Payroll Pick-Up Authorization Form
Payroll Pick-Up Authorization Form
ILA Local 1423
Please fill below
I, ________________________________, payroll ID #__________________ give permission and authorize, ___________________________________, to pick up my paycheck/direct deposit voucher(s).
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.
Date
Date
/
MM
/
DD
YYYY
*Only one (1) person can be authorized per worker.