Get Payroll Deduction Authorization Form

Filling out the Payroll Deduction Authorization Form online is a straightforward process that enables you to authorize payroll deductions for Group Legal Care. This guide will walk you through each component of the form, ensuring you complete it accurately and efficiently.

Follow the steps to complete your Payroll Deduction Authorization Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your name in the appropriate fields, ensuring to fill in your last name, first name, and middle initial as needed.
3. Input your Social Security number in the designated section. This information is essential for identification purposes.
4. Provide your Employee Payroll Account number in the required field. This helps your employer track your payroll deductions correctly.
5. Indicate your choice of coverage by selecting either 'Individual' or 'Family' for the biweekly premium to be deducted, noting the costs associated with each option.
6. Confirm your selection by checking the applicable option next to 'New Hire' or 'Open Enrollment', depending on your current enrollment status.
7. If you wish to cancel your coverage, indicate this choice in the provided section.
8. Sign the form in the designated signature line to validate your authorization.
9. Enter the date on which you are signing the form, ensuring this reflects the current date.
10. Once you have completed the form, save your changes. You may then download, print, or share the form as needed.

Complete your Payroll Deduction Authorization Form online today to ensure your Group Legal Care enrollment.