This form is to be used by authorized persons only to manage Merced Faculty Association program participation. You must have JavaScript enabled to use this form. Requested By * Requestor Email * Employee Information Employee Last Name * Employee First Name * Employee ID * Employee Email * Upon submission, the employee will receive a notification of the action request. Please ensure the email address provided is accurate. Withholding Information Type of Action * Add Remove Modify Actions will be effective the pay date following receipt based on the published deadline calendar found at: https://bfs.ucmerced.edu/our-services/payroll-services/deadlines-calendars Amount * $ Authorization * The faculty member's signed authorization to add, remove or adjust a withholding amount must be attached. Files must be less than 10 MB.Allowed file types: jpg jpeg bmp pdf. Leave this field blank
