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Payroll Deduction Authorization

Thank you for prayerfully considering a payroll deduction, however small, to support the construction of the NEW HIGH SCHOOL.  Our goal is 100% participation!

Deduction Amount (per pay period)*
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Timeframe*
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Signature*
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Sign this form

By pressing “Sign Form,” you are agreeing to signing this form electronically.
Signature *
Type to sign
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Date:

By submitting this form, I hereby authorize the amount directed above to be automatically deducted from each pay period by HCS Payroll, for the timeframe indicated. I reserve the right to change or cancel the deduction at any time by contacting the HCS Payroll Supervisor.

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