UFF-FSU-Graduate Assistants United Dues Authorization Form

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United Faculty of Florida - Florida State University - Graduate Assistants United

I authorize the University Board of Trustees, through the University, to deduct from my pay, starting with the first full pay period commencing not earlier than seven (7) days from the date this authorization is received by the University, membership dues and uniform assessments of the United Faculty of Florida in such amount as may be established from time to time in accordance with the constitution and bylaws of the UFF and certified in writing to the Florida State University Board of Trustees by the UFF, and I direct that the sum or sums so deducted be paid over to the UFF.

Dues payments to UFF are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code.

This authorization shall continue until either (1) revoked by me at any time upon thirty (30) days written notice to the University Personnel Office, or (2) the discontinuance of my status within this bargaining unit for more than two consecutive semesters (i.e. Fall-Spring, Spring-Summer, or Summer-Fall).

****UFF-FSU-GAU dues are currently 1% of bi-weekly salary.****

First Name *

Middle Initial *

Last Name *

FSU ID *

This is the prefix to your FSU email. For example, if your email address is "abc14d@ my.fsu. edu" then your FSU ID is abc14d

Non-FSU email address *

GAU must avoid using FSU addresses whenever possible.

Home / Cell Phone Number *

Employing Department *

If Other, please specify

If you don't see your department or program listed above, enter it here.

Campus Office *

Home Address (Local) *

City *

State *

Zip Code *

By checking this box, you agree that you have read the above authorization statement and agree to the terms. Complete your authorization by signing and dating below. *

I agree

Required

Digital Signature - Please type your full name *

Date *

YYYY

Want to do more than just become a member? There are lots of ways to get involved! You can visit our website to learn more, or indicate which roles you're interested in and someone will get back to you soon with more information: fsugau.org/get-involved

Department Representative

Organizing Committee

Bargaining Committee

Political Action Committee

Diversity Committee

Communications Committee

University Action Committee

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