Sample 4
X
Sample 4
☰
X
Member Login
×
About
Button
Header Examples
Office Locations
Officers & Staff
Demo Video
Photo Gallery
Office Locations
News Feeds
Example Form
Contact Us
Member Resources
Login
Member Home
Members Only Page
Reducing Spam
Domain Name Ownership
Custom Article Posting for Members
Meeting Minutes
Events Calendar
Message Board
Contracts
Constitution/Bylaws
Committees
Meeting Minutes
Online Voting
Downloads
Job Calls
Contractors
Member Directory
Officers/Staff
Classified Ads
Home
Member Resources
Member Home
Members Only Page
Reducing Spam
Domain Name Ownership
Custom Article Posting for Members
Meeting Minutes
Events Calendar
Message Board
Contracts
Constitution/Bylaws
Committees
Meeting Minutes
Online Voting
Downloads
Job Calls
Contractors
Member Directory
Officers/Staff
Classified Ads
Login
About
Button
Header Examples
Office Locations
Officers & Staff
Demo Video
Photo Gallery
Office Locations
News Feeds
Example Form
×
Username
Password
Login
Register an Account
Cancel
Forgot Login?
Dues Checkoff
Print Name
*
I hereby authorize my employer to deduct from my wages each and every month an amount equal to the monthly dues, initiation fees and uniform assessments of Local Union 317, and direct such amounts so deducted to be turned over each month to the Secretary-treasurer of such Local Union for and on my behalf.
This authorization is voluntary and is not conditioned on my present or future membership in the Union.
The authorization and assignment shall be irrevocable for the term of the applicable contract between the union and the employer or for one year, whichever is the lesser, and shall automatically renew itself for successive yearly or applicable contract periods thereafter, whichever is lesser, unless I give written notice to the company and the union at least sixty (60) days, but not more than seventy-five (75) days before any periodic renewal date of this authorization and assignment of my desire to revoke same.
Signature
*
Use your mouse, finger, or touch device to write your signature.
Clear
Social Security Number
*
Date
*
Address
*
City
*
State
*
Zip Code
*
Employer
*
*
Required Fields
Submit Form
Demo Local 1234
PO Box 3010
Clackamas, OR 97015
888-248-5557
X
Powered By
UnionActive
- Copyright © 2025. All Rights Reserved.
Privacy Policy & Terms of Service