How To Get Out Of Apwu Union
Counterfoil of Organization Dues From Payroll Withholdings
(See Privacy Act Statment on Contrary)
PART A — Completed past Employee (Please Impress)
1. Employee Name
2. Social Security Number
(Last, Starting time, MI)
3. Postal service Office
Proper name and Country
4. Post Role Finance Number
™
5. Proper noun of Arrangement and Lawmaking
6. Employee's Dues Deduction Ceremony Date
(Run across opposite side for organizations and codes)
seven. I hereby certify that I sent copy 3 of this cancellation to the above
®
named system's national office VIA CERTIFIED Mail
on this
date, _____________________________ , as detect of my intention
to discontinue payroll withholdings. Find must be received within
the required window flow (come across ELM, Chapter 9). Notice to the
______________________________________________________
®
arrangement must be sent by Certified Mail
to organization's
Employee Must Sign & Date
(Mo., 24-hour interval, Year)
national office, as directed in ELM, Affiliate 9.
Office B — Completed by Employing Role
Date Form Received in the Employing Office:
Original and Copy 2 Volition Exist Separated by Processing Center
PART C — Completed past Processing Center
1. Date Course Received
(Mo., Day, Twelvemonth)
two. Arrangement Code
3. Effective Pay Menses — Twelvemonth
4. Engagement Processed
(Mo., Twenty-four hour period, Year)
5. Verified By
(Initials)
6. Form Will Not Be Processed and Is Beingness Returned to the Employee Because:
Non received within the required 20-ten solar day window menstruum (see notice in Part A., no. 7).
Not currently enrolled in the arrangement shown.
Class incomplete. Meet detail __________________.
Explicate:
FOR DDE/DR Utilize
Entered By
P/P
Initials
1188,
PS Form
Apr 2017 (Page i of ii) PSN 7530-01-000-9016
ane – HRSSC/eOPF
Cancellation of Organization Dues From Payroll Withholdings
(See Privacy Act Statment on Reverse)
Part A — Completed by Employee (Please Print)
1. Employee Name
2. Social Security Number
(Concluding, First, MI)
3. Mail Role
Name and Land
iv. Post Office Finance Number
™
v. Name of Arrangement and Code
6. Employee's Ante Deduction Anniversary Date
(Encounter reverse side for organizations and codes)
7. I hereby certify that I sent copy 3 of this counterfoil to the above
®
named organization's national office VIA CERTIFIED Post
on this
date, _____________________________ , as observe of my intention
to discontinue payroll withholdings. Notice must be received inside
the required window period (meet ELM, Chapter nine). Notice to the
______________________________________________________
®
system must be sent by Certified Post
to organization'southward
Employee Must Sign & Date
(Mo., Twenty-four hour period, Year)
national office, as directed in ELM, Chapter ix.
Part B — Completed past Employing Role
Date Form Received in the Employing Office:
Original and Re-create ii Will Be Separated by Processing Centre
PART C — Completed by Processing Center
1. Date Form Received
(Mo., Day, Year)
2. Organization Lawmaking
3. Effective Pay Period — Year
4. Date Processed
(Mo., Day, Year)
five. Verified Past
(Initials)
vi. Grade Will Non Be Processed and Is Being Returned to the Employee Because:
Non received within the required 20-ten day window period (see notice in Part A., no. 7).
Non currently enrolled in the organization shown.
Form incomplete. See particular __________________.
Explain:
FOR DDE/DR USE
Entered By
P/P
Initials
1188,
PS Form
April 2017 (Page 1 of ii) PSN 7530-01-000-9016
1 – HRSSC/eOPF
Privacy Act Statement
Your data will exist used to satisfy your request regarding allotments from your salary. Drove is authorized by 39
The statesC. 401, 409, 410, 1001, 1003, 1004, 1005, 1206, and 29 U.s.C. 2601 et seq.
Providing the information is voluntary, but if not provided, we may not process your request. Nosotros may disclose your
data every bit follows: in relevant legal proceedings; to constabulary enforcement when the U.S. Post (USPS) or requesting
agency becomes enlightened of a violation of constabulary; to a congressional office at your request; to entities or individuals under contract
with USPS (service providers); to entities authorized to perform audits; to labor organizations equally required by police force; to federal,
state, local or foreign regime agencies regarding personnel matters; to the Equal Employment Opportunity Committee;
to the Merit Systems Protection Board or Office of Special Counsel; and records pertaining to supervisors and postmasters
may be disclosed to supervisory and other managerial organizations recognized by the USPS. For more information regarding
our privacy policies, visit www.usps.com/privacypolicy.
