Dearborn Federation of Teachers 681 Dues Form

By providing the information on this form, I authorize Dearborn Federation of Teachers - Local 00681 and the American Federation of Teachers (AFT) to deduct dues for membership per the above information and in accordance with the Dearborn Federation of Teachers - Local 00681 constitution, the state constitution and the AFT constitution. Dues payments are not deductible as charitable contributions for federal income tax purposes, but a portion thereof may be deductible as a miscellaneous itemized deduction. The dues amount may change if authorized according to the requirements of the local, state or national constitutions. If this happens, I authorize my bank or credit card to adjust my payment when notified by Dearborn Federation of Teachers - Local 00681. I agree this authorization remains in effect until terminated in writing by me or until Dearborn Federation of Teachers - Local 00681 is given written notification of my separation from my employer and/or the bargaining unit.

PAC DISCLOSURE:I hereby authorize a contribution to the Dearborn Federation of Teachers PAC in the bi-weekly amount indicated above. This authorization is signed freely and voluntarily and not out of any fear of reprisal, and I will not be favored nor disadvantaged because I exercise this right. I understand this money will be used to make political contributions by Dearborn Federation of Teachers PAC. This voluntary authorization may be revoked at any time by notifying Dearborn Federation of Teachers PAC in writing of the desire to do so. Contribution or gifts to Dearborn Federation of Teachers PAC is not deductible as charitable contributions for federal income tax purposes. Contributions cannot be reimbursed or otherwise paid by any other person or entity. Section 55(6) of the Michigan Campaign Finance Act provides that a corporation, a joint stock company, a domestic dependent sovereign, or a labor organization “may solicit or obtain contributions for a separate segregated fund established on an automatic basis, including but not limited to a payroll deduction plan, only if the individual who is contributing to the fund affirmatively consents to the contribution at least once in every calendar year.