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NKSFB, LLC Pledge Form
Your Contact Information
Employee #
*
Last Name
*
*
Denotes required fields
Gift Details
Payment Method:
Payroll Deduction - Per Pay Period
Payroll Deduction - One Time
I wish to donate now with a Credit/Debit Card - One Time
Donation Amount (US $)
Amount: $
Credit Card Num
Exp. Date (MMYY)
CVV
I do not wish to receive communications from St. Jude.
PLEDGES OF $10 OR MORE PER PAY PERIOD will receive a St. Jude T-shirt
Please select t-shirt size:
No T-Shirt
Small
Med
Large
XL
XXL
XXXL
I authorize NKSFB, LLC to deduct the amount selected from my paycheck each pay period as a charitable contribution from me to St. Jude Children’s Research Hospital. I understand that deductions will be made from my post-tax wages. As such, I am responsible to pursue any income tax deduction that I may be eligible to receive when filing my individual income tax return. I further understand that I may cancel my donations at any time by providing written notice to NKSFB, LLC Payroll at least 10 days prior to the effective scheduled pay date chosen.
Please click the Submit button only once, to avoid multiple transactions/donations.
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