Profit Sharing Loan by mbq13451

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									                                 PAYROLL DEDUCTION AUTHORIZATION



This is authorization to

to deduct from my paycheck                                                 *. This is for item number(s):

(circle item number(s))

                                          REPAYMENT OF:

1.         Loan                                     7.          Credit Union


2.         Retirement                               8.          Profit Sharing


3.         Advance on Wages                         9.          Donations to Agencies


4.         Savings                                  10.         Insurance Premiums


5.         Savings Bonds                            11.         Union Dues


6.         Uniforms                                 12.         Other

*This deduction is to be made:


(Check appropriate box)                             One Time Only


                                                    Weekly


                                                    Bi-Weekly


                                                    For                          Weeks




Date:

Employee's Signature

Printed or Typed Name

Project Name

HUD Project Number

								
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