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Get Federal Agencies To Collect Thisinformation

Ect thisinformation. This completed form is used to request that labor organization duesbededucted from yourpayandtonotify yourlabororganization ofthededuction. Completing thisform is voluntary, butit maynotbeprocessed if all requested information is not provided. Thisrecord maybe disclosed outside youragency to: 1)the Department of theTreasury to make proper financial adjustments; 2)a Congressional office if youmake aninquiry tothatoffice related tothisrecord; 3)acourtoranappropriate Governmen.

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