SUAA-UIUCDUES DEDUCTION AUTHORIZATION AND DUES PAYMENT FORM

SECTION A: DUES DEDUCTION AUTHORIZATION

If you do want your SUAA dues deducted from your monthly annuity checks, complete only this Section A and return it to SUAA-UIUC, 364 Henry Administration Building, 506 South Wright Street, Urbana, IL 61801. Monthly deductions will begin as soon as possible and will continue until you inform the State Universities Retirement System otherwise.

(I hereby authorize the State Universities Retirement System to deduct each month the amount certified by the UIUC chapter of the State Universities Annuitants Association as the current rate of dues.)

SECTION B: ANNUAL DUES PAYMENT

If you do not want your SUAA dues deducted from your monthly annuity check but you want to pay your dues for 2003-2004, complete only this Section B and return it with a check for $30.00 payable to SUAA-UIUC and mail to SUAA-UIUC, 364 Henry Administration Building, 506 South Wright Street, Urbana, IL 61801. This payment will pay your dues from July 1, 2003 through June 30, 2004. Additional payments will be required each year to continue your membership beyond June 30, 2004.

Inside Illlinois Subscription Form

Please enter my subscription to Inside Illinois for the 2003-2004 year. Subscription will begin in August and extend through July. Enclosed is my check for $7.00, payable to SUAA-UIUC, for subscription. I understand that I must be a paid-up member of SUAA-UIUC in order to receive this subscription service.