[name and address of union]
[To the appropriate union officer (see your union constitution)]:
I am employed by [name of employer].
Effective immediately, I resign from membership in the [name of local union] and all of its affiliated unions. I demand that you reduce, to the maximum extent allowed by law, any financial obligation I may have to you.
I object to paying any dues, fees or assessments, and demand that, to the extent permitted by Act 10, I be immediately allowed to stop paying any dues, fees or assessments to [name of local union] and all of its affiliated unions. If you believe that Act 10 does not free me now or at some future time from paying full compulsory union fees, please let me know immediately the legal basis for your claim.
If you notify me that you believe I am still required to financially support the union, I assert my rights in two ways:
1. If I am still compelled to pay any dues, fees or assessments, I object to the collection and expenditure by the union of any dues, fees or assessments for any purpose other than my pro rata share of the union's costs of collective bargaining, contract administration, and grievance adjustment, as is my right under Abood v. Detroit Board of Education, 431 U.S. 209 (1977). Pursuant to Teachers Local 1 v. Hudson, 475 U.S. 292 (1986), I demand that you provide me with my procedural rights, including: reduction of my fees to an amount that includes only lawfully chargeable costs; notice of the calculation of that amount, verified by an independent certified public accountant; and notice of the procedure that you have adopted to hold my fees in an interest-bearing escrow account and give me an opportunity to challenge your calculation and have it reviewed by an impartial decision maker. Consider this objection to be permanent and continuing in nature; and,
2. To the extent I am still required by Act 10 and by a contract covering my employment in effect on June 29, 2011, I will continue to meet any lawful obligation of paying a representation fee to the union under its "union shop" or "agency shop" agreement with [name of employer] until the current agreement is modified, renewed, extended or expires, whichever comes first, at which time Act 10 frees me from being required to pay you anything. However, at the time that Act 10 frees me from being required to anything, I assert my right to no longer financially support the union in any way.
Please reply promptly to my request. Any further collection or expenditure of dues or fees from me made without a valid, supporting contract (as provided in Act 10) and the procedural safeguards required by law will violate my rights under the Wisconsin labor laws and the U.S. Constitution.
[cc: Employer HR/Personnel Department]