Common Contracts
1 similar Payroll Deduction Agreement contracts
ContractPayroll Deduction Agreement • April 5th, 2014
Form. No. CC001 Guarantor Name and Guarantor Number: GMHA Preparer’s Name, Date, and Signature: GOVERNMENT OF GUAM EMPLOYEE PAYROLL DEDUCTION AGREEMENT 1 TO: (Employer’s name and address) 2 Regarding: (Guarantor’s/Employee’s name and address) Social Security or Driver’s License Number: 2 EMPLOYER – Your employee, the Guarantor, identified above on the right named you as the responsible agency or party that oversees his or her payroll. Pursuant to 4 GCA §4307 and 5 GCA §20111, the Guarantor has elected payroll deduction as an option to satisfy his or her debt with GMHA. Although Guarantor and GMHA has negotiated to settle the Guarantor’s GMHA debt through payroll deduction, GMHA will not consider this agreement valid and binding, under the conditions and terms provided herein, until this form (CC001) has been completely filled out and signed by Guarantor and Employer. 3 TO BE COMPLETED BY EMPLOYER The Guarantor, , is employed with . The Guarantor is eligible for payroll deduction. T
