CSUF | Employee Payroll Deduction

Please fill out and submit this form to initiate, change or cancel your payroll deduction.

Payroll deductions are maintained by the Cal State Fullerton Philanthropic Foundation in University Advancement. Contributions may be tax deductible. Please consult your tax adviser. An annual gift acknowledgment will be provided for tax purposes.

Required fields are marked with *

Employee Information

* First Name

* Last Name

* Affiliation (select all that apply) FacultyStaff

* Department

* Campus Email

* Campus Phone

* Residential Address

* City

* State

* ZIP

Payroll Deduction Information

* Select one New Payroll DeductionChange Payroll Deduction
(replaces existing deduction)Cancel Payroll Deduction

Designate Your Donation

Select a General Fund

Monthly Deduction Amount

AND/OR...

Search for Fund to give or donate to multiple funds. Enter fund information below.

Fund Name and ID
Provide information in the following format: Fund Name (Fund ID).

Monthly Deduction Amount

Fund Name and ID
Provide information in the following format: Fund Name (Fund ID).

Monthly Deduction Amount

Fund Name and ID
Provide information in the following format: Fund Name (Fund ID).

Monthly Deduction Amount

Total Monthly Deduction Amount: $

* I authorize University Advancement to contact me upon submission for final approval of fund designation(s), donation amount(s) and authorization of the listed deduction from my payroll.
* I acknowledge that University Advancement will coordinate with Human Resources, Diversity and Inclusion to complete the required paperwork, which includes my Social Security Number, and authorize the State Controller to deduct from my salaries and wages the amount specified on this form.

If you need additional assistance or information, contact Grace Johnson at titanfund@fullerton.edu or 657-278-4180.

* For security, please check the box below and follow the instructions.