DUES CHECKOFF AUTHORIZATION AND ASSIGNMENT
LOCAL UNION 1095 IS AN AFFILIATE WITH THE LABORERS' INTERNATIONAL UNION OF NORTH AMERICA, AFL-CIO
I do hereby assign to the Southwest Laborers District Council, and affiliated LIUNA Local Union 1095 (affiliates of the Laborers' International Union of North America), and any successors, such amounts from my wages as shall be required to pay an amount equivalent to the initiation fees, readmission fees, and memebership dues of the local union, as may be established for its members from time to time. My Employer, including my present Employer and any future Employer, is hereby authorized to deduct amounts from my wages and pay the same to the local union and/or its authorized representative, in accordance with the collective bargaining agreement in existence between the Union and my Employer.
This authorization shall become operative upon the effective date of each collective bargaining agreement between my Employer and the Union.
This authotization shall be irrevocable for a period of one (1) year, or until termination of the collective bargaining agreement in existence between my Employer and the Union, whichever occurs sooner; and I agree and direct that this authorization shall be automatically renewed and shall be irrevocable for successive periods of one (1) year each, or for the period of any subsequent agreement between my Employer and the Union, whichever is shorter, unless written notice is given by me to my Employer and the local union no more than 20 days and not less than 10 days prior to the expiration of each period of one (1) year, or of each applicable collective bargaining agreement between my Employer and the Union, whichever occurs sooner. For the effective period of this checkoff authorization and assignment, and to the extent permitted by law, furthermore, this checkoff authorization shall continue in accordance with the above renewal and revocation provisions irrespective of my membership in the Union
Union dues and fees are not decutible as charitable contributions for federal income tax purposes. Local dues may qualify as business expenses, however, and may be deductible in limited circumstances subject to various restrictions imposed by the Internal Revenue Service.
AUTHORIZATION FOR REPRESENTATION
I desire to be represented and hereby authorize the Laborers' International Union of North America, and its affiliated Southwest Laborers' District Council and Local Union 1095 thereof to be my collective bargaining agent in matter of rates of pay, wages, fringe benefits, hours of employment and all other conditions of employment. This authorization shall apply to the Employer for whom I am employed or referred to on this date and to all other Employers for whom I may become employed after this date. This authorization is signed by me for the purpose of securing for the Union voluntary recognition and negotiations rights with my employer and with any future Employer. It may be revoked only by me, through written notice to the Union.
