I, {name} hereby authorize and direct my employer to deduct from my wages the following assessment and direct such amounts so deducted to be turned over each month to the Secretary/Treasurer of Teamsters Local Union No. 690, for and on my behalf, $0.40 per hour for each and every hour worked for Union Programs.
This authorization and assignment is voluntary and shall be irrevocable for a period of one year from the date hereof or until the termination date of said agreement, whichever is the lesser, without regard to whether or not I am a member of the Union during that period, and I agree that this authorization shall be automatically renewed and irrevocable for successive yearly or applicable contract periods thereafter, whichever is lesser, unless I give written notice to the company and the Union at least sixty (60) days, but not more than seventy-five (75) days before any periodic renewal date of this authorization and assignment of my desire to revoke same. I understand this is voluntary and that under current law, the payments covered by this authorization are not deductible as charitable contributions for federal income tax purposes.