Payroll Deduction Authorization for BCTC Faculty/Staff Contributions
1. Action Code:
(1) This is a NEW deduction.
(2) I am ADDING a deduction to my current deduction.
(3) I am CHANGING my deduction.
(4) I am TERMINATING my deduction.
2. Employee ID:
3. Employee Name: Mr. Mrs. Ms. Dr.
Last First MI
4. College Name:
5. Campus Phone:
6. Total Amount of Gift:
7. Amount to be deducted from EACH pay check:
8. Date deduction to begin:
(MUST BE AT LEAST TWO WEEKS FROM CURRENT DATE)
9. GIFT DESIGNATION:
10. Gift to: Foundation College
11.
Employee Signature Date Signed
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Instructions on how to complete Payroll Deduction Authorization form
1)  desired 
2) Enter your Employee ID number.
3) preferred formal titlePrint your
4) Enter your college name.
5) Enter your campus phone number.
6) Enter the TOTAL gift amount.
7) Enter the amount to be deducted each paycheck.
8) Enter the date your deduction is to begin. (Must be at least two weeks from the
current date.)
9) IF YOU KNOW THE ACCOUNT TITLE AND NUMBER:
Enter them on the Gift Designation lines. The Office of Development will
verify account title and number.
IF YOU DO NOT KNOW THE ACCOUNT TITLE AND NUMBER:
Describe the program your gift is to benefit. Please be specific. The Office of
Development will enter the proper Account Title and Number. You will be
consulted if there is a question regarding your gift designation.
FOR MULTIPLE GIFTS:
If you want your contribution to be distributed to more than one account,
please describe each program (account) and indicate the amount each is to
receive.
10) hether the gift is to the Foundation or to the College.
11) Sign the form. This deduction will not be processed without your signature
and date signed.