______________, 2009

Today’s Date

(Certified Mail – Return Receipt Requested)

Secretary-Treasurer Paul Rubin
UFCW Local 99
2401 North Central Avenue, 2nd Floor
Phoenix, Arizona 85004

and

Fry’s or Safeway Personnel/Payroll/Human Resources Department
__________________

Address

__________________

Dear Sirs:

Effective immediately, I am not a member of UFCW Local 99. If your records show me as a member, I hereby resign that membership.

Now that there is no longer a collective bargaining agreement in effect between the union and my employer, you must cease deducting any further union dues from my salary. In the absence of a collective bargaining agreement, dues deduction authorizations may be revoked at any time. I hereby revoke and rescind any dues deduction authorization I may have signed.

If you refuse to accept this letter as both an effective resignation and an immediately effective dues check-off revocation, I ask that you promptly inform me, in writing, of exactly what steps you believe I must take to effectuate my resignation and/or revocation of the dues check-off authorization.

Sincerely,

____________________
Name (Print)

____________________

Signature

____________________

Address

____________________