Complete this form for every new job undertaken (even with the same employer). Include the completed authorization form with your other “start paperwork” and initial time card. Keep a copy of the authorization form for your records; you may need it later.

EMPLOYERS:

Include this completed authorization form with the Employee’s “start paperwork” and initial time card that goes to the payroll house. Give a copy of the completed authorization form to the employee and fax a copy to the Union Business Office at 212-977-2011.

• Dues Checkoff Authorization Form