WAGE ASSIGNMENT AUTHORIZATION & ENROLLMENT FORM
BROTHERHOOD OF MAINTENANCE OF WAY EMPLOYES DIVISION – IBT

TO Illinois Railway, LLC:

I authorize the Carrier to deduct from my wages an amount necessary to pay my monthly union dues (not including fines and penalties) as reported to the Illinois Railway by the Brotherhood of Maintenance of Way Employes Division of The International Brotherhood of Teamsters. I authorize the Illinois Railway to remit that amount to the Brotherhood of Maintenance of Way Employes Division of The International Brotherhood of Teamsters. This authorization may be revoked in writing by me at any time after the expiration of one (1) year from the date I sign it.

I, the undersigned:

1. Apply for membership in the Brotherhood of Maintenance of Way Employes Division—IBT, and agree to abide by its Constitution and Bylaws;
2. Authorize this Union to be my exclusive bargaining agent.