COLLECTIVE BARGAINING AGREEMENT Between NEW YORK UNIVERSITY And LOCAL ONE SECURITY OFFICERS UNION
July 1, 2001 - June 20, 2006

APPENDIX F

AUTHORIZATION FORM

To:___________________________ Date:____________________

You are hereby authorized and directed to deduct an initiation fee from my wages or salary as required by Local One Security Officers Union, as a condition of my membership and in addition thereto, to deduct each month my monthly membership dues from my wages or salary; and to remit all such deductions so made to Local One Security Officers Union, no later than the tenth day of each month immediately following the date of deduction or following the date provided in the Collective Bargaining Agreement for such deductions.

This agreement is a voluntary act on my part and shall be irrevocable for a period of one (1) year or until the termination date of the Collective Bargaining Agreement, whichever is sooner, and shall, however, renew itself from year to year unless the employee gives written notice addressed to Local One Security Officers Union @ 122 Waverley Place, New York, NY 10011 at least 15 days prior to any termination date of the revocation of this authorization.

Name:_____________________________

Address:___________________________

__________________________________

Soc. Sec. #________________________

Signature:_________________________

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