Payroll Deduction Authorisation

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(*)

Invalid Input - please type numbers only

Work Email(*)

Invalid email address.

Current Employer(*)

Invalid input

Payroll contact name(*)

Please add the payroll officers name

Payroll E-mail(*)

Invalid email address.

Payroll Telephone

Invalid Input - please type numbers only

To the Payroll Officer:
I want the above amount, or any other amount as advised to the Council by depa to be deducted from my pay by my employer and remitted to depa. Please start deductions from my pay for the period ending:

Invalid Input

Deduction Amount(*)

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

(*) 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

Payroll Deduction Authorisation Form

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