Payroll Deduction Authorization

Employee*

I voluntarily authorize Horizons HR Services to deduct the following items:

Fees*

$35.00 New Hire Administration Fee Deduction

Please Note: This does not include drug test or background check fees.

Upon termination of my employment or ending of an assignment, regardless of the reason, I hereby authorize any unpaid amounts I may owe to be deducted from my final paycheck.

I understand that these deductions CANNOT drop my minimum hourly wage below the applicable minimum wage amount at any point, including if taken upon termination of employment or ending of an assignment.

Digital Signature*

Date*