L. E. 0. Credit Union
Payroll Deduction Authorization
Employee Number
Name
(Please Print)
I hereby authorize the Payroll Department of The Lubrizol Corporation to
Dollars ($
deduct
)
from my pay each payroll period, until further notice from me, and transfer
this amount to the L. E. 0. Credit Union to be credited as follows:
Share Account $
Christmas Club $
Sub Account
$
Other
$
Signature of Member
Date