Payroll Deduction Authorization Agreement

PAYROLL DEDUCTION AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS

I hereby authorize KRATON ™ Polymers, hereafter called company, to initiate credit entries to my account indicated below and the credit union to credit the same to such account. In the event of overpayment to my account, I authorize the company to make an adjustment entry to my account for the amount of overpayment.

Credit Union Name Employee Name Employee No.

KRATON BELPRE FEDERAL CREDIT UNION

Credit Union Address Employee Account No.

P. O. Box 235

Credit Union City State Zip Amount of Deduction

Belpre OH 45714

ABA Transit No.

044202505

AMOUNT TO BE DEDUCTED IN ONE OF THE FOLLOWING METHODS – (Check only one)

 Above amount deducted every pay period.

Verification of the amount withheld is my responsibility and I will notify employer immediately of any exceptions.

DATE: SIGNATURE:

This agreement may be terminated upon thirty days prior written notification by completing the area below.

CANCELLATION OF PREVIOUS AUTHORITY

I hereby request KRATON Polymers to cancel my previous payroll deduction authorization in the amount of $ being remitted to Credit Union. The last deduction is to be made for the pay period ending .

DATE: SIGNATURE:

EMPLOYEE NO.: