Fillable Gift Authorization Form - Employee Payroll Deduction (Yuba College)

Fill Online, Printable, Fillable, Blank Gift Authorization Form - Employee Payroll Deduction (Yuba College) Form

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Gift Authorization Form - Employee Payroll Deduction (Yuba College)

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The Gift Authorization Form - Employee Payroll Deduction (Yuba College) form is 1 page long and contains:

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  • 6 check-boxes
  • 13 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Yuba College

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FOUNDATION OFFICE
Serving YCCD Since 1972
Gift Authorization Form - Employee Payroll Deduction
EMPLOYEE INFORMATION (Please print)
Name: _____________________________________________Employee ID# ____________________
Address Line 1: ______________________________________________________________________
Address Line 2: ______________________________________________________________________
City/State/Zip: _______________________________________________________________________
Phone: ____________________________Email:___________________________________________
College/Campus Affiliation: ____________________________________________________________
Note: If you want your gift to be utilized where needed most, write “unrestricted” in
program/scholarship designation line.
For Official Use EMPLOYEE PAYROLL DEDUCTION
Gift Designation (Program/Scholarship/Campus) Amount/Month Effective Start Stop Change
Code: _______ _________________________________ $_________ ___/___/___
Gift Designation (Program/Scholarship/Campus) Amount/Month Effective Start Stop Change
Code: _______ _________________________________ $_________ ___/___/___
Employee Signature: ____________________________________________ Date: _______________
How to reach us:
Yuba Community College District Tel: (530) 749-3868
Foundation Office Email: Foundation@yccd.edu
425 Plumas Blvd., Suite 200
Yuba City, CA 95991
These forms are available in hard copy at the YCCD Foundation Office.
Payroll deductions can be started, changed or stopped at the employee’s direction.
For assistance contact the YCCD Foundation Office.
Return completed forms to the YCCD Foundation Office.
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Gift Authorization Form - Employee Payroll Deduction (Yuba College)

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Completed 25 July 2020

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