2013 Greater Mississippi CFC

How to Complete a CFC Paper Pledge Form

The Paper Pledge Form• Check and double check!

– Make sure the pledge form is filled out completely

– Double check the math – Ensure that information is

legible on ALL copies

• Do NOT open confidential gifts

Don’t forget the thank-you gift!

1. Employee Name2. Work Address3. Civilian or Military4. Federal Agency5. Social Security Number OR EIN - PAYROLL PLEDGE ONLY (some agencies use an EIN)-6. Work Phone – important in case of problems.7. Payroll Deduction – Military/Civilian – two different pay intervals.

Allotment Source: for Military, add Branch of Service.8. Select a pre-determined amount or fill in the amount on the top line.

Determine amount per pay period then multiple by 12 or 26. Be sure to check the math here. NOTE: minimum of $2.00 per pay period for Military and $1.50 per pay period for Civilian.

9. Cash/Check – Enter amount of cash/check. If check, enter check number.10. Charity Designations – The total gift allocated among the designated organization MUST

equal total annual gift. If it does not, the remaining allocation will go to the undesignated fund.11. Incentive Awards – Select yes or no to receive award for Bronze, Silver or Gold Eagle donors.12. Information Release - Authorization to release name to designated charities. Employee to

complete this section ONLY if they want their gift acknowledged by the charity.13. Employee signature/date – required ONLY for payroll deduction.

Note: Copy 1 goes to Payroll Office. Copy 2 goes to Campaign Office. Copy 3 goes to Employee.

Instructions for completing paper Pledge Form

What to Do Next?• Double check your pledge

– Is math correct?– Is all requested information provided?

• Be sure to mark your desired gift if you qualify for an Eagle level gift

• Give the paper copy to your key worker.

Thank you for your donation!!