DPCF Payroll Deduct Form .pdf
Original filename: DPCF Payroll Deduct Form.pdf
Title: DELTA PILOTS ASSISTANCE FUND (501c)
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Delta Pilot Payroll Deduction
You can return the completed form by one of three methods:
• Faxing the form to 404-763-5169,
• Emailing a scanned copy with signature to email@example.com.
• Postal Mail to ALPA, 100 Hartsfield Centre Parkway, Suite 800, Atlanta, GA 30354.
• Drop off in any LEC drop box located in the pilot lounges
Please contact MEC Treasurer, Bren Fries at 800-USA-ALPA or firstname.lastname@example.org if you have any
Authorization for Payroll Deduction
Start a deduction from my semi-monthly pay for remittance to the DPCF.
Change my semi-monthly contribution to the DPCF.
Stop my semi-monthly contribution to DPCF.
Start/Change or Stop: (must
be 15 or 30 /31st
Do we have your permission to feature your donation in our newsletters & online news articles?
Would you like to donate in Memory of someone?
Name for Memoriam
All of us at DPCF would like to thank you for your contribution to our fund.
We are a nonprofit 501c3. This contribution is tax-deductible.
Please allow one to two pay periods to take effect.
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