I hereby authorize my employer and associated agencies to deduct each pay period the amount certified above as a voluntary contribution to be paid to AFSCME Council 31, P.O. Box 2328, 615 South Second Street, Springfield, IL 62705, to be used in accordance with the by-laws of the PEOPLE Qualified Committee for the purpose of making political contributions. My contribution is voluntary, and I understand that it is not required as a condition of membership in any organization, or as a condition of continued employment, and is free of reprisal, and that I may revoke this authorization at any time by giving written notice.

In accordance with Federal Law, the PEOPLE committee will accept contributions only from members of AFSCME and their families. Contributions or gifts to the PEOPLE Qualified Fund are not tax deductible as charitable contributions for Federal Income Tax purposes.