STORE: _______________________ AUTHORITY TO DEDUCT

To Whom It May Concern: Control No.

I hereby authorize PEOPLE SERVE MULTI PURPOSE COOP. (Company) to deduct from my salary with details as follows:

Amount: PHP Reference Document:

Reason for Deduction: Other Relevant Details:
Purchase Losses
Damages Penalty
Others:

I understand and acknowledge the deduction may not be made if I have insufficient income during a pay period.
I understand and acknowledge dues such as Income Tax and Government Contribution Payments take priority over these deductions.
I understand deductions may not take effect during the current payroll cycle.
I will not hold the Company liable for any deductions that are not made.
In the event my employment ends for any reason before the final deduction is made, the entire balance shall be deducted from
my final pay.

For Office Use Only Validation Authorized by: _________________________________________

Deduction per Payout Printed (Full) Name and Signature
Number of Payouts
Deduction Start Date Date
Credit Funds To

Submit signed form in 2 copies

------------------------------------------------------------------------------------------------------------------------------------------------

STORE: _______________________ AUTHORITY TO DEDUCT

To Whom It May Concern: Control No.

I hereby authorize PEOPLE SERVE MULTI PURPOSE COOP. (Company) to deduct from my salary with details as follows:

Amount: PHP Reference Document:

Reason for Deduction: Other Relevant Details:
Purchase Losses
Damages Penalty
Others:

I understand and acknowledge the deduction may not be made if I have insufficient income during a pay period.
I understand and acknowledge dues such as Income Tax and Government Contribution Payments take priority over these deductions.
I understand deductions may not take effect during the current payroll cycle.
I will not hold the Company liable for any deductions that are not made.
In the event my employment ends for any reason before the final deduction is made, the entire balance shall be deducted from
my final pay.

For Office Use Only Validation Authorized by: _________________________________________

Deduction per Payout Printed (Full) Name and Signature
Number of Payouts
Deduction Start Date Date
Credit Funds To Payroll

Submit signed form in 2 copies