Financial Policy Handbook 2017

8. I agree that if I violate the terms of this agreement, I will reimburse the City for all charges incurred and any fees related to the collection of those charges within three (3) business days, if not paid I understand that the City may initiate a payroll deduction to recoup these charges.

_______________________ ______________________ ____________________ _________________ Employee Name (Print) Employee Signature Department Last 4 Digits of Card

_______________________ ______________________ _____________________ Issue Date Return Date Department Director