Enhancing the Quality of Education

Payroll Deduction

(For Montgomery County Intermediate Unit Employees Only)

Employees of the Montgomery County Intermediate Unit can elect to contribute to the Foundation’s activities through a bi-weekly deduction from their paycheck.

Please complete the following form to make contributions:

Name:*
Address:*
Phone:*
-

I hereby agree to have the Montgomery County Intermediate Unit’s payroll department deduct the sum of:

Bi-weekly Amount:*

from my paycheck on a bi-weekly basis for the purpose of making a donation to the MCIU Education Foundation commencing on

Start Date:*

This deduction authorization shall continue in effect from the start date of the payroll deduction, unless revoked in writing addressed to the MCIU payroll department.

The MCIU Education Foundation is an IRS 501(c)(3) organization, therefore this deduction is tax deductible as a charitable contribution for federal income tax purposes. Individuals should maintain copies of this form and paycheck vouchers for audit purposes.

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