I, Applicants Name*, do hereby authorize Teamsters Local 767 to place me on Honorable Withdrawal, (retirement, worker's compensation, medical leave, termination, ect.) pursuant to Article XVIII, Section 6 of the Constitution of the International Brotherhood of Teamsters. This is not a resignation of membership from the Local Union, but it will allow your dues to be suspended during the period of time you are on Honorable Withdrawal. During the period I am on an Honorable Withdrawal, I will not be employed in the craft. It shall be compulsory to call Teamsters Local Union 767 immediately upon your return to employment in the craft, in order to avoid inadvertent dues deductions.