Organizations and Codes
Recognized Bargaining Agents
Code Other Labor Organizations
Code
POSTAL Law OFFICERS Clan
C
AMERICAN FEDERATION OF GOVERNMENT
A
PO BOX 5187
EMPLOYEES, AFL-CIO
CHICAGO IL 60680-5187
80 F STREET NW
WASHINGTON DC 20001-1528
NATIONAL POSTAL Professional person NURSES
D
NATIONAL Alliance OF POSTAL EMPLOYEES
East
4502 SPRUCE KNOLL LANE
1628 11TH STREET NW
INDIANAPOLIS IN 46220-6332
WASHINGTON DC 20001-5011
NATIONAL POSTAL MAIL HANDLERS Marriage
H
Supervisory and Managerial Organizations
1101 CONNECTICUT Artery NW SUITE 500
WASHINGTON DC 20036-4304
L
P
NATIONAL ASSOCIATION OF Letter CARRIERS, AFL-CIO
UNITED POSTMASTERS AND MANAGERS OF
100 INDIANA AVENUE NW
AMERICA
WASHINGTON DC 20001-2196
8 HERBERT STREET
ALEXANDRIA VA 22305-2600
NATIONAL RURAL LETTER CARRIERS' ASSOCIATION
R
NATIONAL ASSOCIATION OF POSTAL SUPERVISORS
S
1630 DIKE STREET FL 4
1727 King STREET SUITE 400
ALEXANDRIA VA 22314-3465
ALEXANDRIA VA 22314-2753
Westward
AMERICAN POSTAL WORKERS UNION, AFL-CIO
USPS HUMAN RESOURCES SHARED SERVICE
1300 L STREET NW
CENTER
WASHINGTON DC 20005-4128
PO BOX 970400
GREENSBORO NC 27497-0400
1188,
PS Form
April 2017 (Page 2 of 2)
Cancellation of Organization Dues From Payroll Withholdings
(Come across Privacy Act Statment on Reverse)
Office A — Completed by Employee (Please Print)
1. Employee Proper noun
2. Social Security Number
(Last, First, MI)
3. Post Office
Proper noun and State
four. Post Office Finance Number
™
5. Name of Organization and Code
vi. Employee's Ante Deduction Anniversary Date
(See reverse side for organizations and codes)
seven. I hereby certify that I sent copy 3 of this cancellation to the above
®
named system's national function VIA CERTIFIED Postal service
on this
date, _____________________________ , every bit find of my intention
to discontinue payroll withholdings. Find must exist received within
the required window period (meet ELM, Affiliate 9). Notice to the
______________________________________________________
®
organization must exist sent by Certified Post
to organization's
Employee Must Sign & Engagement
(Mo., Twenty-four hour period, Yr)
national office, as directed in ELM, Affiliate 9.
PART B — Completed by Employing Office
Date Course Received in the Employing Part:
Original and Re-create 2 Will Be Separated by Processing Center
Role C — Completed by Processing Center
ane. Appointment Form Received
(Mo., Day, Year)
ii. System Code
3. Constructive Pay Menses — Twelvemonth
4. Date Processed
(Mo., Day, Year)
v. Verified By
(Initials)
6. Form Volition Non Be Processed and Is Being Returned to the Employee Because:
Non received within the required xx-10 day window catamenia (see notice in Part A., no. 7).
Not currently enrolled in the organization shown.
Class incomplete. See item __________________.
Explicate:
FOR DDE/DR USE
Entered By
P/P
Initials
1188,
2 – Employee's Copy
PS Form
April 2017 (Folio one of 2) PSN 7530-01-000-9016
Privacy Deed Statement
Your information will be used to satisfy your request regarding allotments from your salary. Collection is authorized by 39
U.South.C. 401, 409, 410, 1001, 1003, 1004, 1005, 1206, and 29 United states of americaC. 2601 et seq.
