Remote Locality Rental Assistance
Authority to Deduct or Vary Rent
Human Resource Services
HRS-04-025 Version 1.02
Issued January 2015
This form is completed at the time of the first deduction and will cover any variation of deductions during
the course of employment and therefore will need to be submitted once only.
Employee name
Employee no.
Faculty/Division
school//branch
Campus location
Email
I
Phone
(please print full name)
authorise Charles Darwin University to deduct, or vary rental deductions if required, from my salary for the rental
property occupied by myself and eligible dependants.
Effective from
To
Signature
Date
Return to Office of Human Resource Services (HRS)
Human Resource Services
Entred in Alesco
Pay no.
Pay date
PO signed
Date