Dues Authorization Form

Union Dues Authorization Form

Palm Bay Professional Firefighters - Local 2446
Name

First Name Last Name
Please Read the Following and Sign Below

I {name} hereby authorize the City of Palm Bay and the Palm Bay Professional Firefighters, Local 2446 to deduct union dues from my paycheck in the amount of 1.6% (one point six percent) of my base salary plus per-capita payments to the IAFF, FPF and AFL-CIO on a monthly basis.

*Monthly Union Dues are deducted over the course of two seperate bi-weekly paychecks.
Signature *
Today's Date *

Month Day Year
Today's Date
Should be Empty:

Union Dues Authorization Form