Social - Orange County Attorney`s Association

Dues/Fee Payer Acknowledgment Form
Please Print
Name: ______________________________
Social Security Number:________________
Office: ______________________________
Date: ______________________________
Work Location: ________________________________________________________________
Telephone Number: ____________________
Hire Date: ___________________________
By signing below, I acknowledge receipt of the following OCAA documents:
Notice of Financial Obligation Under Agency Fee Arrangement & Means of Satisfaction
Thereof; Association Policy Concerning Objections to Agency Fee Calculation
Agency Fee Appeals Procedure
Notice of Chargeable and Non-Chargeable Expenses to Nonmember Agency Fee Payers
Audited Financial Statement for Year Ending 12/31/07
Payroll Authorization Form
Notice to Association of Nonmember Agency Fee Payer Status
Membership Application
Request for Religious Objection Form
Checklist Re: Completion of Agency Shop-Related Forms
Please mail a copy of the completed form to:
OCAA, 600 W. Santa Ana Blvd., Suite 114-F, Santa Ana, CA 92701
Note: A copy of the receipt must be mailed to Orange County Attorneys Association on the new
employee's sign up date.