Garbage Payroll

 
 
 
GARBAGE PAYROLL DEDUCTION FORM
 
 
 
UNIT NUMBER          ­­­         ___________________________
EMPLOYEE NAME             ___________________________
BANNER NUMBER            ___________________________
 
 
I hereby authorize the University of the South to deduct my share of the Sewanee Community Garbage Service fee, currently $22.00 per month, effective July 1, 2012 from my pay in equal installments beginning with the first payroll on _______________.
 
The fee is subject to change each fiscal year and I understand that I will be notified prior to July 1st of each year of the amount due for the next fiscal year (July 1 – June 30th)
 
This payroll deduction authorization will remain in force as long as I am eligible to pay by way of payroll deductions.
 
 
____________________________________      _________________
Signature                                                                 Date
 
 
Return completed form to:
 
Laurie Kianka
Rental Housing Administrator
735 University Avenue
Sewanee, TN 37383
 
CC: Debbie Ladd