Uniform Deduction form

Uniform Deduction form
I herby authorize ParCou LLC to deduct from my wages for 2 uniform shirts, 1 badge and background report. The total of $50.00 will be deducted from my first paycheck.
Name*

First NameLast Name
Job Site*
Size*

MediumLargeX LargeOther
Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Should be Empty: