Aetna healthfund health savings account (hsa) payroll deduction instructions this form allows you to have hsa contributions deducted from your payroll. you may use this form to authorize either a onetime transaction or periodic transfer. note: if...
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Authorization for payroll deduction date: substitute teacher name: employee id number: i authorize the douglas county school district (dcsd) to initiate a onetime payroll deduction in the amount of $5.00 for the purpose of securing a certified...
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Blue white and blue white you and you 16020 faculty staff annual giving program faculty andand staff annual giving program payroll deduction authorization form payroll deduction authorization form pleaseone select one to option make your via...
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The annual fund faculty & staff payroll deduction form faculty and staff play an important role in helping cgu offer high quality programs, including the support of cgu with valuable philanthropic gifts. payroll deduction is simple, and you can...
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Classified senate council payroll deduction authorization form employee name: date: employee id or last 4 of ss#: department: work email address: work telephone no.: dues options: enter a check next to the appropriate payroll deduction option...
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Student information full name: last first m.i. address: street address apartment/unit # city student phone: state zip code student email: college/university: anticipated graduation: parent information parent name: parent phone: parent name: parent...
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Aetna healthfund health savings account (hsa) electronic funds transfer authorization (eft) instructions this form allows you to transfer funds into your hsa directly from your checking account. you may use this form to authorize either a one-time...
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Candidate induction programme and pack candidate name: date of induction: location of induction inductor name: this document is yours to keep. it provides a handy reference to help you get the most from your qualification as well as providing you...
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New york state illustrated talk evaluation form name address street city zip county years in 4h title of presentation approximate length of presentation (circle one): 5min. 7min. 10min. 15min. scoring scale: outstandingno above expectation met...
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Authorization for automatic payroll deduction to: president, oas staff association (gsb 622a) from: extension re: authorization to deduct from my salary for the activity marked below i authorize dfs: to deduct a monthly washington sport club fee...
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Inver hills community college foundation 2014-2015 faculty & staff pledge drive yes! i want to be an everyday hero who makes a lasting difference in the lives of our students! name home address: city: state: zip: payment options annual per pay...
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Yes, i care! enclosed is my gift of: $ clear form i want my gift to make a difference! please use my gift for: o one time only o university s greatest need o monthly o general scholarships o quarterly o other please specify: o each pay period...
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Updated: 2/4/2015 annual fund drive employee payroll deduction authorization i hereby authorize north arkansas college payroll to make the following payroll deduction(s) from my employment pay and remit to north arkansas college foundation, inc.,...
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Sample for use by payroll administrator payroll deduction for bankpac contribution i want to support banking in georgia with a contribution of $ to the gba fedpac for the 2012 campaign. i authorize (bank) to deduct this contribution from my net...
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Preschool/kindergarten school year 20162017 options classes olam baby. for babies 6 weeks to 12 months with their parents. meets on fridays from 9 to 10:15 am. onetime charge of $300 for the year. shabbatot. for children under 20 months with their...
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