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Dear ________________ (Name of Union): My religious beliefs prevent me from contributing to this union because ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ (Please be as detailed as possible. Feel free to mention convictions given by God, religious doctrine or theology, Scriptural references, or specific religious experiences) In accordance with Section 701(j) of Title VII of the Civil Rights Act, I ask that you distribute my union dues in their entirety to the following non-profit charities: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ (NOTE: Your union may designate up to 3 charities for you to choose from when diverting your dues to charity. You may list as many or as few as you wish from the list provided. If the union does not designate any charities, you may choose any non-profit, non-religious, non-labor charity) I hereby declare, under penalty of perjury, that the above is true and correct. Thank you for your reasonable accommodation of my sincerely held religious beliefs. Sincerely, _____________________ Before submitting your completed letter to your union, please send a copy to our office. Our mailing address is: Pacific Justice Institute You can also FAX your letter to us at (916) 857-6902, or send it to us via email at pji@pacificjustice.org
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