PAYROLL DEDUCTION AUTHORIZATION FORM Sample Clauses

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
Sample 1Sample 2Sample 3See All (12)
AutoNDA by SimpleDocs
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.
Sample 1Sample 2Sample 3
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.
Sample 1Sample 2
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)
Sample 1Sample 2
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.
Sample 1Sample 2
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:
Sample 1
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
Sample 1
AutoNDA by SimpleDocs
PAYROLL DEDUCTION AUTHORIZATION FORM. As a payroll deductions xxxxxx, I hereby:
Sample 1
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.
Sample 1

Related to PAYROLL DEDUCTION AUTHORIZATION FORM

  • Payroll Deduction Schedule The Board will deduct the representation fee in equal installments, as nearly as possible, from the paychecks paid to each employee on the aforesaid list during the remainder of the membership year in question. The deductions will begin with the first paycheck paid:

  • Other Payroll Deductions In addition to the above, the City will deduct from an employee's payroll check, upon authorization by the employee, amounts payable to causes or organizations selected by the Union. At any one time, no more than ten (10) such causes or organizations may be identified by the Union as authorized to benefit from such payroll deductions unless otherwise authorized by the City in its sole discretion. The Union will notify the City of the causes and organizations to be so authorized. Payroll deductions shall be governed by the ability of the City Auditor's payroll system to handle same.

  • Payroll Deductions An employee shall be entitled to have deductions from her salary assigned for the purchase of Canada Savings Bonds.

  • Payroll Deduction 27. The Union shall provide the Employee Relations Director and the City Controller with a current statement of membership fees. Such statement of membership fees shall be amended as necessary. The Controller may take up to thirty (30) days to implement such changes. Effective the second complete pay period commencing after the election or request or showing described in subsection (b) and each pay period thereafter, the controller shall make membership fee or service fee deductions, as appropriate, from the regular periodic payroll warrant of each City employee described in subsection (a) thereof, and, each pay period thereafter, the Controller shall make membership fee or service fee deductions, as appropriate, from the regular payroll warrant of each such employee. Nine (9) working days following payday the controller will promptly pay over to the Union all sums withheld for membership or service fees.

  • PAYROLL DEDUCTION OF UNION DUES A. Provision shall be made by the District for payroll deductions of employee organization dues and assessments of all members upon written authorization by the employee Union member on an official form. Employees shall authorize dues deduction in accordance with Chapter 41.56.110 RCW when they become Union members. An employee may cancel their payroll deduction of dues and assessments by written notice to the Union and to the District, with the District stopping dues deductions following written confirmation from the Union that the employee’s dues/fees authorization has been terminated in compliance with the terms of the written authorization executed by the employee. The District will make every effort to end the automatic dues deduction effective on the first pay period but no later than the second pay period after receipt of the written cancellation notice from the employee and confirmation from the Union that the cancellation notice is compliant with the terms of the written authorization.

  • Payroll Deduction of Fair Share Fee The Board shall deduct from the pay of all employees in the bargaining unit who elect not to become or to remain members of the Association, a Fair Share Fee for the Association’s representation of such non-members during the term of this Agreement. No non-member filing a timely demand shall be required to subsidize partisan political or ideological causes not germane to the Association’s work in the realm of collective bargaining.

  • Open Enrollment Period Open Enrollment is a period of time each year when you and your eligible dependents, if family coverage is offered, may enroll for healthcare coverage or make changes to your existing healthcare coverage. The effective date will be on the first day of your employer’s plan year. Special Enrollment Period A Special Enrollment Period is a time outside the yearly Open Enrollment Period when you can sign up for health coverage. You and your eligible dependents may enroll for coverage through a Special Enrollment Period by providing required enrollment information within thirty (30) days of the following events: • you get married, the coverage effective is the first day of the month following your marriage. • you have a child born to the family, the coverage effective date is the date of birth. • you have a child placed for adoption with your family, the coverage effective date is the date of placement. Special note about enrolling your newborn child: You must notify your employer of the birth of a newborn child and pay the required premium within thirty -one (31) days of the date of birth. Otherwise, the newborn will not be covered beyond the thirty -one (31) day period. This plan does not cover services for a newborn child who remains hospitalized after thirty-one (31) days and has not been enrolled in this plan. If you are enrolled in an Individual Plan when your child is born, the coverage for thirty- one (31) days described above means your plan becomes a Family Plan for as long as your child is covered. Applicable Family Plan deductibles and maximum out-of-pocket expenses may apply. In addition, if you lose coverage from another plan, you may enroll or add your eligible dependents for coverage through a Special Enrollment Period by providing required enrollment information within thirty (30) days following the date you lost coverage. Coverage will begin on the first day of the month following the date your coverage under the other plan ended. In order to be eligible, the loss of coverage must be the result of: • legal separation or divorce; • death of the covered policy holder; • termination of employment or reduction in the number of hours of employment; • the covered policy holder becomes entitled to Medicare; • loss of dependent child status under the plan; • employer contributions to such coverage are being terminated; • COBRA benefits are exhausted; or • your employer is undergoing Chapter 11 proceedings. You are also eligible for a Special Enrollment Period if you and/or your eligible dependent lose eligibility for Medicaid or a Children’s Health Insurance Program (CHIP), or if you and/or your eligible dependent become eligible for premium assistance for Medicaid or a (CHIP). In order to enroll, you must provide required information within sixty (60) days following the change in eligibility. Coverage will begin on the first day of the month following our receipt of your application. In addition, you may be eligible for a Special Enrollment Period if you provide required information within thirty (30) days of one of the following events: • you or your dependent lose minimum essential coverage (unless that loss of coverage is due to non-payment of premium or your voluntary termination of coverage); • you adequately demonstrate to us that another health plan substantially violated a material provision of its contract with you; • you make a permanent move to Rhode Island: or • your enrollment or non-enrollment in a qualified health plan is unintentional, inadvertent, or erroneous and is the result of error, misrepresentation, or inaction by us or an agent of HSRI or the U.S. Department of Health and Human Services (HHS).

  • Special Enrollment Period An eligible individual and eligible dependents may be enrolled during special enrollment periods. A special enrollment period may apply when an eligible individual or eligible dependent loses other health coverage or when an eligible individual acquires a new eligible dependent through marriage, birth, adoption or placement for adoption.

  • Disclosure Statement for Xxxxxxxxx Education Savings Accounts 1. Who is Eligible for a Xxxxxxxxx Education Savings Account? Anyone may contribute to a Xxxxxxxxx Education Savings Account regardless of his or her relationship to the beneficiary. The beneficiary of a Xxxxxxxxx Education Savings Account

  • PAYROLL DEDUCTION OF DUES 4.1: On receipt of a lawfully executed written authorization from an employee, on a form approved by the City’s Director, General Accounting Division, the City will deduct each pay period from the employee’s pay, the amount specified by said employee, but not less than regular dues.

Time is Money Join Law Insider Premium to draft better contracts faster.