Payroll Deduction Form

Which kind of deduction would you like to do?

    New Deduction

    By submitting new deduction form you understand that MLBA will begin a new recurring payroll deduction.

    Employee Name
    Oracle Employee Number
    Chapter
    Contribution Amount Per Pay Period

    Note: Making Lives Better with Alorica (“MLBA”) NIT 10407389-6 is a nonprofit organization. This contribution to MLBA is a voluntary, tax deductible contribution that may be discontinued at any time. Donations made to MLBA are tax deductible to the extent allowed by law based on the donor’s particular tax situation. Please consult a tax advisor for further details.

    To begin your contribution, you must fill out the top of this form and return to your chapter’s HR or site payroll coordinator. Your contribution will begin on the next paycheck covering the payroll period during which this form is received and processed and will continue until an election to discontinue your contribution is received. Funds cannot be designated to a specific individual or organization.

    Employee Signature
    Typing your full name above constitutes a digital signature.
    DateMM/DD/YYYY Format
    ** ONLY CLICK THE SUBMIT BUTTON ONCE **
    ** YOU WILL RECEIVE A CONFIRMATION MESSAGE WHEN YOUR SUBMISSION IS COMPLETED **

      Change Existing Deduction

      By submitting change deduction form you understand that this deduction will override the current deduction.

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      Employee Name
      Oracle Employee Number
      Chapter
      Contribution Amount Per Pay Period

      Note: Making Lives Better with Alorica (“MLBA”) NIT 10407389-6 is a nonprofit organization. This contribution to MLBA is a voluntary, tax deductible contribution that may be discontinued at any time. Donations made to MLBA are tax deductible to the extent allowed by law based on the donor’s particular tax situation. Please consult a tax advisor for further details.

      To begin your contribution, you must fill out the top of this form and return to your chapter’s HR or site payroll coordinator. Your contribution will begin on the next paycheck covering the payroll period during which this form is received and processed and will continue until an election to discontinue your contribution is received. Funds cannot be designated to a specific individual or organization.

      Employee Signature
      Typing your full name above constitutes a digital signature.
      DateMM/DD/YYYY Format
      ** ONLY CLICK THE SUBMIT BUTTON ONCE **
      ** YOU WILL RECEIVE A CONFIRMATION MESSAGE WHEN YOUR SUBMISSION IS COMPLETED **

        One-Time Deduction

        By submitting one-time deduction form you understand that you will be donating a one-time payroll contribution.

        Employee Name
        Oracle Employee Number
        Chapter
        Contribution Amount

        Note: Making Lives Better with Alorica (“MLBA”) NIT 10407389-6 is a nonprofit organization. This contribution to MLBA is a voluntary, tax deductible contribution that may be discontinued at any time. Donations made to MLBA are tax deductible to the extent allowed by law based on the donor’s particular tax situation. Please consult a tax advisor for further details.

        To begin your contribution, you must fill out the top of this form and return to your chapter’s HR or site payroll coordinator. Your contribution will begin on the next paycheck covering the payroll period during which this form is received and processed and will continue until an election to discontinue your contribution is received. Funds cannot be designated to a specific individual or organization.

        Employee Signature
        Typing your full name above consistutes a digital signature.
        DateMM/DD/YYYY Format
        ** ONLY CLICK THE SUBMIT BUTTON ONCE **
        ** YOU WILL RECEIVE A CONFIRMATION MESSAGE WHEN YOUR SUBMISSION IS COMPLETED **

          Term Deduction

          By submitting term-deduction form you understand that you will be terminating your reoccurring payroll contribution.

          Employee Name
          Oracle Employee Number
          Chapter

          Note: Making Lives Better with Alorica (“MLBA”) NIT 10407389-6 is a nonprofit organization. This contribution to MLBA is a voluntary, tax deductible contribution that may be discontinued at any time. Donations made to MLBA are tax deductible to the extent allowed by law based on the donor’s particular tax situation. Please consult a tax advisor for further details.

          To begin your contribution, you must fill out the top of this form and return to your chapter’s HR or site payroll coordinator. Your contribution will end on the next paycheck covering the payroll period during which this form is received and processed. All contributions prior to the paycheck designated will be irrevocable and cannot be reversed.

          Employee Signature
          Typing your full name above consistutes a digital signature.
          DateMM/DD/YYYY Format
          ** ONLY CLICK THE SUBMIT BUTTON ONCE **
          ** YOU WILL RECEIVE A CONFIRMATION MESSAGE WHEN YOUR SUBMISSION IS COMPLETED **