I.B.E.W. Local 108 Dues Deduction Form

I.B.E.W. Local 108

Union Dues Deduction Authorization
Company*
Name*

First NameLast Name
Today's Date*

MonthDayYear
Date
I hereby direct {typeA7} to deduct 2 hours pay per month plus:
Must Check One:*

$44.00 A Membership$23.00 BA Membership
Optional Deductions 1:

$10.00 TECO Fast Aid
Optional Deductions 2:

$6.00 Clarios Sick Fund
Beginning on the date below as payment of my membership dues in the International Brotherhood of Electrical Workers, Local 108.*

MonthDayYear
Date
Signed*

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