AUTHORITY TO DEDUCT FROM EMPLOYEE’S SALARY/WAGES

To Whom It May Concern: To Whom It May Concern:

In consideration of the loan granted to me by Barbaza Multi-Purpose In consideration of the loan granted to ___________________________
Cooperative in the amount of __________________________ Pesos (Php by Barbaza Multi-Purpose Cooperative in the amount of
_________), I hereby authorized my employer’s Cashier/Disbursing __________________________ Pesos (Php _________), I/We, as Co-
Officer to deduct/collect from my salary every payday, the amount Maker/s hereby authorized my employer’s Cashier/Disbursing Officer
of __________________________ Pesos (Php _________), as payment for to deduct/collect from my salary every payday, the amount of
my monthly obligations to the said Cooperative until the loan __________________________ Pesos (Php _________), as payment for my
including its interests and penalty as the case may be are fully paid. loan amortization of ________________________________ that is due to
the said Cooperative until the loan including its interests and penalty
I prefer the first payment to be done on ________________ and the like
as the case may be are fully paid.
amount every month thereafter broken down as follows:
In case of default, termination or separation from office,
Loan Amortization: Php__________________ I/We further authorized my employer’s Cashier/Disbursing Officer to
Interest: Php__________________ withhold the corresponding amount due to Barbaza Multi-Purpose
Fines, if any: Php__________________ Cooperative from all my moneys, bonuses, retirement and other
Capital Build Up (CBU): Php__________________ benefits.
Savings Deposit: Php__________________ Done this _______________ day of ________________________________
TOTAL: Php__________________ at _____________________________________________________________.

In case of default, termination or separation from office, I

_________________________
further authorized my employer’s Cashier/Disbursing Officer to Signature over Printed Name Of
withhold the corresponding amount due to Barbaza Multi-Purpose The Employee as Co-Maker
Cooperative from all my moneys, bonuses, retirement and other
benefits. _________________________
Done this _______________ day of ________________________________ Signature over Printed Name Of
The Employee as Co-Maker
at _____________________________________________________________.

_________________________ Processed by: _______________________

Signature over Printed Name Of Loans Account Specialist
The Employee as Principal Borrower