Benevolent Fund Payroll Deduction Form

Benevolent Fund Payroll Deduction Request Form 

For questions, please contact UAB Gift and Biographical Records by phone at 205.934.7242 or via email at gifts@uab.edu

Steps to Complete Your Benevolent Fund Payroll Deduction Request

1) Complete and submit this form.
2) Watch for ​Action Required: Payroll Deduction Request message to email address entered below.
3) Reply All​ to the email with "Yes" to confirm your payroll deduction request.




UAB or UABMC Email Address Required Field


Anonymity Options
Anonymity Options
Pledge Details
Requested Action Required Field
Requested Action




$
If ending your pledge, enter $0.

​​For Biweekly Payroll Donors:

  • One Time Gifts are deducted from one payroll.
  • The amount of Monthly Deductions or Installments will be evenly split between the first two (2) paycheck of each month. 


Benevolent Fund donations will be evenly divided between your designation choices less administrative costs. 
OPTIONAL - Pledge Start Date

If you do not​ wish to begin your payroll deduction immediately, indicate preferred Start Date. 

Please be aware, however, that payroll deduction updates may not take effect for up to two (2) pay cycles. 

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In Honor/Memory of Someone Special



Payroll Appeal