EX-99.2 5 ex99-2.htm EXHIBIT 99.2 ex99-2.htm

 
EXHIBIT 99.2
 
 
MIDDLESEX WATER COMPANY
Subsidiaries and Affiliates

DIVIDEND REINVESTMENT AND COMMON STOCK PURCHASE
EMPLOYEE
AUTHORIZATION FORM FOR PAYROLL DEDUCTION


THE MIDDLESEX WATER COMPANY IS HEREBY AUTHORIZED TO WITHHOLD THE AMOUNT INDICATED BELOW FROM MY PAYCHECK WEEKLY.
 


$_____________

EMPLOYEE NAME ___________________________________
 
EMPLOYEE ADDRESS ______________________________________
 
________________________________________________________________

SOCIAL SECURITY NUMBER _____________________________

Date of birth___________________(Must be 21 to participate)
 
SIGNATURE _________________________DATE ___________________
 



Minimum payroll deduction of $5 weekly
Maximum of $100 weekly
Employees on Bi-Weekly payroll will have twice the amount listed above withheld.


CJS