Student Loan Payroll Deduction Authorization
Employee Information
Full Name
Employee ID
Department
Position
Contact Number
Loan Information
Lender Name
Loan Account Number
Deduction Amount
Deduction Frequency
Weekly
Bi-Weekly
Monthly
Authorization
I authorize my employer to deduct the specified student loan payment from my payroll and remit it to the lender above until further written notice from me.
Employee Signature
Date