Your full name, the network address you are accessing this page from, and the timestamp of submission will serve as signature indicating:
In the event payroll deduction from my employer is not available or is not deemed practical by the Union, I authorize SEIU Local 503 to make withdrawals from my checking or savings account, in accordance with the authorization provided below or to another account I provide and authorize separately. I am authorized to make decisions about the account provided to the Union. SEIU will notify me of the transition to direct pay at the current mailing address on file with SEIU prior to initiating the first payment via debit card, credit card, checking, or savings account, as authorized below.
I hereby authorize SEIU to initiate a recurring, automatic electronic funds transfer with my financial institution beginning on the date listed in the transition notice provided to me in order to deduct from the account listed below (or separately provided) amount of 1.7% of my gross earnings, and issue fund payments at a prorated amount up to $2.75 per month, except that the total minimum deduction shall be no less than $2.30 per pay period and the maximum deduction shall be no more than $150 per pay period. Because the dues deduction is based on a percentage of gross earnings, the dollar amount deducted may change each month based on payroll dates and if my hours of work or rate of pay changes, and I agree to not receive any advance notice before the dues payment is deducted as long as the amount is between $2.30 and $150 per pay period. My authorized deductions shall be made based on the gross pay amount in the paycheck immediately preceding the pay processing date of the current transaction and shall be made one (1) business day after each pay processing date designated by my employer.
The dues amount may change if authorized according to the requirements of the SEIU Local 503 Union Bylaws or the Service Employees International Union Constitution and Bylaws. If this happens, I authorize SEIU to initiate a recurring, automatic electronic funds transfer in the amount of the new dues amount when notified by SEIU in writing of the new amount and with at least ten (10) days’ notice before the next funds transfer date. In the case of checking and savings accounts, adjusting entries to correct errors are also authorized. I agree that these withdrawals and adjustments may be made electronically and under the Rules of the National Automated Clearing House Association. This authorization shall remain in effect until I revoke my authorization in writing or with another permitted method.
I acknowledge that failure to pay my dues on a timely basis may affect my membership standing in the Union, as set forth in the SEIU Local 503 Bylaws. Contributions to SEIU are not tax deductible as charitable contributions. However, they may be tax deductible as ordinary and necessary business expenses.