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”) is a nonprofit organization. This contribution to MLBA is a voluntary contribution that may be discontinued at any time.

    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.



    By typing in your full name above you are digitally signing this form.
    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.

      Employee Name
      Oracle Employee Number
      Chapter
      Contribution Amount Per Pay Period

      Note:Making Lives Better with Alorica (“MLBA”) is a nonprofit organization. This contribution to MLBA is a voluntary contribution that may be discontinued at any time.

      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.



      By typing in your full name above you are digitally signing this form.
      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”) is a nonprofit organization. This contribution to MLBA is a voluntary contribution that may be discontinued at any time.

        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.



        By typing in your full name above you are digitally signing this form.
        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”) is a nonprofit organization. This contribution to MLBA is a voluntary contribution that may be discontinued at any time.

          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 **