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Voluntary Payroll Deduction Authorization Form: Today's Date: Effective Date: Employer Name: Employee Name

Michael Angelo Galicia authorized a voluntary payroll deduction of $500 from his salary at Primus@Knowledge Specialists effective April 12, 2019. He agreed that any outstanding amount owed at the end of his contract would be deducted from his final paycheck, and that his employer could retain his entire final paycheck if needed to satisfy the amount due. The form was missing the company ID for the specified salary deduction.

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aprille anne
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264 views1 page

Voluntary Payroll Deduction Authorization Form: Today's Date: Effective Date: Employer Name: Employee Name

Michael Angelo Galicia authorized a voluntary payroll deduction of $500 from his salary at Primus@Knowledge Specialists effective April 12, 2019. He agreed that any outstanding amount owed at the end of his contract would be deducted from his final paycheck, and that his employer could retain his entire final paycheck if needed to satisfy the amount due. The form was missing the company ID for the specified salary deduction.

Uploaded by

aprille anne
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Voluntary Payroll Deduction Authorization Form

Today’s Date: 04 / 12 / 2019

Effective Date: 04/12/2019

Employer Name: Primus@Knowledge Specialists.

Employee Name: Michael Angelo Galicia

Type of Deduction Total Requested Amount Deduction

Salary Deduction 500.00 Missing company ID

I hereby authorize my employer to make the above deductions from my pay in accordance with the
above terms. I understand and agree that I am responsible for satisfying the above amounts. I understand
and agree that any amount that is due and owing at the time of my end of contract,will be deducted from
my last paycheck or any other amounts that may be owed to me. This authorizes my employer to retain
the entire amount of my last paycheck in compliance with the law.

Employee Signature: Date: 04 / 12 / 2019

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