LASD Members Order Number Welcome to LASPA. Please complete your personal information, read and acknowledge the New Member Agreement and submit the form. A LASPA representative will contact you shortly. Last Name * First Name * Employee Number * Rank * Address * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana IAIowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Unit of Assignment * Personal Email Address * Cell Phone Number * If you were referred by a co-worker, please enter their name so they can receive proper credit. Referred By Are you aware of any pending or possible administrative investigations against you? * Yes No Have you been involved in a 998 in the last year? * Yes No Have you been involved in a CAT III UOF in the last year? * Yes No Have you been advised that a POE has been filed against you in the last year? * Yes No Have you been ROD in the last year? * Yes No Have you been benched in the last year? * Yes No Have you been placed on Performance Review or Peer Mentoring in the last year? * Yes No Have you been involved in an on-duty TC in the last year? * Yes No You agree by submitting this application, that LASPA reserves the absolute right to withhold legal representation and/or payroll reimbursement benefits, relative to any incident that predates your joining LASPA. New Member Agreement This agreement states the terms whereby you agree to representation by the Los Angeles Sheriffs Professional Association (“LASPA”) Services Covered Legal representation at all stages of administrative proceedings initiated by the County of Los Angeles and/or the Los Angeles County Sheriff’s Department, up to and including any Civil Service Commission or other County Administrative entity assigned to hear your matter. In addition, legal representation in all administrative proceedings involving SB2 (the revocation or suspension of a certification or license to serve as a peace officer) initiated by LASD and/or POST. LASPA is currently in litigation with the Employee Relations Commission regarding its right to represent employees facing discipline of five days and under. If you have such a grievance, you will be provided independent counsel at LASPA’s cost for all litigation related thereto. LASPA’s rights before the Civil Service Commission for discipline over five days is unaffected. LASPA Board of Directors determines what attorneys can join its panel, at their discretion, and in that capacity may delete from or add attorneys or other representation to the panel. While LASPA will pay for any assigned attorney on its panel, LASPA is not obligated to pay for an outside attorney of your choice. LASPA reserves the right to discontinue representation at any time provided such a recommendation is made by your assigned counsel. *If member chooses supplemental criminal and/or civil defense plan coverage such matters will be covered per the terms of the supplemental coverage. Services Excluded Any matter not specified in the above “Services Covered” provision, which includes, but is not limited to: criminal defense (if member is not enrolled in supplemental coverage), civil defense(if member is not enrolled in supplemental coverage), workers’ compensation, benefits, unemployment benefits, retirement benefits, and any claim before any state or federal court. You should consult with your own lawyer at your own expense if you believe any of these areas are involved in your case. You may consult with any LASPA panel attorney for up to one-hour, free-of-charge and decide whether or not to pursue a legal action at your own expense with said panel attorney or another attorney of your choice. Also excluded is legal representation to contest facts, charges, allegations, or grounds for revocation or suspension under SB2 for events which automatically disqualify an individual from holding the position of a peace officer (e.g. conviction of certain crimes, permanent court orders prohibiting an individual from possessing a firearm, being found not guilty by reason of insanity, etc.) where those facts, charges, allegations or grounds have been finally determined or adjudicated in a separate legal proceeding, including where the member pled guilty or nolo contendere. Coverage also does not extend to post-administrative hearing review, including judicial proceedings. Fees and Costs Legal representation is a benefit for those who are eligible, dues-paying members of LASPA before their legal problems arose and therefore, there are no additional charges for taking advantage of this membership benefit. However, if your payroll deduction dues payment is interrupted due to disciplinary action taken against you (i.e. suspension without pay), you must maintain your dues payment on your own to continue to receive representation services. Routine costs such as copying, subpoena services, etc. will be paid by LASPA. LASPA however, is not obligated to pay extraordinary costs such as expert witness fees or transcripts costs. Notwithstanding the foregoing, the payment of any fees or costs rests within the sole