United Way of Albany County

Riverstone Bank Payroll Deduction

Riverstone PRD

Riverstone Bank Payroll Deduction Authorization Form

Please fill out this form to donate to United Way of Albany County using payroll deduction. There is a designation section on this form if you would like to designate your donation to a specific Community Partner Nonprofit(s).
Name
Name
First
Last
Address (optional)
Address (optional)
City
State/Province
Zip/Postal
Country
Are you filling out this form to...

Donation Amount

Designations

What would you like your donation to go towards?
If you would like to designate your donation to a specific United Way Community Partner Nonprofit(s) and/or program, please indicate them here.

Additional Contact Info

Would you like your donation to remain anonymous?
Would you like to receive a United Way THANK YOU by mail? If yes, please be sure to include your address in the contact section.
Would you like to receive emails with news and updates from United Way of Albany County?

Payroll deduction Authorization

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