APPENDIX B
NASHTIA FOOD SERVICE
Oo PAYROLL DEDUCTION AUTHORIZATION
at a
Last Name: First Name: MLL:
Address:
Street
City State Zip
Home Phone Cell Phone
Home/Non-School Email Address
School: Date:
TO NASHUA BOARD OF EDUCATION:
| hereby authorize you to deduct UNION dues from my earnings with the next paycheck and continuing
in equal installments in an amount equal to the UNION dues as set by the membership in accordance
with the provisions of the Constitution of the Nashua Teachers’ Union. This amount shall be paid to
the Treasurer of the Nashua Teachers’ Union, Local 1044, AFT, AFL-CIO. This authority shall remain in
full force and effect for all purposes while | am employed in this school system, or until revoked by me
in writing between September 1** and September 15" of any given year.
EMPLOYEE'S SIGNATURE
Return this form to:
Nashua Teachers’ Union
7¢ Taggart Drive
Nashua, NH 03060
Dues, contributions, or gifts to the Nashua Teachers’ Union are not deductible as charitable
contributions for federal income tax purposes. Dues paid to the Nashua Teachers’ Union, however,
may qualify as business expenses, and may be deductible in limited circumstances subject to various
restrictions by the Internal Revenue Code.
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