discretion of LASPA. Communications LASPA or its assigned legal representative will keep you informed of the progress of your case and you agree to cooperate to assist LASPA in the investigation and preparation of your case. You also agree to keep LASPA informed of your current residence address and telephone numbers, and immediately notify LASPA of any changes. Legal Representation Member herby acknowledges and agrees that in order to be eligible for Legal representation; member must give LASPA counsel first opportunity to represent him/her. LASPA will not provide legal representation for those members who are currently being represented by an alternative union or who elect to represent themselves. Continuing Membership If you are member less than twelve months prior to requesting legal representation under this Agreement, you agree to maintain LASPA membership for a period of three years after the final disposition of the matter covered under this Agreement. Payroll Reimbursement In the event you are suspended without pay, you are eligible for payroll reimbursement of your gross pay (excluding overtime) up to 30 days, depending on your level of membership. You are NOT eligible for reimbursement if the alleged conduct involves: matters outside the course and scope of employment, intentional disregard for Department rules, regulations or policies, repetitive policy violations, reckless behavior, refusal to comply with State, County or Department health mandates, or if the investigation leading into disposition of discipline began prior to you joining LASPA. You must utilize LASPA counsel for each phase of any Department investigation (the initial interview through the final grievance stage) to be eligible for payroll reimbursement. Notwithstanding the foregoing, any payroll reimbursement rests entirely within the discretion of LASPA’s Committee Board. In order to collect a payroll reimbursement check you agree to personally appear at LASPA’s office and submit a W-9 form for LASPA’s tax reporting purposes. Cancellation of Membership Unless member otherwise agreed to maintain membership for a specific duration, member may cancel LASPA membership for any reason at any time. Membership will remain active unit the following normally scheduled dues deduction, then the cancellation will be effective. LASPA likewise reserves the right to cancel membership for any reason. However, if LASPA cancels a member and that member is being actively represented by LASPA counsel in a pending matter (grievance, discipline appeal, etc.), member will continue to be represented by LASPA counsel (if member chooses) for the duration of the underlying matter. New member agreement I have read and acknowledge the contents of the New Member Agreement Rank: You Must Select One * Deputy Sheriff—-$80 Sergeant—-$90 Lieutenant—-$100 Reserve Deputies—-$225 for 1 Year Reserve Deputies—-$60 for 3 Months Custody Assistant—-$60 Security Officers—-$40 Security Assistants—-$35 Law Enforcement Technicians—-$50 Other If you selected Other, please specify your position below: Deductions Agreement I hereby authorize the auditor of the County of Los Angeles or his agents to deduct monthly from salary earned by me in any department or district of the County of Los Angeles, the amount shown hereon and to pay same to: The Los Angeles Sheriff’s Professional Association. If all or any portion of this deduction authorization includes insurance premiums and/or employee organization dues, I also authorize the auditor to adjust from time-to-time the amount of this deduction as may be required to comply with adjustments in county subsidy amounts or in premiums under existing contracts with said insurance plans, or to comply with dues schedules determined by said employee organizations’ governing body in accordance with such organizations’ constitution, charter, bylaws, or other applicable legal requirements. This authorization cancels and replaces any previously signed by me with this deduction agency for this purpose and shall remain in effect until canceled by me by written notice. I expressly understand and agree that the auditor, his agents, or the county acting under this authorization shall not be liable in any manner for failure or delay in making the deduction or payments here authorized. Agree Yes, I agree to the above terms and conditions. TeamLegal Defense is a supplemental insurance benefit that provides members with legal defense costs, including attorney fees, in the event a criminal or civil case is brought against a member related to on-duty conduct. TeamLegal Defense coverage requires a $10 monthly fee ($8.00 legal fee, $2.00 LASPA admin fee) that will automatically be added to the existing monthly dues of all members, excluding clerical. Should you wish to opt-out of this benefit, you must send a request to firstname.lastname@example.org. For further information about the plan, please visit TeamLegal LASPA does not disclose your membership information to any third-party. All personal information is kept strictly confidential.