How to Complete a Payroll Giving Card
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Section 1: Payroll Authorization

To continue your current payroll deduction with no changes:

•  You do not need to do anything! Your previous instructions will remain in effect until you change them. Thank you!

Please start by completing the following sections of Section One of the Payroll Giving Card:

To begin a payroll deduction or to contribute to additional charitable agencies:

•  Check the "NEW" column next to the name of the agency to which you wish to begin contributing.

•  In the "$ AMOUNT" column, write in the amount of your contribution per pay period.

To change the amount of your current payroll deduction:

•  Check the "CHANGE" column next to the name of the appropriate agency.

•  In the "$ AMOUNT" column, write in the new amount of your contribution per pay period.

To cancel a current donation:

•  Check the "CANCEL" column next to the name of the appropriate agency.

Note: Minimum amount for payroll deduction is $2.00 per FDA per pay period.

Section 2: One-Time Gift

Use section 2 to make a one-time gift:

•  Write a personal check payable to “LAUSD CCC” for the desired amount.

Section 3: Donor Designation

Complete this section to designate your gift (payroll deduction or a one-time gift) to a specific charity.

•  Indicate the amount of the gift and whether it is through payroll deduction or check/cash.

•  Enter the complete name, telephone number, and address to which the gift is being designated.

•  A maximum of two (2) agencies can be designated.

•  Please note: If you choose to designate your gift to a specific charity not listed in the agency directory, please make sure the charity you designate is a tax-exempt organization - IRS classification 501(c) (3).

Section 4: FDA Authorization

•  Check one agency to process your gift.

•  Please note that every designation must be processed through one of the participating charitable agencies. The agency selected to process the designation must be the same agency checked on the payroll giving form (if giving through payroll deduction). A designation is on-going until superseded by a new designation, or until cancelled.

•  Please make sure the charity you designate is a tax-exempt organization - IRS classification 501(c) (3). You will be notified in writing if your designated charity does not meet this requirement. If you do not respond within 60 days after notification, your gift will be treated as an undesignated contribution by the agency you selected. Designations are paid in full minus administrative costs.

•  NOTE: Only the charitable agencies listed in this section have the ability to pass through funds to any 501(c)3 designated nonprofit.

Section 5: Acknowledgment

Use this section to receive an acknowledgment of a gift:

•  Complete the shaded area with employee's last name, first name, e-mail (optional), home street address, city, zip code, day time telephone number, and school/department.

•  Acknowledgements are to be used for tax purposes as proof of contribution. Unless this section is completed, charities will not be able to acknowledge the employee.

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