• Joe Duffle, President
    Matt Bruno, Secretary Treasurer
    855 W San Bernardino Ave,
    Bloomington, CA 92316

    membership@ufcw1167.org
    Phone: (909) 877-5000 Ext. 3

    LOCAL 1167 Drug Employer
    Membership Application

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  • I hereby make application for membership in the UNITED FOOD AND COMMERCIAL WORKERS INTERNATIONAL UNION and affirm that the above statements are true, and I agree that all moneys paid by me shall be forfeited and my membership declared void if they are not correct. I authorize the UNITED FOOD AND COMMERCIAL WORKERS INTERNATIONAL UNION to represent me for the purposes of collective bargaining and handling of grievances, either directly or through such local union as it may duly designate.

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  • PAYROLL DEDUCTION AUTHORIZATION
    (Union Dues and/or Initiation Fee).

  • I hereby assign to UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL NO. 1167 from any wages or compensation earned or to be earned bymeas your employee such sums as may be specified to by said Union as due and owing from me as regular initiation or reinstatement fee and/or regular dues. I authorize and direct you to deduct such amounts from my pay and remit the same to the Union monthly so long as this authorization remains in effect.

    This assignment, authorization and direction shall be irrevocable for the period of one (1) year from the date of delivery hereof to you, indicated below, or until the termination of the collective bargaining agreement which is now in force between your Company and the Union, whichever occurs sooner; and I further agree and direct that this assignment, authorization and direction shall be automatically renewed and shall be irrevocable for successive periods of one (1) year each or for the period of each succeeding applicable collective bargaining agreement between your Company and the (15) Union, whichever shall be shorter, unless written notice of revocation is given by me to the Company and the Union within the fifteendays immediatelypreceding the expiration of any such period of one (1) year or the termination of any applicable collective bargaining agreement between the Company and the Union, whichever occurs sooner.

    Dues and/or fees paid to UFCW Local 1167 are not deductible as charitable contributions for federal tax purposes.

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