Fillable PAYROLL DEDUCTION AUTHORIZATION FORM (Mercer University)

Fill Online, Printable, Fillable, Blank PAYROLL DEDUCTION AUTHORIZATION FORM (Mercer University) Form

Use Fill to complete blank online MERCER UNIVERSITY pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

PAYROLL DEDUCTION AUTHORIZATION FORM (Mercer University)

On average this form takes 6 minutes to complete

The PAYROLL DEDUCTION AUTHORIZATION FORM (Mercer University) form is 1 page long and contains:

  • 1 signature
  • 25 check-boxes
  • 10 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Mercer University

BROWSE MERCER UNIVERSITY FORMS
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
PAYROLL DEDUCTION AUTHORIZATION FORM
Mercer University Employee ID#:
Title Department
o College of Health Professions
o College of Liberal Arts
o College of Pharmacy
o Eugene W. Stetson School of Business
o Georgia Baptist College of Nursing
o McAfee School of Theology
o
College of Professional Advancement
o School of Engineering
o School of Medicine
o Tift College of Education
o Townsend School of Music
o Walter F. George School of Law
FUND(S) I WISH TO SUPPORT (When selecting more than one fund please designate the amount to each fund.)
o
General University Support
o Athletic Foundation
o Baptist Scholars
o McDuffie Center for Strings
o Mercer On Mission
o Mercer University Press
o Parents Fund
o Grand Opera House
o Tarver Library
o Swilley Library
o Law Library
o Medical Library
SCHOOLS OTHER LIBRARIES
o Other Program ___________________________________________________________________________________
I wish to support the University and hereby authorize
the payroll office to deduct from my monthly
paycheck the following contribution:
$
x 12 Periods
$
TOTAL
Chancellor’s Circle – $2500 ($208.34 monthly)
President’s Club – $1000 ($83.34 monthly)
Penfield Club – $500 ($41.67 monthly)
Spires Club – $250 ($20.84 monthly)
Towers Club – $100 ($8.34 monthly)
LEADERSHIP GIVING LEVELS (Calendar Year)
SIGNTATURE OF EMPLOYEE DONOR
Signature
EMPLOYEE DONOR/ame
Name
Deductions continue indefinitely.
To change your payroll deduction setup, please email
bate_ca@mercer.edu with the subject "Payroll Deduction"
and include the relevant information to discontinue or to
change the fund(s) and/or amount(s) of deduction.
Special Instructions:
PAYROLL DEDUCTION DETAILS
Pursuant to the Revenue Reconciliation Act of 1993, no goods or services are provided to you. Mercer University's federal identification
number is 58-0566167. The fiscal year is July 1 to June 30. Refer to your payroll check stub for your total contributions.
(New or additional deduction?)
Date
Begin my payroll deductions on this date*:
*Please note, payroll is processed before the last day of the month. To ensure your gift is processed in the same month as your form is submitted,
please submit your form before the 15th of the month.
PLEASE RETURN COMPLETED FROM TO:
University Advancement
Chrystal Bate
Director of Advancement Services
bate_ca@mercer.edu
New Setup (I want to start a payroll deduction gift.)
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

PAYROLL DEDUCTION AUTHORIZATION FORM (Mercer University)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 23 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document