Payroll Deduction Authorisation Form
  1. To have depa membership fees deducted from your pay and sent by your council to us, fill out this form and press 'submit'. The details will be automatically emailed to your payroll office and depa.
  2. Full Name(*)
    Please type your full name.
  3. Work Telephone(*)
    Invalid Input - please type numbers only
  4. Work Email(*)
    Invalid email address.
  5. Current Employer(*)
    Invalid input
  6. Payroll contact name(*)
    Please add the payroll officers name
  7. Payroll Telephone
    Invalid Input - please type numbers only
  8. To the Payroll Officer:
    I authorise you to deduct my depa membership fees until further notice and remit them to depa. Please start deductions from my pay for the period ending:
  9. Invalid Input
     Pay period ending please specify
  10. Deduction Amount(*)
    We need to know your employment status - please select as applicable
     Please select your membership status and fee.
  11. Declaration(*)
    Please tick this to confirm
  12. Security check (*)(*)
    Security check (*)
    Invalid numbers, please try again.
    Please type the numbers below
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