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PAYROLL DEDUCTION AUTHORIZATION FORM for Serving the Employees of Granite Construction, its subsidiaries, and majority owned joint ventures. I, (Print full name) hereby authorize the Corporate Payroll Department to deduct from my paycheck the following amount for deposit into my Gibbons & Reed FCU account. I also authorize Granite Construction to forward/share address and phone number changes from my employee file to the Gibbons & Reed FCU during the time this deduction is in place. Amount to be deducted: $______________________________ ___________________ (per pay period) (effective date) Employee’s SSN:____________________________ Employer : ____________________________ Job Location: _______________________ (Please list all Granite companies from whom you want a deduction.) ____________________________________________ Employee Signature _____________________ Date Circle One: Start Change Cancel Forward this completed form to Granite’s Payroll Department in Watsonville.