Employee Deduction – D1 Security and Investigations LLC LIC# C24065501

Employee Deduction Form

Your form has been sent!

I authorize the D1 Security and Investigations LLC to deduct from my pay for uniforms and/or security license fees the following:

Acknowledge (required)

I Agree

Amount due

For the following

These deductions will be deducted in the following terms:

Payment 1

Beginning Balance

Date (YYYY-MM-DD)

Amount of Deduction

Check Number

Balance

Notes

Payment 2

Beginning Balance

Date (YYYY-MM-DD)

Amount of Deduction

Check Number

Balance

Notes

Payment 3

Beginning Balance

Date (YYYY-MM-DD)

Amount of Deduction

Check Number

Balance

Notes

Payment 4

Beginning Balance

Date (YYYY-MM-DD)

Amount of Deduction

Check Number

Balance

Notes

Signature

Date (YYYY-MM-DD)