Standard Form 1187 Revised March 1989 U.S. Office of Personnel Management Section A-For Use By Labor Organization 1. Name of Employee (Print or Type-Last, First, Middle) 4. Home Address (Street Number, City, State and ZIP Code) 2. Employee Identification Number (SSN or Other) 3. Timekeeper Number 5.

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 organizaion dues be deducted from your pay and to notify your labor organization of the deduction.

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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 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.

The 1187 form is used by federal agencies and federal payroll processors to assign membership to the correct employee and initiate withdrawal of bi-weekly membership dues. Here is an

Form 1187/Revised 2003 Section A—Authorization By EmployeeSection A—AuthorizationBy Employee L 2. HOME ADDRESS APT. OR SUITE NO. 6. NAME OF AGENCY 7. OFFICE PHONE NUMBER AND EXT. CITY STATE ZIP + FOUR 3. EMPLOYEE SSN 1. LAST NAME FIRST M.I. 4. DATE OF BIRTH 5. HOME PHONE NUMBER: MM D D Y Y)))) EXT. GENDER (OPT.) SIGNATURE OF EMPLOYEE YES NO

Form 1187/ Revised September 2021 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.

Updates to Publication 1187, after August 31, 2024, are listed in Part E. Exhibit 1, Publication 1187 Tax Year 2024 Revision Updates.