PAC Form

PAC Authorization Form

Palm Bay Professional Firefighters - Local 2446
Name

First NameLast Name
I {name} hereby give authorization to the Treasurer of IAFF Local 2446 to direct five dollars ($5.00) per month of my current monthly union dues, into a PAC Account for political purposes. I understand this option is my decision and that I may opt out of this by not signing the form. I understand that this option will not be an increase of any kind to my union dues.
Signature*
Today's Date*

MonthDayYear
Today's Date
Additional Extra Deduction for PAC

In addition to the above, I voluntarily request that the Treasurer of Local 2446 increase my current dues by Five Dollars per month. This voluntary increase will be deposited into the Local 2446 PAC Account.

I understand that by signing below and submiting this form will result in a dues increase of $5.00 per month in addition to my regular monthly dues and per capita payments.

If you do not wish to do this, please simply type "NO" in the signature box below.
Signature*
Today's Date*

MonthDayYear
Today's Date
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PAC Authorization Form