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Ed States Code (Allotments and Assignments of Pay) permits Federal agencies to collect this information. This completed form is used to request that labor organization dues be deducted from your pay and to notify your labor organization of the deduction. Completing this form is voluntary, but it may not be processed if all requested information is not provided. This record may be disclosed outside your agency to: 1) the Department of Treasury to make proper financial adjustments; 2) a Congressio.

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