IATSE Political Action Committee Payroll Deduction Authorization Form
Dear IATSE Member:
Your union IATSE works for you on many levels, but by law your dues cannot be used to contribute to federal candidates. However, your
Union (like most unions and large companies) sponsors a separate Political Action Committee (PAC) for this purpose which is funded by voluntary
donations. Such a committee allows a union to amass small contributions from many members into a large campaign contribution which can really
make a difference.
Our PAC only supports candidates standing behind issues of importance to IATSE members in their workplace, not extraneous social
issues. Our next President will be appointing one or more Justices to the Supreme Court, a court which regularly impacts employees’ rights on
issues of safety, overtime pay, organizing and non-discrimination. The Senate plays a critical role in the appointment of judges at all levels of our
federal courts who have similar impact upon employees and unions. A new Congress can do much more to stop non-union employers from
unfairly taking work away from signatory employers and IATSE members.
Most members donate to our PAC through the convenience of having a small sum deducted from each paycheck: below is a payroll
deduction form for your use. Please give as generously as your circumstances allow. Feel free to contact your Local Union with any questions about
our PAC. Thank you for your support.
Sincerely,
Matthew D. Loeb
President
If you wish to authorize a payroll deduction for purposes of making a voluntary contribution to the IATSE-PAC, please complete the form below.
I, the undersigned, do hereby authorize my Employers and/or their payroll services (“Employers”) to deduct the amount designated below from
my paychecks and to remit such amount to the International Alliance of Theatrical Stage Employees Political Action Committee (hereinafter “IATSEPAC”). Such deduction shall be made only if sufficient funds remain after all withholdings and statutory and/or court-ordered deductions have been
made.
Choose one:
☐
I authorize a deduction of $__ per pay period.
☐
I authorize a one-time deduction of $____.
Print Name: _______________________________________________
Social Security Number: __________________________________
Mailing Address: ___________________________________________
City: __________________________ State/ZIP: ______________
Email: __________________________ Local Union Number: _______
Phone Number: ________________________________________
Check this box if working
Occupation: _____________________ Name of Current Employer & Production: ____________________________ on a commercial ☐
This authorization is made voluntarily with the specific understanding that:
•
I am an IATSE member and a U.S. citizen or permanent resident. I am not providing services to the employer through a loan-out corporation.
The signing of this authorization form and the making of contributions to the IATSE-PAC are not conditions of membership in the union nor of
employment with Employer, and I may refuse to so do without fear of reprisal. I am making a voluntary contribution to fund-raising efforts
sponsored by the IATSE-PAC. The IATSE-PAC will use my contributions for political purposes, including, but not limited to, the making of
contributions or expenditures on behalf of candidates for federal office, and addressing political issues of public importance.
•
Contributions or gifts to the IATSE-PAC are not deductible as charitable contributions for federal income tax purposes.
•
Federal law requires the IATSE-PAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the
employer of individuals whose contributions exceed $200 in a calendar year.
Employee Signature: ________________________________________
Date: _____________________________________________________
RETURN THE PINK COPY TO YOUR EMPLOYER. SEND THE BLUE COPY TO: IATSE-PAC c/o PAC SERVICES, 150 Post Office Road, #2398, Waldorf, MD
20604 OR EMAIL A COPY TO THEM AT [email protected]; SEND THE YELLOW COPY TO YOUR LOCAL, AND KEEP THE WHITE COPY FOR
YOUR RECORDS.
[This form solely for use with non-AMPTP employers].