Payroll deduction form

If you would prefer you can also download our printable form. This option requires Adobe Acrobat, which can be downloaded free.

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Denotes a required field or section.

I am a:

Faculty member
Support staff
uOttawa retiree

Gift information:

Please deduct: required

per pay

**Deductions will begin on the next pay.

Contact information:

Salutation: required

First name: required

Last name: required

Telephone: required

Email:

Point of contact:

Address:

City:

Province/State: required

Postal code: required

Country:

Gift designation type:

Faculty/Service:

Other project or initiative:

In memory/honour of:

Is this gift in memory/honour of someone: Yes No

This gift is in: memory of honour of

Relative Friend Mentor Other:

Name of person: required

Please notify the following person of my gift: