Relay for Life Payroll Deduction Modification

Relay for Life Payroll Deduction Modification

Complete the form below to modify or cancel any current Relay for life Payroll Deductions that are being deducted from your paycheck. Please allow 1-2 weeks for changes to take effect.
  • Employee Name: * Required
  • Home Address: * Required
  • Current Amount Being Deducted Per Pay Period (Week) * Required
  • Requested Amount To Be Deducted Per Pay Period (Week) * Required
  • Date Format: MM slash DD slash YYYY