Rai Boro Uniform Payroll Deduction Agreement
Authorize payroll deductions for the cost of required company uniforms at Rai Boro.
Employee Information
Please provide your details as they appear in company records.
Employee Full Name
*
First Name
Last Name
Payroll Deduction Authorization
Select your preferred deduction method and provide the necessary details.
Items Received
Items Received
Select deduction method
*
One-time deduction from next payroll cycle in the full amount of $155
Installments per pay period
One-time deduction amount (USD) Begins on the first payroll
Installment amount per pay period (USD) until $155.00 is paid in full
Employee Signature
*
Submit Agreement
Submit Agreement
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