Payroll Deduction Authorization for Charitable Giving
Employee Information
Employee Name
Employee ID
Department
Email
Charity Information
Charity Name
Charity Registration/Tax ID
Charity Address
Deduction Details
Deduction Amount (per pay period)
Start Date
End Date (if applicable)
I hereby authorize my employer to deduct the amount specified above from my pay and remit it to the designated charity.
Signature
Date