Providing the information is voluntary, but if not provided, we may non process your request. We may disclose your
information as follows: in relevant legal proceedings; to law enforcement when the U.S. Mail service (USPS) or requesting
agency becomes enlightened of a violation of law; to a congressional role at your request; to entities or individuals under contract
with USPS (service providers); to entities authorized to perform audits; to labor organizations as required by law; to federal,
state, local or foreign government agencies regarding personnel matters; to the Equal Employment Opportunity Commission;
to the Merit Systems Protection Board or Office of Special Counsel; and records pertaining to supervisors and postmasters
may be disclosed to supervisory and other managerial organizations recognized past the USPS. For more information regarding
our privacy policies, visit www.usps.com/privacypolicy.
Organizations and Codes
Recognized Bargaining Agents
Code Other Labor Organizations
Code
POSTAL POLICE OFFICERS Clan
C
AMERICAN FEDERATION OF GOVERNMENT
A
PO BOX 5187
EMPLOYEES, AFL-CIO
CHICAGO IL 60680-5187
80 F STREET NW
WASHINGTON DC 20001-1528
NATIONAL POSTAL Professional person NURSES
D
NATIONAL Alliance OF POSTAL EMPLOYEES
Eastward
4502 SPRUCE KNOLL LANE
1628 11TH STREET NW
INDIANAPOLIS IN 46220-6332
WASHINGTON DC 20001-5011
NATIONAL POSTAL Postal service HANDLERS Matrimony
H
Supervisory and Managerial Organizations
1101 CONNECTICUT AVENUE NW SUITE 500
WASHINGTON DC 20036-4304
L
P
NATIONAL Association OF Alphabetic character CARRIERS, AFL-CIO
UNITED POSTMASTERS AND MANAGERS OF
100 INDIANA AVENUE NW
AMERICA
WASHINGTON DC 20001-2196
8 HERBERT STREET
ALEXANDRIA VA 22305-2600
NATIONAL RURAL LETTER CARRIERS' Association
R
NATIONAL Clan OF POSTAL SUPERVISORS
South
1630 DIKE STREET FL four
1727 King STREET SUITE 400
ALEXANDRIA VA 22314-3465
ALEXANDRIA VA 22314-2753
Due west
AMERICAN POSTAL WORKERS Spousal relationship, AFL-CIO
USPS HUMAN RESOURCES SHARED SERVICE
1300 L STREET NW
CENTER
WASHINGTON DC 20005-4128
PO BOX 970400
GREENSBORO NC 27497-0400
1188,
PS Form
April 2017 (Page ii of 2)
Cancellation of System Dues From Payroll Withholdings
(See Privacy Act Statment on Reverse)
Part A — Completed by Employee (Please Print)
ane. Employee Proper noun
ii. Social Security Number
(Last, Starting time, MI)
iii. Post Role
Name and State
4. Post Office Finance Number
™
5. Name of System and Code
6. Employee's Ante Deduction Anniversary Appointment
(Meet reverse side for organizations and codes)
7. I hereby certify that I sent re-create 3 of this cancellation to the above
®
named arrangement'due south national office VIA CERTIFIED Mail
on this
date, _____________________________ , as notice of my intention
to discontinue payroll withholdings. Notice must be received inside
the required window period (see ELM, Chapter 9). Find to the
______________________________________________________
®
organization must be sent by Certified Post
to organization'southward
Employee Must Sign & Date
(Mo., Day, Yr)
national part, as directed in ELM, Chapter 9.
PART B — Completed past Employing Office
Date Form Received in the Employing Office:
Original and Re-create 2 Will Exist Separated by Processing Center
PART C — Completed past Processing Eye
1. Engagement Course Received
(Mo., Day, Year)
two. Arrangement Code
iii. Effective Pay Period — Year
four. Engagement Candy
(Mo., Mean solar day, Twelvemonth)
5. Verified By
(Initials)
6. Class Will Not Be Processed and Is Being Returned to the Employee Because:
Not received within the required twenty-10 day window period (come across notice in Part A., no. 7).
Non currently enrolled in the organization shown.
Class incomplete. Run into item __________________.
Explain:
FOR DDE/DR USE
Entered Past
P/P
Initials
1188,
3 - Organization'southward Re-create
PS Form
April 2017 (Folio 1 of two) PSN 7530-01-000-9016
Source: https://www.templateroller.com/template/1904458/ps-form-1188-cancellation-organization-dues-from-payroll-withholdings.html
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