CHECK AND PAYROLL DONATION FORM
 
Your donation will assist employees in times of need.

Check Donation:
Please fill in the information below, print and return it to:
ERF Collection Account
P. O. Box 341729
Memphis, TN 38184-9424

Payroll Deduction Donation:
Please complete this form and submit it to ERF Collection Account via the Submit Donation button below.  If you have any trouble submitting the form online, please print the application out and mail it to ERF Collection Account at the address above.  


Personal Information:

Date:


Name:


Email Address:


Business Location:


Country:


For Acknowledgements - Home Address:


Are you a full-time International Paper employee?
YES    NO 

Method of Payment (Please check below): 

 Check - made payable to IP Employee Relief Fund
 Payroll Deduction - a gift of $   per pay period
 Payroll Deduction - one time gift of $ 

For Payroll Deduction Purposes Only:

Personnel Number (Found in the upper left of your pay stub):


Payee Key:  3210    Wage Type:  288C

Please type your First and Last Name:
First Name  
Last Name 

I understand that checking this box constitutes a legal signature confirming that I acknowledge and warrant the truthfulness of the information provided in this document.