GENERAL DIRECTIONSPlease print neatly. Use the online directory at directory.cvcgives.org or the 2019 campaign's printed directory when selecting your charities. Not all charities participate each year. This pledge form should only be used once the regular campaign period has ended, after December 31, 2019. When entering the number of pay periods on your pledge form, start with your next upcoming pay period and count the number of pay periods remaining through December 31, 2020. Pledges by payroll deduction do not automatically renew to the next year's campaign. To calculate the amount per pay period divide your total gift amount by the number of pay periods. Payroll deductions submitted using this form will count towards your agency's 2019 campaign total. To pledge by credit card or host a special fundraising event, go to cvcgives.org.

EMPLOYEE PAYROLL DEDUCTION PLEDGE CARD

2019 – 2020CAMPAIGN

We have proven that Virginia employees have a giant heart for giving with your overwhelming support of successfully raised funds for deserving local and global charities year after year. Raising $2.8 million last year is an awe inspiring feat for all of us. Your valuable contribution made this collective success possible.

This year, a total of 995 charities have been proven eligible for inclusion in our eve roster. Each of us is duty-bound to contribute or co-create This year, a total of 995 charities have been proven eligible for inclusion in our eve roster. Each of us is duty-bound to contribute or co-create innovative fundraising campaigns to help these charities continue their advocacy for our commonwealth, our country, and our world. The agencies with the highest total gift and the highest percentage of employees' donating will receive recognition at CVC's Annual Recognition Event. As a state employee, you can donate, start a fundraiser, or boost a fundraising campaign thereby promoting the continuity of the programs of selected charities for their worthy beneficiaries. At CVC, we are humbly propelled and fueled by your drive and determination to make this campaign the best one yet. We are one with you in putting our best foot forward in achieving our goals this year. With grateful hearts, we thank you for your commitment and cooperation in our state-wide campaign.

Vilma Alejandro, Director of Employee Programs Virginia Department of Human Resource Management

Explore our website www.cvcgives.org to learn more!

Dear Fellow State Employees,

SUBMIT THIS FORM TO YOUR PAYROLL OFFICE

First Name

Email

Agency Name

EMPLOYEE PAYROLL DEDUCTION PLEDGE CARD

2019 - 2020 CAMPAIGN

Last Name

Employee ID

Agency Code

Gift Designation: A complete list of eligible charities may be found at directory.cvcgives.org or contact your CVC Agency Coordinator for a printed directory.

0 I do NOT wish to designate my gift to a specific charity.

0 I wish to designate my gift to the following specific charities:

eve Code# Charity Name Annual Gift

$

$

$

$

$

Ackn owledgement: 0 I wish my gift to remain anonymous.

Street City

Authorization: By signing below, I authorize this gift to the CVC.

Signature of Donor

EASY PAYROLL DEDUCTION:

Deduct $

for

for a total gift of

pay periods,

$

per pay period

Your gift is 100% tax deductible.

0 Please share my gift amount, name and address.

State Zip

Date

You will receive an email confirmation from eve once received. Thank you for your generous gift!

Submit this form to your Payroll Office. Please do not mail this form to eve.

PAYROLL OFFICE USE ONLY

0 I confirm this employee's payroll deduction has been in�iated with the amount per pay period and gift total as stated above.

Payroll Office Signature Date

Email Phone

Instructions to Payroll: Email this completed form to support@cvcgives.org.