Naps Form Authorization For Deduction Of Dues

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UNITED STATES POSTAL SERVICE
NAPS FORM 1187
AUTHORIZATION FOR DEDUCTION OF DUES
Rev. April 2011
PLEASE PRINT LEGIBLY
Converting from Direct Pay to Dues Withholding
PLEASE PRINT LEGIBLY
EMPLOYEE INFORMATION
(All information required)
EMPLOYEE’S NAME (Last, First, Initial) ____________________________________________________, _______________________________________, ________
STREET ______________________________________________________________________________________________________________________________
(Home Address Only – DO NOT USE WORK ADDRESS)
CITY ____________________________________________________________________STATE ____________ ZIP+4 ______________________--- _____________
_
_
SOCIAL SECURITY NUMBER
(Required)
(Required)
_
-
USPS EMPLOYEE ID NUMBER
(Required)
FINANCE NUMBER AS LISTED ON PAY STUB
NON-GOVERNMENT EMAIL (Optional)
HOME PHONE (Optional)
_
_
@
I hereby authorize the United States Postal Service (USPS) to deduct from my pay each pay period the amount certified below as the regular dues of the National
Association of Postal Supervisors (NAPS), which includes a yearly subscription for The Postal Supervisor magazine as part of the membership dues, and to remit
such amounts to that organization in accordance with its arrangements with USPS. I further authorize any change in the amount to be deducted which is certified by
NAPS as a uniform change in its dues structure.
I understand that this authorization will become effective the pay period received by the HR Shared Service Center (HRSSC), PO Box 970400, Greensboro, NC
27497-0400 or following pay period. I further understand that my dues may only be canceled either by separation from the USPS or by using USPS PS
Form 1188, Cancellation of Organization Dues from Payroll Withholdings, and that I may revoke this authorization at any time by filing the original of
such a revocation form with the USPS HRSSC, PO Box 970400, Greensboro, NC 27497-0400. PS Form 1188 is available on the USPS Intranet on the
st
st
Forms page. Such revocation will not be effective however until the first full pay period following March 1
or September 1
of any calendar year,
whichever date first occurs after the PS Form 1188 is received in the HRSSC. (See ELM Section 925 for full explanation of Cancellation of Dues
Withholding guidelines.) Additional information may be obtained by calling HRSSC at 1-877-477-3273 option 5.
Dues to the National Association of Postal Supervisors are not deductible as charitable contributions. However, they may be tax deductable as ordinary and
necessary business expenses.
___________________________________________________________________
___________
SIGNATURE OF EMPLOYEE, POST OFFICE TITLE AND LEVEL
DATE
S
NATIONAL ASSOCIATION OF POSTAL SUPERVISORS
BRANCH NUMBER or STATE _________________
I hereby certify that the regular dues of this organization for the above named member are currently established at $______.___ per pay period.
________________________________________________ Title _________________________________
_____________
SIGNATURE AND TITLE OF BRANCH OFFICER
DATE
(required)
NAPS SPONSOR
PLEASE PRINT LEGIBLY
(If applicable – all information required)
SPONSOR’S NAME __________________________________________________________________________ BRANCH # ______________
ADDRESS _________________________________________________________________________________________________________
CITY _________________________________________________________ STATE ___________ ZIP+4 _________________ -- __________
ORIGINAL AND ONE COPY – SEND TO NAPS HEADQUARTERS, 1727 King St, STE 400, Alexandria, VA 22314-2753
RETAIN ONE COPY FOR BRANCH RECORDS
GIVE ONE COPY TO EMPLOYEE

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