Staff Salary Deduction Date* DD slash MM slash YYYY Name First Last Total amount*Number of deductions*Please enter a number from 1 to 5.Note that this may be amended by the Employer should the deduction amount be high / the urgency of payment e.g. accident damage excess be required soonerReason for deduction*LoanSalary advanceNegligence i.e. accident damage excessConsent* I agree to the deduction.This serves to confirm that I, the above mentioned staff member, authorise the company to deduct from my salary the amount in equal installments and for reasons as shown above. Δ
