Authorization For Payroll Deduction - Free Legal Forms and Contracts

This free legal form and contract is provided as is and should be used for information, sample and example purposes only. Always consult your attorney. It is a valid legal document.

PAYROLL DEDUCTION AUTHORIZATION

The undersigned hereby authorizes______________________________
to deduct $__________ from my gross earnings each payroll period
beginning, the following:

In payment for: Amount:

_____Credit Union $_______.__

_____Employee Savings Plan _______.__

_____401 K Plan _______.__

_____Union Dues _______.__

___ _______________________ _______.__

___ _______________________ _______.__

___ _______________________ _______.__

___ _______________________ _______.__

Total $_______.__

Signature_______________________________Date________________________

Print Name__________________________________________________________

Social Security Number______________________________________________

Please keep a copy of this for your records.