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Payroll Deduction Authorization

Free Printable Payroll Deduction Authorization FormFree Printable Payroll Deduction Authorization Form

This review list is intended to educate you about the subject of this document and to aid you in its preparation. To have these requests signed and placed in the workers’ files is simply good housekeeping. There are several reasons to do so, none of which indicate that it is an issue.


1. Obtain two signatures from the employee, one for their records and one for the files

Payroll Deduction Authorization

I, ___________________, authorize Employer to deduct the following Amount of Deduction, $ _________, from my gross earnings for each payroll period beginning ___________ as detailed below:

This Deduction shall be for:

______________________ Date:
Employee Name
Payroll Deduction Authorization
Review List

This review list is provided to inform you about this document in question and assist you in its preparation. This is simply good housekeeping to get these requests signed and in the employees’ files. There are a host of reasons to do so and none suggesting it is a problem.

1. Have the employee sign two copies, one for their records and one for the files.


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