FOP Lodge #70 Retiree Dues Deduction
This form is for RETIRED Members of FOP Lodge #70.

By filling out and electronically signing this form, you will authorize automatic, yearly deduction of your membership dues from your October pension check.  Dues will be remitted by the County to FOP Lodge #70.

NOTE:  Names have been submitted for 2025.  Any new entry will not be effective until 2026.
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FULL NAME of Member *
DATE OF BIRTH of Member *
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Mailing Address of Member *
Email Address of Member
I,  the undersigned, hereby authorize Anne Arundel County to deduct from my pension earnings the sum necessary for payment of dues in effect (or such revised amount as may hereafter be approved in accordance with its constitution) for the Fraternal Order of Police Lodge No. 70 and to remit same to the Lodge. I reserve the right to revoke this authorization for continuing membership by written notice to the Fraternal Order of Police Lodge No. 70 not less than ten days before the first day of the month for which such revocation shall take effect.

SIGNED:
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(Type Name)
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