Payroll Deduction Form ← BackThank you for your response. ✨ Agency Name(required) Employee Name(required) Deduction Effective Date(required) YYYY-MM-DD Requested Deduction Amount per Pay Period(required) Payroll Deduction Select an option Salt Lake Valley Police & Fire Memorial Foundation PrintSubmitting form I hereby authorize my employer to make the above deductions from my pay in accordance with the above terms. I understand and agree that I am responsible for satisfying the above amounts. I understand and agree that any amount due or owing upon my termination, regardless of whether my termination was voluntary or not, will be deducted from my last paycheck or any other amounts owed to me. I further understand and agree that deductions will be made after all mandatory taxes and employer programs which I have enrolled, for which I am eligible, or to which I have agreed. Notice to Finance Department – Mail to: Salt Lake Valley Police & Fire FoundationMountain America Credit UnionC/O SL Valley Police & Fire Memorial FoundationPO Box 2331Sandy, Utah 84091Please include reference 0863 Routing #3240 7955 5 Δ Employee Signature Date Share this: Share on X (Opens in new window) X Share on Facebook (Opens in new window) Facebook Like Loading...
Salt Lake Valley Police and Fire Memorial Foundation