PAYROLL DEDUCTION AUTHORIZATION FORM. By (Please Print) Last Name First Name Middle Name To: Name of Employer Department Effective , 20 , I hereby request and authorize you to deduct from my earnings each payroll period an amount sufficient to provide for the regular payment of the current rate of monthly: (check one) 1) union dues; or 2) service fees as established by the Police Officers Association of Michigan. The amount deducted shall be paid to the Treasurer of the Police Officers Association of Michigan. Employee's Signature Street Address City and State
PAYROLL DEDUCTION AUTHORIZATION FORM. The Company or its contractor or subcontractor shall prepare for each worker’s signature a payroll deduction authorization form identifying all payroll deductions excluding those required by law, such as federal income taxes, Medicare and Social Security.
PAYROLL DEDUCTION AUTHORIZATION FORM. As a payroll deductions xxxxxx, I hereby: 1) Authorize the Office of Parking Services to START CHANGE STOP my payroll deductions.
PAYROLL DEDUCTION AUTHORIZATION FORM. CONTRACTOR, Subcontractor, and Sub subcontractor shall prepare for employee signature a payroll deduction authorization form to identify all payroll deductions excluding those required by statute, such as federal income taxes, Medicare and social security.
PAYROLL DEDUCTION AUTHORIZATION FORM. You are hereby authorized, until otherwise requested by me in writing, to deduct from wages earned by me while in your employ, the regular monthly dues and initiation fee for the International Union of United Automobile, Aerospace and Agricultural Implement Workers of America, Local #2192. Such regular monthly dues shall be equal to two (2) hours of pay per month at the employee's current hourly rate of pay. The aforesaid membership dues shall be remitted by you to the Financial Secretary of Local #2192 or his successor. Employee's Signature Date Witness (Unit Payroll Officer)
PAYROLL DEDUCTION AUTHORIZATION FORM. As a payroll deductions xxxxxx, I hereby:
PAYROLL DEDUCTION AUTHORIZATION FORM. During the life of this Agreement and in accordance with the terms of the form of authorization of check off of dues hereinafter set forth, the Committee agrees to deduct Union membership dues levied in accordance with the constitution of the Union from the pay of each employee who executes or has executed such form and remit the aggregate amount to the treasurer of the Union along with a list of the employees who had said dues th deducted. Such remittance shall be made by the tenth (10 ) day of the succeeding month.
PAYROLL DEDUCTION AUTHORIZATION FORM. I hereby authorize and direct the Nazareth Area School Board to deduct from my salary and transmit the amount of money deducted for my regular membership dues as certified or as may be certified to the Nazareth Area School Board by the Authorized officers of the Nazareth Area Education Association. This authorization to remain valid until the expiration of the present agreement between the Nazareth Area School Board and the Nazareth Area Education Association or any extension thereof unless a written revocation, giving fifteen (15) days notice, is submitted by me to the Nazareth Area School Board and the Nazareth Area Education Association. NAME ADDRESS SOCIAL SECURITY NO. BUILDING SIGNATURE DATE APPROVED BY NAZARETH AREA EDUCATION ASSOCIATION: BY OFFICE
PAYROLL DEDUCTION AUTHORIZATION FORM. Name: School: I hereby request and authorize the Board of Education of School District #54 to deduct from my earnings and transmit to the Association an amount sufficient to provide for regular payment of my obligation in conformance with Article III. Such amount will be annually certified by the Association. I understand that the deductions will be in eighteen (18) equal installments, starting with the fifth (5th) payroll period and continuing for the next seventeen (17) payroll periods. I also understand that if I should leave the District for any reason during the school term, the Board will deduct the full remainder of my unpaid obligation from my final paycheck. I hereby waive all right and claim for monies so deducted and transmitted in accordance with this authorization and relieve the Board and all its officers for any liability therefor. Date: Signature: District ID Number:
PAYROLL DEDUCTION AUTHORIZATION FORM. This is to authorize eighteen (18) equal deductions annually from my pay for dues in the amount of $ for the Southeast Delco Federation of Support Staff. This authorization will remain in effect unless canceled in writing fifteen (15) days prior to the expiration of the collective bargaining agreement in effect on this date.
