Check-In to DC7

Out-of-Area Members (i.e. members of other District Councils) should file this report when working within DC7's Jurisdiction. Report must be filed prior to the start of work.

Please note: Each job location requires a separate form submission.

District & Local

My District Council # *

Local Number *

Employee Information

Employee Name * Cell Phone *

SSN (last 4) * Email Address

Jobsite Information

Job Name * Start Date *

Employer Name * Number of days on project *

Add Craft *

Jobsite Location

Jobsite Address * City * State * ZIP *

Dues Check-Off Authorization

By completing and signing this Dues Check-Off Authorization Form (“Authorization”), I hereby allow the various employers who are signatory to the Agreement with Painters & Allied Trades District Council No. 7. “DC7”), affiliated with the International Union of Painters and Allied Trades “IUPAT”), including any renewal thereof, and by whom I may be employed during the term of such Agreement or any renewal thereof, to deduct from my wages and transmit to the International Union of Painters and Allied Trades (“Union”), irrespective of my status in the Union, such amount as the Union may certify to be due and owing as initiation fees/administrative processing fees, regular and/or administrative dues, as amended from time to time (“Authorized Dues”).

I understand that this Authorization and assignment is irrevocable for the period of one (1) year following the dates it was signed or until the current collective bargaining agreement expires, whichever occurs sooner. This Authorization shall automatically renew itself for successive yearly or applicable contract periods thereafter, whichever is lesser, unless between fifty (50) and sixty (60) days prior to any periodic renewal date, I specifically provide written notice revoking this Authorization which I send to the Union and the employer by whom I am then employed (“Employers”).

I further authorize the Employers, when I am working for them or any one of them within the jurisdiction of any union affiliations with the IUPAT other than by my own local union, to deduct from my wages the amount of administrative dues or business agent “assessment” (in the nature of dues) in the bylaws of that other Union, I authorize said employers ot continue to deduct from my wages the Authorized Dues and remit same to my own local union.

I understand that dues to DC7 are not deductible as charitable contributions for federal income tax purposes.

I also understand that I am authorizing DC7 to collect certain data about me and that transmitting any information using technology poses an inherent risk to that data. I agree to accept that risk and provide DC7 with this information to facilitate and expedite the purpose of this Authorization.

By checking this box and typing my name below, I am electronically signing this form.