Sample

Salary Deduction Request Form

Employee details
Date
Name
MyKad No.
Position
Job Grade
Staff Number
Department/Segment
Superior

Details of deduction
Deduction for
Total deduction amount
Installment agreed
(number of months)
Deduction commencement
month (payroll month)
Deduction to end month
(payroll month)

I hereby authorize the company to deduct the above from my salary. I fully understand the company will
credit the balance of my wages into my bank account after the above deduction and other necessary
legal/statutory deductions.

-----------------------------------
Employee Signature

For HR Use

Verified by Signature : Remarks

Name :

Date :
Approved by Signature :

Name :

Date :

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This sample policy/letter/document is merely a sample or guidance. Companies are advised to practice caution
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