Union dues and other payments made to the Union are not tax-deductible...

I, the undersigned, hereby apply for admission to membership in the above Local Union and voluntarily choose and designate it as my representative for purpose of collective bargaining, hereby revoking any contrary designation. If admitted to membership, I agree to abide by the constitution of the International as well as the Local Union Bylaws, which are not in conflict with the International laws and thereupon accept and assume the following oath of obligation. I pledge my honor to faithfully observe the Constitution and Laws of the International Brotherhood of Teamsters I pledge that I will comply with all the rules and regulations for the government of the International Union and this Local Union. I will faithfully perform all the duties assigned to me to the best of my ability and skill. I will conduct myself at all times in a manner as not to bring reproach upon the union. I shall take an affirmative part in the business and activities of the Union and accept and discharge my responsibilities during any authorized strike or lockout. I will never discriminate against a fellow worker. I will at all times bear true and faithful allegiance to the International Brotherhood of Teamsters and the Local Union.

Checkoff Authorization and Assignment (where applicable) “I hereby authorize my Employer to deduct from my wages my monthly union dues, initiation fees, transfer fees, reinitiation fees, fines, back dues and assessments owing to Teamsters Local Union No. 120, affiliated with the International Brotherhood of Teamsters, 9422 Ulysses St. NE, #120, Blaine, MN 55434, of which I am a member or about to become a member and direct that such amounts so deducted be sent to the Secretary-Treasurer of said Local Union, for and on my behalf. These deductions are to be made in the following manners:

Initiation fees, reinitiation fees and transfer fees shall be deducted in 4 monthly payments, plus the monthly dues, back dues, fines and assessments calculated as defined below. Dues shall be the greater of the minimum monthly dues established by the International Brotherhood of Teamsters or Teamsters Local Union No. 120 rounded to the nearest whole dollar. This authorization is voluntary and is not conditioned on my present or future membership in the Union.

This authorization and assignment shall be irrevocable for the term of the applicable contract between the Union and Company, 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 Union at least sixty (60) days and not more than seventy-five (75) days before the periodic renewal date of this authorization of my desire to revoke the same.

I subscribe, freely and voluntarily the sum indicated on the previous page each week to DRIVE with the understanding that this voluntary contribution may be used by DRIVE for political purpose, including contributions to support candidate for local, state and federal offices. I understand my right to refuse to contribute without reprisal and that the amounts listed serve merely as suggestions. I am free to subscribe more, less, or nothing, without benefit or disadvantage.

I further hereby authorize and request my employer to deduct from my earnings the sum indicated on previous page each week to be remitted to National DRIVE.

I reserve the right in accordance with the applicable state or federal laws to revoke this voluntary authorization at any time by giving written notice of such revocation to National DRIVE in accordance with such laws or otherwise.

A copy of the DRIVE report is filed with the Federal Election Commission and is available for purchase from the Federal Election Commission, Washington, D.C. 20463. Donation not U.S. tax deductible.