Membership Application

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Local 483 Application

First Name

Last Name

Address

Zip

City

State

County

Home Phone

Cell Phone

Date of Birth

Social Security Number

Name of Employer *

Department/Bureau *

Worksite

Work Group

Position

Membership or Employment Type *

Local Union No. 483, affiliated with the LABORERS’ INTERNATIONAL UNION OF NORTH AMERICA

I do hereby assing to Local 483 Laborers' International Union of North America, such amounts from my wages as shall be required to pay an amount equivalent to the initiation fees, readmission fees, membership dues, and related assessments, as the Union may establish from time to time.

My Employer is hereby authorized to deduct such amounts from my wages and pay the same to the Local Union and/or its authorized representative.

To the extent permitted by law, this authorization shall become effective upon its execution. This authorization shall be irrevocable for a period of one (1) year, or until termination of the Collective Bargaining Agreement in existence between my Employer and Union, whichever occurs sooner. I agree and direct that this authorization shall be automatically renewed and shall be irrevocable for successive periods of one (1) year each, or for the period of any subsequent agreement between my Employer and Union, whichever shall be shorter, unless written notice is given by me to my Employer and Union not more than twenty (20) days and not less than ten (10) days prior to the expiration of each one (1) year period, or of each Collective Bargaining Agreement between my Employer and Union, whichever occurs sooner. This check-off authorization shall continue irrespective of my membership in the Union or any union-security clause or obligation contained in the Collective Bargaining Agreement.

Union dues are not deductible as charitable contributions for federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code. Union dues may qualify as business expenses, job-related expenses, or other “unreimbursed employee expenses” to the extent permitted by the Internal Revenue Service.

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