DEPARTMENT OF EDUCATION

NATIONAL EMPLOYEES’ UNION

(DepEDNEU)
Rm. 306, Dorm E, DepED Complex, Meralco Avenue, Pasig City
DOLE-CSC Registration No. 1737
Accreditation No. 862
CNA Registration No. 162

CHECK-OFF AUTHORIZATION

To: Payroll Services Unit/ Cash Division,

Department of Education
Regional/Division Office No. ____________
Address: _____________________________
Note to the Applicant:
Please sign this AUTHORIZATION
on the pace provided below to
avoid delay in processing of your
application.

I hereby authorize the Department of Education, Payroll Services Unit/ Cash Division to
deduct from my monthly Salary Payroll the amount of __________________________
(P__________) as payment for my semi-annual DepEd-NEU union dues, to start upon approval
of this application for union membership or, upon notice.

___________/____________/_______________ ___________________________________
(Div. No.) (Station. No.) ( Employee No.) (Applicant’s Signature Over Printed Name)

(for internal office use only) Application Approved by:

Application Received by/Date: ____________
Application Form Control No.: ____________
Assigned Identification Card No.: __________ ___________________________________
(Signature Over Printed Name)

_____________________________
(Position)

________________________
(Date)