AUTHORIZATION FOR PAYROLL DEDUCTION Clause Samples

AUTHORIZATION FOR PAYROLL DEDUCTION. The Organization certifies that it has and will maintain individual employee authorizations regarding union membership. The Organization shall provide written notification to the District of any unit member who is a member of the Lemoore Elementary Classified Organization, or who has applied for membership, and who has authorized deduction of Organization membership dues (Appendix E). Pursuant to such written notification, the District shall deduct one-tenth (1/10) of such annual dues from the regular salary warrant of the unit member each month for ten (10) months per year. Deductions for unit members who join the Organization after the commencement of the school year shall be appropriately prorated to complete dues and payments by the end of the school year. Any new, changed, or discontinued deduction must be received by the District’s Business Department before the 15th of any month in order for the deduction to be processed for that pay period. a. With respect to all sums deducted by the District pursuant to authorization of the employee, the District agrees to promptly remit such monies to the Organization accompanied by an alphabetical list of bargaining unit members for whom such deductions have been made, and indicating any changes in personnel from the list previously furnished. b. Upon appropriate written authorization from the bargaining unit member, the District shall deduct from the salary of any bargaining unit member, and made appropriate remittance for annuities, credit union, savings bonds, charitable donations, or any other plans or programs approved by the District.

AUTHORIZATION FOR PAYROLL DEDUCTION. All employees may voluntarily execute an authorization form authorizing the Medical Center to deduct the funds referenced in 2.1.1 above from wages and forward them to the Association on behalf of the employee.

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.

AUTHORIZATION FOR PAYROLL DEDUCTION. Effective / / I hereby request and authorized you to deduct Union Dues from my earnings each pay period in equal installments. This amount shall be paid to the Treasurer of the Greater ▇▇▇▇▇▇▇▇ Regional Teachers Federation, Local 1707, American Federation of Teachers (AFT), AFT-Massachusetts, AFL-CIO. Union Dues paid to the Greater ▇▇▇▇▇▇▇▇ Regional Teachers Federation may not be deductible for federal income tax purposes; however, under limited circumstances, dues may qualify as a business expense. These deductions may be terminated at any time by me by written notice to both the Federation and the Committee, or upon termination of my employment. Employee’s Signature Date

AUTHORIZATION FOR PAYROLL DEDUCTION. I hereby authorize my employer and/or Sound Transit to withhold monthly dues and/or representation fees and to forward those funds to my exclusive bargaining representative, Local Union No. , AFL-CIO. I understand that this authorization will go into effect within 30 days of receipt. I also understand it will take 30 days on receipt of written notification to terminate this authorization. Date: Print Name: Social Security Number: Signature:

AUTHORIZATION FOR PAYROLL DEDUCTION. You acknowledge that in connection with the exercise of certain options to purchase the Company’s common stock, the Company extended a loan to you in the principal amount of $360,000 (the “Loan”). You hereby authorize the Company to use the net proceeds of the Bonus, to the extent earned by you, to repay the Loan, including all accrued and unpaid interest as of that date.

AUTHORIZATION FOR PAYROLL DEDUCTION. Authorization of payroll deduction shall continue in effect from year-to-year unless revoked in writing by the employee with thirty (30) days notice to the SPOA or challenged in writing pursuant to the City’s General Ordinance 6090. The City shall deduct such dues during each of the twenty-six (26) pay periods during the year. Upon receipt of a monthly invoice/spreadsheet delivered ten (10) days before the end of the month, the amounts deducted shall be direct deposited within ten (10) days to the SPOA. The amounts deducted shall be transmitted within ten (10) days to the SPOA. The City will not be held liable for check-off errors but will make proper adjustments with the SPOA for errors, within a thirty (30) day period from the time the error has been identified. Provided the City acts in compliance with provisions of this article, the SPOA will indemnify, defend, and hold the City harmless against any claims made and against any suit instituted against the City as a result of the City’s enforcement of this Article or as a result of any check-off errors.

AUTHORIZATION FOR PAYROLL DEDUCTION. By Last Name First Name Middle Name To Effective Date I hereby request and authorize you to deduct from my earnings monthly an amount established by the Union as monthly dues. The amount deducted shall be paid to the Union. This authorization is revocable during the term of this Agreement.

AUTHORIZATION FOR PAYROLL DEDUCTION. City of Memphis, Tennessee BY: (Please Print) Last Name First Social Security Number ADDRESS: Number/Street City Zip Telephone I, the undersigned, hereby designate the Memphis Police Association as my duly chosen and authorized representative on matters relating to my- employment, subject to the provisions of the current agreement between the City of Memphis and the Memphis Police Association I hereby authorize and direct the City of Memphis to deduct from my earnings, each payroll, the following: _ DUES - The regular dues of the Memphis Police Association _ PAC- Contribution to the MPA’s Political Action Committee _ Memphis Police Association Charitable Foundation, Inc. Please ▇▇▇▇ appropriate box(es) SUPPLEMENTAL LIFE INSURANCE _ $20.00 _ $50.00 DENTAL AND VISION INSURANCE _ Single _ Employee +1 _ Family The amounts to be so deducted shall be certified to the City of Memphis by the Secretary-Treasurer of the Memphis Police Association and shall be remitted as such by the City. This authorization may be terminated by me by giving thirty (30) days written notice to the City of Memphis, Director of Human Resources and to the Secretary- Treasurer of the Memphis Police Association. Date Signature IBM# Email Address: