Wage Deduction Authorization Form

I understand and agree that the Adult Education Center, may deduct money from my pay for reasons that fall into the following categories:

 My share of the premiums for the Adult Education Center’s dental, vision, and supplemental insurance plans.

 Any contributions I may make into a retirement plan sponsored, controlled, or managed by the Adult Education Center.

 If I receive an overpayment of wages for any reason, repayment of such overpayments to the Adult Education Center.

 The cost to the Adult Education Center of personal long distance calls I may make on the Adult Education Center phones or on Organization accounts, of personal faxes sent by me using the Adult Education Center’s equipment or accounts, or of non-work related access to the Internet or other computer networks by me using the Adult Education Center’s equipment or the Organization accounts.

 The cost of repairing or replacing any Organization supplies, materials, equipment, money, or other property that I may damage (other than normal wear and tear), lose, fail to return, or take with appropriate authorization from the Adult Education Center during my employment.

 The reasonable cost or fair value, whichever is less, of meals, lodging, and other facilities furnished to me by the Adult Education Center in connection with my employment.


I agree that the Adult Education Center may deduct money from my pay under the above circumstances, or if any of the above situations occur, on a semi-monthly basis as long as the deduction would not cause the amount received after the deduction to fall below the minimum wage level.
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