HomeNFFE1187-ID-Become a NFFE-IAM Member Today by Filling Out the Form Below! Section 5525 of Title 5 United States Code (Allotments and Assignments of Pay) permits Federal agencies to collect this information. This completed form is used to request that labor organization dues be deducted from your pay and to notify your labor organization of the deduction. Completing this form is voluntary, but it may not be processed if all requested information is not provided. This record may be disclosed outside your agency to: 1) the Department of the Treasury to make proper financial adjustments; 2) a Congressional office if you make an inquiry to that office related to this record; 3) a court or an appropriate Government agency if the Government is party to a legal suit; 4) an appropriate law enforcement agency if we become aware of a legal violation; 5) an organization which is a designated collection agent of a particular labor organization; and 6) other Federal agencies for management, statistical and other official functions (without your personal identification). Executive Order 9397 allows Federal agencies to use the social security number (SSN) as an individual identifier to avoid confusion caused by employees with the same or similar names. Supplying your SSN is voluntary, but failure to provide it, when it is used as the employee identification number, may mean that payroll deductions cannot be processed. Your agency shall provide an additional statement if it uses the information furnished on this form for purposes other than those mentioned above.Today's Date* Date Format: MM slash DD slash YYYY First Name*Middle NameLast Name*Employee Identification Number*(Last 4 of SSN)Timekeeper Number*Home Address*(Street Number, City, State and ZIP Code) Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Personal Email Enter Email Confirm Email Personal Mobile Phone NumberName of Agency*(Select Your Agency)Bureau of Consular Affairs/Passport ServicesDefense Contract Management AgencyDefense Information Systems AgencyFederal Aviation AdministrationGeneral Services AdministrationIndian Health ServiceJob Corps Civilian Conservation CentersNational Park ServiceNational Technical Information ServiceRisk Management AgencyU.S. Army Corps of EngineersU.S. Bureau of Land ManagementU.S. Coast GuardU.S. Department of AgricultureU.S. Department of Air ForceU.S. Department of ArmyU.S. Department of CommerceU.S. Department of DefenseU.S. Department of Health and Human ServicesU.S. Department of Homeland SecurityU.S. Department of Housing and Urban DevelopmentU.S. Department of NavyU.S. Department of StateU.S. Department of the InteriorU.S. Department of TransportationU.S. Department of Veterans AffairsU.S. Fish and Wildlife ServiceU.S. Forest ServiceU.S. Geological SurveyU.S. Marine CorpsU.S. Small Business AdministrationU.S. Social Security AdministrationOtherLocal Lodge Number*(Select Your Local Lodge Number)12712143458609512212517818122525125927327634637638740545746647647858963964272173975885891992795110011028103111241138115011531164121412411295133213401384139814291431144214501453146114871525155816271641164216501690169717531765177117811798180018011804183618401855186518871904191919371945195019531956195719661968198119951998202320352049206220662081208621022107210921352138215221532165217121892192219521962197219822005300You can also search for your local number once you clicking on the drop down.Dues Per Pay Period $0.00 Authroization by Employee* I agree to the following provisions.I hereby authorize the above-named agency to deduct from my pay each pay period, or the first full pay period of each month, the amount certified above as the regular dues of the (Name of Labor Organization): National Federation of Federal Employees (NFFE) and to remit such amount to that labor organization in accordance with its arrangements with my employing agency. I further authorize any change in the amount to be deducted which is certified by the above-named labor organization as a uniform change in its dues structure. I understand that this authorization if for a biweekly deduction will become effective the pay period following its receipt in the payroll office of my employing agency. I further understand that Standard Form 1188, Cancellation of Payroll Deductions for Labor Organization Dues, is available from my employing agency and that I may cancel this authorization by filing Standard Form 1188 or other written cancellation request with the payroll office of my employing agency. Such cancellation will not be effective, however, until the first full pay period which begins on or after the next established cancellation date of the calendar year after the cancellation is received in the payroll office. Contributions or gifts (including dues) to the labor organization shown at left are not tax-deductible as charitable contributions. However, they may be tax deductible under other provisions of the Internal Revenue Code.ELECTRONIC SIGNATURE –Signature*Please digitally sign this form by typing your full name.Human VerificationCommentsThis field is for validation purposes and should be left unchanged.