dues check-off crad

Dues Check off Assignment:

Subject to the limitations imposed by the State Laws, I hereby designate as my

collective bargaining representative, Law Enforcement Officers Professional

Association, (L.E.O.P.A.) and authorize and direct my employer to deduct and pay

to it from my wages such amounts for my initiation fees and monthly dues as from

time to time are certified by said labor organization to be due and owing to it as

periodic dues and initiation fees uniformly required by LEOPA, as a condition of

acquiring / maintaining membership therein. Such amounts are to be deducted each

month and to be forwarded to the Secretary – Treasurer of LEOPA

LAW ENFORCEMENT OFFICERS PROFESSIONAL ASSOCIATION

Name *
First Middle Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Date of Birth *
MM / DD / YYYY
Email *
Employer *
Dues Authorization *
I hereby designate L.E.O.P.A. as my collective bargaining representative, and authorize and direct my employer to deduct and pay to it from my wages, any and all initiation fees and monthly union dues.
Signature *
Clear
Today's Date *
MM / DD / YYYY

LEOPA