• Union Dues Deduction Authorization for IAFF Local 3800

    Complete this form to authorize union dues deductions from your pay. I, the undersigned, hereby request and voluntarily authorize the Employer to deduct from my wages or compensation due me, an amount equal to the regular monthly dues uniformly applicable to members of the International Association of Fire Fighters, Local 3800, in accordance with the Constitution and Bylaws of the Union. This amount is currently $98.33 per month and is subject to change as provided for in said Constitution and Bylaws of Local 3800. Further, I agree to a one-time initiation fee which is currently $15. This authorization shall remain in effect and shall be irrevocable unless I revoke it by sending written notice to both the Employer and the Union by registered mail during a period of fifteen (15) days immediately succeeding any yearly period subsequent to the date of this authorization or subsequent to the date of termination of the applicable contract between the Employer and the Union, whichever occurs sooner, and shall be automatically renewed as an irrevocable check-off from year to year, unless revoked as hereinabove provided, irrespective of whether I am a Union member.
  • Format: (000) 000-0000.
  • Date*
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    2 digit month, 2 digit day, 4 digit year
  • PAC Fund Contribution 

    I hereby authorize the Employer to deduct from my pay the sum of $5 per month and to forward that amount to the Local 3800 Political Action Committee. This authorization is signed voluntarily and with the understanding that the Local 3800 Political Action Committee will use this money to make political contributions and expenditures in elections, in accordance with applicable election laws. I am aware of my right to refuse to sign the authorization without reprisal. This authorization may be revoked by mailing notices of revocation by United States Registered Certified Mail, Return Receipt Requested, to:

     

    Secretary/Treasurer

    IAFF Local 3800

    P.O. Box 2012

    Grass Valley, CA 95945 

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