Wage Deduction Authorization Agreement Sample

Wage deduction authorization is an agreement between an employer and its employee that allows the employer to deduct a certain amount of money from the employee`s wages to cover a particular debt or obligation. This agreement can provide a convenient and efficient way for employees to manage their finances and debts. However, it is essential to ensure that the agreement is legally binding and enforceable. That is why it is crucial to have a sample agreement that outlines the terms and conditions of the wage deduction authorization.

Here is a sample wage deduction authorization agreement that can be customized to suit the specific needs of your organization:


This agreement is made between [Employer`s name] and [Employee`s name] on [date], and it is effective from [date].

1. Purpose

The purpose of this agreement is to authorize [Employer`s name] to deduct [amount in figures] from [Employee`s name] wages, payable on [payroll frequency], for [purpose of deduction, e.g., repayment of a loan, insurance premium, child support or garnishment order, etc.]

2. Authorization

[Employee`s name] authorizes [Employer`s name] to deduct the above amount from his/her wages until the debt or obligation is fully paid off. The authorization will remain in effect until [date of completion of the deduction], or until [Employee`s name] revokes it in writing.

3. Termination

[Employee`s name] may terminate this authorization at any time by submitting a written request to [Employer`s name], provided that all outstanding debt or obligation has been fully paid off.

4. Revocation

[Employee`s name] may revoke this authorization at any time by submitting a written request to [Employer`s name] before the payroll cutoff date. However, revocation will not be effective for that pay period and any deductions made before revocation will not be refunded.

5. Exceptions

[Employer`s name] shall not be responsible for any deductions that are not made due to error, malfunction, or other circumstances beyond its control. Also, [Employee`s name] shall not assign or transfer this agreement to any other party.

6. Notification

[Employer`s name] shall provide [Employee`s name] with a written notice of any changes to the amount, frequency, or termination of the deduction before the payroll cutoff date.

7. Governing Law

This agreement shall be governed by the laws of [state]. Any dispute arising out of or related to this agreement shall be resolved through arbitration in accordance with the rules of the American Arbitration Association.

IN WITNESS WHEREOF, the parties have executed this agreement as of the date first written above.

[Employer`s name] [Employee`s name]

By: ___________________ By: ___________________

Date: _________________ Date: _________________

In conclusion, a wage deduction authorization agreement is a legal and binding document that should be drafted with care to ensure that it meets the requirements of both the employer and employee. Employers should seek the advice of legal professionals when creating such an agreement to ensure that it is enforceable and complies with applicable laws and regulations. Additionally, employers should provide a copy of the agreement to their employees and ensure that all parties understand the terms of the agreement before signing. By following these steps, employers and employees can work together to ensure a smooth and efficient wage deduction process.