Free Online Legal Forms - Printable Form from All Law - Employment - Payroll Deduction Authorization
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PAYROLL DEDUCTION AUTHORIZATION
I, ___________________________ authorize deduction from my gross earnings for the following specified items and amounts:
IN PAYMENT FOR: AMOUNT
[ ] Credit Union _________.___
[ ] Employee Savings Plan _________.___
[ ] 401 K Plan _________.___
[ ] Union Dues _________.___
to be deducted each payroll period beginning _____________________.
Signature __________________________ Date ________________
Print Name ________________________
Social Security # ______-______-______
Please keep a copy of this for your records.
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