Payroll Deductions - Application Form

Fields with asterisks (*) are required.

Hang Tag Options *

Home Address

Vehicle Information

Parking Payroll Deduction Authorization

Parking Options

*NOTE: The Ilitch School structures have different rates than main/med campus. Please review the rate structure at before completing this form.

Main Campus Options: Choose up to 3 locations (P) Indicates premium location
Mike Ilitch School of Business Options: Please choose one option

*NOTE - if your Ilitch School option includes main campus locations please check them off on the list above.

I hereby authorize a monthly payroll deduction of the monthly pro rated share of the rates established by the Board of Governors for parking privileges to be deducted in accordance with accepted payroll program. I understand there is a one-time/non-refundable fee of $25 for the RFID hang tag.

Please Note: Main campus parking is activated within 1-2 days of our receipt of this form. Parking charges begin the day after activation unless you notify us that you wish to begin parking on an alternate date. If you wish to specify an alternate date you MUST email Renee Varner at

Parking at Mike Ilitch School of Business structures begins on the first day of the month in accordance with our contact with Olympia Entertainment.

Parking passes are intended for the sole use of the OneCard holder only. Any “misuse” of parking privileges by employees could result in the loss of parking privileges and formal disciplinary charges.

Additionally it is our policy that if you have cancelled your deductions in the current month, you cannot reinstate them until 30 business days have passed.

This authorization may be terminated by myself at any time by written notice filed with the OneCard/Parking Service Center. Reimbursement for main campus structures is effective the date the Cancellation Form is received by the Parking Office. Reimbursement for the Mike Ilitch School of Business Structures is effective at the end of the month.

Full refund terms should be reviewed and are available here: