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(person receiving check/check stub) to receive my pay check(s)/check stub(s) payable (pay date). I agree that this form shall serve to hold the employer harmless from any further claims by myself in regards to the above payroll check. Employee's Signature To be signed by person receiving check in presence of person issuing check. Date Date Greene County Authorization To Pick-Up Paycheck/Paystub TO: Payroll / Human Resources I (employee's name) do hereby 1034 Silver Dr. Ste. 201 Greensboro, GA 30642