Employee Housing Deduction Agreement Form
Use this form to record employee housing details, deduction amount and schedule, and the employee’s agreement to the housing deduction terms.
Employee Details
Employee Full Name
*
First Name
Middle Name
Last Name
Employee Department / Team
*
Job Title / Position
*
Work Location / Site
*
Housing Deduction Details
Housing Type or Accommodation Type
*
Company Housing
Shared Housing
Dormitory
Off-Site Rental
Other
Deduction Amount per Pay Period
*
Deduction Frequency
*
Please Select
Weekly
Biweekly
Monthly
Per Pay Cycle
Deduction Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Deduction End Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Agreement and Authorization
Employee Signature
*
Agreement Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
Should be Empty: