Staff Salary Deduction Date* DD slash MM slash YYYY Name First Last Total amount*If no amount is available e.g. due to accident damages, please put zero (0) which indicates that an amount is not finalised as quotes may be outstanding from repairersNumber of deductions*Please enter a number from 1 to 10.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 to vehiclesNegligence i.e. other damages or lossOtherSummary of negligence, damages or loss (include RX number for vehicle damages)Consent* 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
