POLICE AND PUBLIC SAFETY                                PARKING DIVISION

I, "(1)", hereby authorize the University of Arkansas At Pine Bluff to deduct $ "(2)" per pay period from my payroll check beginning on "(3)" for payment toward the balance of $ "(4)" on my university parking permit. This amount is to pay for a parking permit for the 2020-2021 school years. This agreement will remain in effect until my balance is paid in full. 

If replacing a decal it’s $15.00 paid in full.