Payroll Deduction Authorisation

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Payroll Deduction Authorisation Form

To have depa membership fees deducted from your pay and sent by your council to us, fill out this form and press 'submit'. The details will be automatically emailed to your payroll office and depa.
Full Name(*)

Please type your full name.
Work Telephone(*)

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Work Email(*)

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Current Employer(*)

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Payroll contact name(*)

Please add the payroll officers name
Payroll E-mail(*)

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Payroll Telephone

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To the Payroll Officer:
I authorise you to deduct my depa membership fees until further notice and remit them to depa. Please start deductions from my pay for the period ending:
Invalid Input

Pay period ending please specify
Deduction Amount(*)

We need to know your employment status - please select as applicable

Please select your membership status and fee.
(*) Mandatory field
Declaration(*)

I want the above amount to be deducted from my pay by my employer and remitted to depa.
Please tick this to confirm
Security check (*)

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Please type the numbers below