize 1199SEIU, United Healthcare Workers East, to file this payroll deduction card on my behalf with my employer, to withhold $10 per month and to forward that amount to the 1199 Political Action Fund. This authorization is voluntarily made based on my specific understanding that (1) The signing of this authorization form and the making of these voluntary contributions are not conditions of my employment by my Employer or membership in any Union; (2) That I may refuse to contribute without reprisal; and (3) That the 1199 Political Action Fund uses the money it received for political purposes including but not limited to making contributions to and expenditures for candidates for federal, state, and local offices and addressing the political issues of public importance. This authorization shall remain in full force and effect until revoked by me in writing. Last Name First Name Middle Init. Social Sec. # Home Address City State Zip Code Department in which you work Home Phone (include area code) Work Phone (extension) Date Signature EXHIBIT D The cafeteria workers employed at all of the cafeteria locations of the University, which are as follows: Xxxx Xxx Hall Xxxxxx Xxxx Uris Deli Xxxxxxx Cafe Carelton Lounge Blue Java Coffee Bars Faculty Club EXHIBIT E HOLIDAYS