AUTHORIZATION
FOR VOLUNTARY PAYROLL DEDUCTION
I, hereby authorize
(Print employee’s name)
to deduct from my wages
(Employer)
for:
(reason for the deduction)
the sum of PhP , beginning and ending
(Amount) (Date) (Date)
until the total amount of PhP has been deducted.
(Amount)
I am authorizing this voluntary deduction in exchange for the good/service I have
received from the said transaction. In the event my employment ends for any reason
before the final deduction is made, the entire balance:
may, or;
may not be deducted from my final wages.
(Employee’s Signature) (Date signed)