Get Automatic Dues Payment Form - Union Pacific Railroad Employes

This guide provides step-by-step instructions on how to complete the Automatic Dues Payment Form for Union Pacific Railroad Employes online. The form allows members to authorize automatic deductions for their health systems premiums, ensuring a seamless payment experience.

Follow the steps to complete your Automatic Dues Payment Form efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by filling in your bank information in the designated fields, including the name of your bank and its branch location. Make sure to include the city, state, and zip code.
3. Provide the names of applicants as required along with their Medicare or Social Security numbers and dates of birth in the respective fields.
4. Both applicants must sign the form in the space provided, also including the date they are signing.
5. Indicate your preferred payment option by checking the appropriate box for either monthly or quarterly deductions.
6. Include a voided check to ensure accurate bank account information. This should be attached to the completed form.
7. Review all entered information for accuracy before finalizing your submission.
8. Once completed, save the document, and if necessary, download or print a copy for your records before submitting it as per the instructions provided.

Begin filling out your Automatic Dues Payment Form online today to ensure timely processing of your dues.