MPD 3-Month Severance Request

For reference, our current policy states, “In the event that a staff member leaves Life Action employment voluntarily, staff may request up to 3 months’ gross MPD wages (provided that their account can support that withdrawal) as a taxable contribution (or contributions) as part of the severance agreement. Any distribution or reimbursement of remaining funds is subject to the approval of the CEO with input from their direct supervisor, HR Director, Finance team, and MPD Director.”

We will review your request and get back to you soon!

MPD 3-Month Severance Request

Please fill out all of the information, and we will get back to you soon!

Name(Required)

Email(Required)

What is your current MPD salary deduction each month?(Required)

You can find this amount in TNT in the account report.

What is the total amount of 3 month's of your MPD salary (deduction)?(Required)

Please indicate the last day of your employment with Life Action.(Required)