Benevolence Loan Request You must be employed for 90 days to be eligible for assistance. The Benevolence Committee must be allowed a minimum of 2 business days to make decisions on all loan requests. We cannot guarantee approved funds will be provided if the request is made less than 2 business days prior to the needed date. Business Days: Monday-Friday; 8am-5pmEmployee in Need InformationName of Employee in Need* First Last Store Location of Employee in Need* Department of Employee in Need* Job Title/Job Role of Employee in Need* Employee Number* Phone Number of Employee in Need*Email Address of Employee in Need* Employee in Need Hire Date* MM slash DD slash YYYY Person Making Request Information (if other than Employee in Need)This section is ONLY required if you are the person making this benevolence request on the behalf of the Employee in Need.Name of Person Making Request First Last Phone Number of Person Making RequestEmail Address of Person Making Request Benevolence Loan Request InformationAmount Requested*Date Needed* MM slash DD slash YYYY Date of Last Benevolence Loan MM slash DD slash YYYY Amount of Last Benevolence LoanPayback Terms* Weekly Semi-Monthly Requested Payment Amount (Will be Payroll Deducted Each Pay Period Until the Loan is Paid in Full)*Benevolence Loan Request Explanation*Please explain the emergency or hardship situation. What specifically will the funds be used for? (Only under special circumstances will we make checks payable to an individual.) Who should check(s) be made payable to?* If multiple checks are needed, please explain below the dates and amounts of the checks needed.Digital Signature* By clicking here below I attest that all information I have given to complete this Request for Assistance is true and complete to the best of my knowledge. If necessary, I will provide any and all receipts to support amount of assistance given.CAPTCHA Δ
