ACTIVE BALLOT CLUB
I AUTHORIZE the above amount to be remitted to UFCW Local 7R ABC, at such time and in such manner as may be agreed upon by my employer named above and UFCW Local 7R. Also, I UNDERSTAND that this authorization is voluntarily made and that the amount suggested as a contribution is a guideline and that I may contribute more or less than this amount by any lawful means, other than checkoff, or may refuse to contribute at all. I UNDERSTAND that the making of payments to the UFCW Local 7R ABC is not a condition of membership in the Union or a condition of employment and that I have the right to refuse to sign this authorization and not contribute to the UFCW Local 7R ABC without reprisal. In addition, I UNDERSTAND that my contribution will be used for political purposes, including the support of candidates for federal, state and local elections, including the support of candidates for public office. I UNDERSTAND that I expressly reserve the right to revoke this authorization at any time in writing. Lastly, I UNDERSTAND that contributions or gifts to the UFCW Local 7R Active Ballot Club are not deductible as charitable contributions for federal tax purposes.