FOP Payroll Deduction Authorization FOP Payroll Deduction Authorization Name(Required) First Last Email(Required) Employee #(Required)Address(Required) Street Address City ZIP / Postal Code Department Name(Required)I hereby authorize my employer, THE CITY OF JACKSON, to deduct the following monthly amount from my paycheck for FOP dues and legal aid insurance. This amount will be sent to the Fraternal Order of Police, P.O. Box 2846, Jackson, TN 38302.(Required)This deduction will begin with the first paycheck issued on the following date and will remain in effect until canceled in writing by both me and the FOP.(Required)Witness(Required)Your NameYour NameYour NameYour NameSignature(Required)Your NameYour NameYour NameYour NameDate(Required)
