MEMBERSHIP AUTHORIZATION & DUES DEDUCTION/CHECKOFF AUTHORIZATION FORM

MEMBERSHIP & DUES DEDUCTION/CHECKOFF AUTHORIZATION: I hereby request and voluntarily accept membership in the Connecticut Police & Fire Union (CPFU) and I agree to abide by its Constitution and By-laws. I authorize CPFU to act as my exclusive representative in collective bargaining over wages, benefits, and other terms and conditions of employment with my employer. I hereby request and voluntarily authorize my employer to deduct from my earnings and to pay over to the Connecticut Police & Fire Union (CPFU) / Protective Services Employees Coalition, IAFF / IUPA, AFL-CIO an amount equal to the regular monthly dues uniformly applicable to members of CPFU and its affiliates. This authorization shall remain in effect and shall be irrevocable unless I revoke it by sending written notice via U.S. Mail to both the employer and CPFU during the period not less than thirty (30) days and not more than forty-five (45) days before the annual anniversary date of this agreement, or the date of termination of the applicable contract between the employer and CPFU, whichever occurs sooner. This authorization shall be automatically renewed as an irrevocable check-off from year to year unless I revoke it in writing during the window period, even if I have resigned my membership in CPFU.