If the due date of the above selected pay date has passed prior to my election/submission of this form, I fully understand that the deduction amount will be made from the next available pay date stated above.
I fully understand that no refunds or deletions can be made after my authorization has been submitted via this form.
I understand and agree that I am responsible for satisfying the above amounts. I further understand and agree that deductions will be made after any mandatory taxes as well as for any employer programs in which I have enrolled, for which I am eligible, of to which I have agreed.
I understand and agree that any amount that is due and owing at the time of my termination, regardless of whether my termination was voluntary or not, will be deducted from my last paycheck or any other amounts that may be owed to me. This authorizes TRA Medical Imaging to retain the entire amount of my last paycheck in compliance with the law.