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Parking Forms
Payroll Deduction
Name of
Employee______________________________________________________
Last First M.I.
Social
Security No.____________________
E-mail______________
Name of Dept.
__________________________________
Room No. (At
Work)_________________
Telephone No. (At
Work)_________________________
The Taxpayer Relief Act of 1997; the
Transportation Equity Act of 1998 (TEA) and subsequent
changes to Section 132 (f) of the Internal Revenue Code
makes HU employees eligible for pre-tax parking payroll
deduction.
Please choose from one of the following
options:
-
I hereby authorize Howard University to
deduct from salaries due me, pre-tax parking fees
currently established at $___________.
To be deducted at $________ per biweekly pay
period. or
-
I hereby authorize Howard University to
deduct from salaries due me, parking fees currently
established at $___________.
To be deducted at $________ per biweekly pay
period.
Payroll deduction will automatically be
enrolled pre-tax if an option is not selected.
I understand that this deduction will become
effective the first full pay period following my parking
registration date. I further understand that this
authorization may be revoked at any time that I cease to use
the parking facilities by filing a written revocation
request and surrendering the permit to the designated
official.
I further understand that interruption of my payroll
deduction by the surrender of my parking permit will not
entitle me to refund of money unless excess funds were
deducted. It is my responsibility to apply for any
refunds due me.
I further understand and agree that if I
receive any parking violations, I have thirty (30) calendar
days after the date of issuance in which to pay the
violation(s). Unpaid violations due in excess of
thirty (30) calendar days will be subject to an additional
ten dollar ($10) fine. If the violation is not paid
within thirty (30) calendar days, the outstanding delinquent
amount (including additional fine) may be deducted from
salaries due me.
Signature of
Employee ________________________ Date________________
DO NOT WRITE BELOW LINE
______________________________________________________________________
Permit # _________ Issued By: _________ Date:
__________
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