Payroll Deduction Authorisation Form

Use this form to authorise credit union deductions to be taken directly from your payroll.

You can have as much as you like deducted from payroll.
Your total savings limit is £50,000

STAFF PROCESSING INSTRUCTIONS

1. Ensure that all details match the those on the member's account
2. Send a text to the member confirming that a change to payroll form has been received
3. Action the change to payroll
4. download pdf and import to scanned documents
Name Name First Last
Date of birth Date of birth / DD / MM YYYY
Unit Number

found on the front of your payslip next to your name
Employee Number
Credit Union Membership Number
Mobile Phone
Payroll Authorisation

I, the above named hereby authorise BAE SYSTEMS (OPERATIONS) LTD to *Make / Cease,
deductions from my Salary, to the First Rate Credit Union Ltd.
Please pay the following sum to my credit union account monthly and until further notice. £ Pounds . Pence
enter the monthly amount, or 0.00 to stop payments
Starting from Starting from / DD / MM YYYY

Enter your next monthly pay date. we will commence deduction from this date (or the next available date if payroll cut-off has passed)
Legal section

read the information below and, when agreed, check the boxes, sign and submit
I agree to the First Rate Credit Union Ltd inquiring with BAE SYSTEMS that I am an employee of BAE SYSTEMS LTD. and setting up the payroll deductions as instructed.
I agree to First Rate Credit Union Ltd and BAE SYSTEMS sharing such personal data as may be required to operate my accounts and collect any outstanding loans with the First Rate Credit Union Ltd.

I agree to the First Rate Credit Union Ltd inquiring with BAE SYSTEMS that I am an employee of BAE SYSTEMS LTD. and setting up the payroll deductions as instructed.
I agree to First Rate Credit Union Ltd and BAE SYSTEMS sharing such personal data as may be required to operate my accounts and collect any outstanding loans with the First Rate Credit Union Ltd. I agree
I understand and agree that where a payroll deduction instruction includes repayments on a payroll loan, I may not reduce the deduction below the level of repayments on the loan agreement.

I understand and agree that where a payroll deduction instruction includes repayments on a payroll loan, I may not reduce the deduction below the level of repayments on the loan agreement. I agree
Name Name First Last
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Payroll Deduction Authorisation Form

Payroll Deduction Authorisation Form

STAFF PROCESSING INSTRUCTIONS

Payroll Authorisation

Legal section