Employee Giving | Heart of Sumter

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HEART OF SUMTER

Employee Payroll Giving Authorization

Together, we can help provide opportunities, mentorship, educational support, recreational programs, and resources that strengthen children and families throughout Sumter County.

First name

Last name

Phone

Address

Employer & Company Name

Position

I authorize my employer to deduct the following amount from each paycheck and remit it to Heart of Sumter.

Authorization I understand that: This contribution is voluntary. Contributions will be sent to Heart of Sumter. I may change or cancel my contribution at any time by notifying my employer according to payroll procedures. Contributions may be tax deductible as permitted by law.

Start Date:

Signature

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