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I authorized every employer for whom I may at any time work to deduct from my wages each week for each hour worked by me, such sum as is at the time in effect as the Union's hourly working dues. Said deduction shall represent the working field dues payable by me to the International Association of Heat and Frost Insulators and Asbestos Workers, Local23, Harrisburg Pennsylvania.

At such times as there are changes in the hourly working field dues, I acknowledge that such changes, after being duly authorized by the Local Union, shall be communicated in writing to the employers at which time the employers shall be obligated to alter the amount of the field dues deducted in accord with the altered amount authorized by the Local Union.

In the event I am not a member of the Local Union, I authorized employers for whom I am at any time working to deduct from my wages each week for each hour worked by me, such sum per hour as may be in effect as a service charge to represent my interests. Said service charge is of a lesser hourly amount than the working field dues, but in the event the employer does not desire to have different levels of deduction up to the same amount as would be deducted for working field dues in view of the Union's representation that on a quarterly basis any differential owed to me will be returned by the Union. I recognize that said amount is not dues but is a service charge which I am obligated to pay because of the Union's acting on my behalf in providing me with representation necessary to secure my wages, hours and working conditions.

I direct that the amounts so deducted shall be sent to Local 23 pursuant to arrangements mutually agreed to between Local 23 and the Pennsylvania Insulation Contractors Association for the receipt by Local23 of the working field dues or service charge deducted by all employers pursuant to the authorization contained in this Check Off Authorization.

Because of the irregular nature of my work for one or more of the employers, this Check Off Authorization shall be deemed applicable to all such employers by whom I may be employed pursuant to the terms of a collective bargaining agreement between said employer and employers and Local 23.

This Check Off Authorization shall be irrevocable for a period of one (1) year from the date of its execution or until the termination date of the collective bargaining agreement between Local 23 and said employer or employers, whichever occurs sooner. It shall thereafter renew itself for similar successive period of one (1) year or the termination date of the collective bargaining agreement, whichever is sooner, unless and until upon or before the thirtieth (30th) day prior to any such anniversary date I give to my employer or employers and Local 23 notice in writing by certified mail to discontinue said deductions.

It is understood that until any employer remits the money deducted as aforesaid to Local 23, said employer shall hold the same as trustee of such funds for Local 23.

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