I,   First Name*   Last Name*    hereby authorize and direct my Employer every month to
deduct from my wages all initiation fees, re-initiation or re-instatement fees, membership dues and uniform assessments as required by Teamsters Local Union No. 983, or its legal successor. I further authorize and direct that these monies so deducted be turned over each month to the Secretary-Treasurer of Teamsters Local Union No. 983. 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 a period of one year or until the termination of the applicable collective bargaining agreement, whichever occurs first, and shall thereafter be automatically renewed for successive periods of one year or until the termination of the applicable collective bargaining agreement, whichever occurs first, unless written notice is given by me to my Employer and the Union at least 45 days but not more than 60 days prior to the expiration of each one year period or of the applicable collective bargaining agreement, whichever occurs first.

This authorization and assignment is made pursuant to Section 302 of the National Labor Relations Act, as amended, and is in full force and effect to the extent permitted by the Act. I understand the union dues are not deductible as charitable contributions for Federal income tax purposes.

1.. Have you ever been a member of a Local Union of the International Brotherhood of Teamsters?
ANSWER* If yes, what Local? Location?      

2.. Have you ever applied for admission and been rejected in and Local Union of the International Brotherhood of Teamsters?
ANSWER   *   If yes, what Local?        Location?      

3.. Have you ever been suspended or expelled from a Local of the International Brotherhood of Teamsters?
ANSWER   *   If yes, what Local?      Location?      

4.. Are you willing to take an obligation that will bind you to the International Brotherhood of Teamsters and this Local Union, and that will in no way conflict with your religious beliefs or your duties as a citizen?
ANSWER   *   

I,   First Name*   Last Name*  pledge my honor to faithfully observe the Constitution and Laws of the International Brotherhood of Teamsters, and the by-laws and laws of this Local Union.
I pledge that I will comply with all 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 my 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 pledge not to divulge to non-members the private business of this Union, unless authorized to reveal the same.
I will never knowingly harm a fellow member.
I will never discriminate against a fellow worker on account of race, color, religion, sex, age or national origin.
I will refrain from any conduct that would interfere with the Union’s performance of its legal or contractual obligations.
I will at all times bear true and faithful allegiance to the International Brotherhood of Teamsters and this Local Union.