Authorization of Payroll Deduction

The entered values cannot be saved. Please see the fields below for details.

I authorize one of the following deductions.

A recurring per pay period deduction of $
	I understand that this deduction will continue until I authorize the Charitable Foundation to stop this deduction
Yearly total
A onetime payroll deduction of $
	Note: Employees may submit numerous "One Time" payroll deductions throughout the year. "One Time" payroll deductions will not cancel any recurring per payperiod deductions.
Please Enter an Amount to Deduct
Position Title*:	Please Enter your Position Title
Company Affiliation:	Please Enter your Company Affiliation
EmployeeID #*:	Please Enter your Employee ID #
Printed Name*:	Please Enter Your Printed Name