UMKC Campus Rec: Payroll Deduct Cancellation Form
This form is to be filled by UMKC Staff and Faculty signing for or terminating their membership to enable Campus Recreation advise Human Resources adequately. Please note that based on the date you fill this out, your submission may not be processed in the current pay period.

If you have questions, please email us at umkccampusrec@umkc.edu.
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Today's Date *
MM
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DD
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YYYY
UMKC Email Address *
First and Last Name *
Faculty/Staff ID Number *
Usually begins with a "0" or "1"
Billing Address *
Please include your full street address, city, state, and zip code
Billing Cycle Frequency *
How often do you receive your paychecks?
I understand that by submitting this form, I am requesting to cancel my membership with Campus Recreation and that the cancelation must be received at least 72 hours in advance of payroll processing dates in order for it to be processed by my next paycheck. It is my responsibility to follow up with the department if I still see a deduction on my paycheck or if I have any questions. *
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