The University

Authorization for Pre - Tax Payroll Deduction

NOTE: "Rates are subject to change"

* Required Fields

I authorize the Department of Parking and Transportation to implement pre-tax deduction from my bi-weekly paycheck for the following choices(s):*

Parking Pass:*

Terms and Conditions:

I understand that this pass allows the owner to access any lot and park in one available legal space. This pass does not allow access when restricted by Public Safety. This pass must be used upon entry and exit, failure to do so may result in a fee. This pass will allow the owner to come and go multiple times in one day without deducting an additional use. All returned checks are subject to fee.

I understand that under State and Federal tax regulations this must be an irrevocable monthly election unless a qualifying event occurs. Qualifying events are defined to include: 1) termination of employment, 2) change of residence, 3) change in work location, or, 4) commencement of a substantial leave of absence, such as Maternity Leave, Family Medical Leave or Sabbatical. In the event that my need for parking or transit passes changes without a qualifying event, I understand that parking deductions will continue at the existing rate until a 30 notice is given to Parking and Transportation. If I discontinue participation in the Program due to a qualifying event, I understand that I must wait until the beginning of a new month to re-enroll.