AUTHORITY TO DEDUCT FROM SALARY

TO:  THE SALARIES OFFICE, The University of New South Wales
	(Fax Number: 9385–1420, Internal Fax Extension 51420)

FROM:
 
Payroll Number (Staff Number)	Family Name	Other Names

Title (Mr/Mrs/Miss/Ms)
	Department/School/College

Home Phone No.
	Work Phone No.

	
I hereby authorise and direct you to deduct from my salary the amount of $10.00 (ten dollars) each fortnight and pay the amount so deducted to:

Bank:			Commonwealth Bank
Branch:			University of New South Wales 
BSB:			062-303 
Account No:	10634176 
Account name: 	Campus Cats NSW

Deductions are to commence from the first pay period after acceptance by you of this authority and are to continue until revoked or varied by me in writing.

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                Date             							Signature