1. No category

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[Optional]
- Save via Fayroll Deduction
lf you are employed by Chadd Housing, Dudley College, Dudtey Group of Hospitals,
Dudley & Walsall Mental Health Partnership, Dudley MBC, West Midlands A,mbulance Service or
Worcestershire Acute Hospitals NHS Irusf.
Employee Name
Payroll number
Credit Union membership Number
To the Payroll Office:
* ,
Please commence deductions of
from my salary in favour of Casile & Crystal Credit
Union. Deductions to commence from the first available pay date and shall remain in effect until
such time as castle & crystal gives notice intrriting of any changes.
UI
I hereby authorise the following changes to my previous payroll deduction:
TOTAL Monthly Deduction of
t
tt
Starting from *
" This should be your next pay date.
I understand that the above changes will commence by the start date indicated or as near to that
date as possible, but not before.
Signed
Date
Office Use Onlv
:
Payrol! Deduction
Holiday€
Split
€
.,Member/Junior_€_
Regular
Xmas
DMBc
t]
Dudrey couese
E
DWMH
DGoH
i-_l
chadd
[-l
wMAS
t]
€_
,
wAHr E
Date faxed/posted/emailed:
Prcjed Pad-Financed
by*e EuDrean Union
P-s+"d,,tsv
Eutupean negional
Dev6aopm6ftt Fund