First Name Middle Name Last Name Employee Number Department Number Deduction Number
You need to copy this paragraph into the form field below, and type in your name and employee number again!
I hereby authorize the auditor of the County of Los Angeles or his agents to deduct monthly from salary earned by me in any department or district of the County of Los Angeles, the amount shown hereon and to pay same to: The Los Angeles Sheriff's Professional Association
If all or any portion of this deduction authorization includes insurance premiums and/or employee organization dues, I also authorize the auditor to adjust from time-to-time the amount of this deduction as may be required to comply with adjustments in county subsidy amounts or in premiums under existing contracts with said insurance plans, or to comply with dues schedules determined by said employee organizations' governing body in accordance with such organizations' constitution, charter, bylaws, or other applicable legal requirements. This authorization cancels and replaces any previously signed by me with this deduction agency for this purpose and shall remain in effect until canceled by me by written notice. I expressly understand and agree that the auditor, his agents, or the county acting under this authorization shall not be liable in any manner for failure or delay in making the deduction or payments here authorized.
First Name Middle Name Last Name
Marital Status Married Divorced Single Widowed
Rank Unit Of Assignment
Employee# Hire Date 01/00/99 Business Address City Zip Code
Business Phone Number Extension Home Address City State Zip Code Home Phone Number Cell Phone Number Date Of Birth Social Security Number
Deputy Sheriff, Sergeant, Lieutenant, Deputy District Attorney Investigator, Senior Criminalist
$45.00
Reserve Deputies Annual dues $225 for level I or $60 every three months
Please Select One $225.00 1yr $60.00 for 3 months
Custody Assistant
$30.00
Court Services Specialist, Security Officers
$17.00
Security and Community Service Assistants
$12.00
Law Enforcement Technicians
$23.00
Response Dispatcher
$19.00
Communication Operator II
$21.00
Communication Operator Supervisor
$24.00
Civilian Investigators
$26.00
I hereby declare that I DO NOT want the Association for Los Angeles Deputy Sheriffs, Inc (ALADS) to represent me in employment relations with the County of Los Angeles. I Hereby authorize and seek representation by Los Angeles Sheriffs Professional Association (LASPA) in employment relations with the County of Los Angeles. I also hereby move to decertify ALADS as the bargaining unit for Deputy Sheriffs.
LASPA will take effect on the first of the month following their application.
"I hereby authorize LASPA to complete a payroll deduction cancellation card to terminate my membership in ALADS or POPA"
ALADS Cancellation POPA Cancellation
Date Type In Name Email Address Personal LASD Email
"Your application will be processed immediately, and the appropriate forms will be mailed to you for your signature. Upon return receipt of those documents to LASPA, your membership in LASPA will become effective on the first day of the following month."
