Payroll Deduction Form

* = required field

Some content may be updated based on selection

Payroll Deduction

Thank you for supporting student success through payroll deduction!

Bi-Weekly Payroll Contribution	x26 for IMPACT	Total Annual Gift
$1.00	26	$26
$2.50	26	$65
$3.85	26	$100
$5.00	26	$130
$7.50	26	$195
$10.00	26	$260
$15.00	26	$390
$20.00	26	$520
$25.00	26	$650
$38.50	26	$1,000

Please complete the required fields below.

I would like to:

Create a New Payroll Deduction

Increase or Modify an existing payroll deduction

Employee Information

First Name:

Last Name:

Employee ID

e.g. 9999999999

Preferred email Address:

I understand that my payroll contribution will stay in effect and support student success on a recurring basis, and can be changed at any time via notification to Kim McAuliff, k.b.mcauliff@sunyocc.edu.

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