Authorization for Payroll Deduction

I hereby authorize any eligible directors and/or employees to submit contributions to BUILD by payroll deduction. Copies of payroll deduction cards submitted with this authorization shall be signed by any said directors/employees and returned to the Iowa Bankers Association. I hereby certify all authorized payroll contributions to be forwarded to the IBA by check or ACH, along with a listing of the name, address and contribution amount of each payroll contributor within 10 days of any corresponding payroll period. This authorization serves as a “written request” of the IBA to the bank to provide incidental services and to forward contributions.