AUTHORIZATION OF PAYROLL DEDUCTION
JAMES MADISON UNIVERSITY-CARD SERVICES FLEX ACCOUNT
NAME:___________________________________PEOPLESOFT EMPL ID #___________
CAMPUS DEPT:____________________________CAMPUS PHONE # _______________
Please deduct $_____ from each paycheck until further notice. (You can only change the
amount to be deducted 1 time during the year)
SIGNATURE: __________________________________________DATE:_______________
(I authorize the above indicated payroll deduction and if this is a change in the amount to be
deducted then the above amount replaces all other authorizations)
Please sign and return authorization to Card Services, 2nd Floor Student Success Center, 738
South Mason Street, MSC 3532