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Instructions
You may complete, save & print your pledge card online with the latest Acrobat Reader. If you don't already have it, use this link to easily upgrade to the most recent version of the free Adobe Acrobat reader, then complete your pledge card online.
OR...
Save the PDF pledge form on your computer: right-click this link and choose "Save Target As...". Then print and complete the pledge form.
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Complete all portions of the form, including your complete name, federal agency or organization name, unit/division or payroll office, work address, work phone and social security number (payroll deduction, only).
- If you are pledging a gift through payroll deduction, write in the amount to be deducted each pay period.
- Indicate the agency/charity five-digit code number that you wish to donate.
- Indicate the annual dollar amount for each agency selected. The total dollars should not exceed your total pledge.
- Indicate if you wish to receive an acknowledgement from your designated agencies. If so, provide your home address and/or email address.
- Sign and date to authorize release of this information to the agency and/or your payroll office.
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