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I hereby apply for or reaffirm my membership in the State Marshal Association of Connecticut AFSCME Local 2193 (hereafter the “Union”) and I agree to abide by its Constitution and Bylaws. Effective immediately, I hereby voluntarily authorize reoccurring payment in the amount of dues certified by the Union, and as they may be adjusted periodically by the Union, and to authorize my payment method to be charged such amount monthly by the Union. In the event my payment method is declined when my dues are charged, I authorize the charge of any past due amounts to any updated payment method I make for the purpose of paying my dues.  This voluntary authorization and assignment shall remain in effect, regardless of whether I am or remain a member of the Union for a period of one year from the date of execution, and for year to year thereafter unless I give the Union written notice of revocation not more than ten (10) days before and not more than twenty (20) days after the end of any yearly period. I recognize that my authorization of dues charges, and the continuation of such authorization from one year to the next, is voluntary and is not a condition of my appointment as a marshal. This authorization and assignment shall remain in effect even if I am suspended or on voluntary inactive status and I am later placed back on active status. Dues payments may cease upon retirement or resignation as marshal, provide the union is notified within thirty days of such change of status. Payments to the Union are not deductible as charitable donations for federal income tax purposes. However, state law may extend favored tax treatment.

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