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State Employees'
Charitable Campaign (SECC)

Instructions for Paper Pledges



Employees without access to a computer or who do not wish to use ePledge may complete a paper pledge form.

The SECC Paper Pledge Form is a fillable PDF file. This means that you can type directly into the application on your computer or device. But first you must ensure that you have Adobe Acrobat Reader prior to trying to save the form. If you do not have Adobe Acrobat Reader, please find a free software download for the following devices: Desktop Computers | iPhone/iPad | Android |Windows Phone . This is the only platform that supports the online submission of the application. The pledge form does not automatically save your information, even after you have downloaded it. In order to fill in the pledge form and make necessary changes as you go along, you MUST save the pledge form to your computer or device prior to inputting any information into it.

To fill out manually, use a ballpoint pen and write legibly.

Fill in your full name.

Fill in your Employee ID number if contributing through payroll deduction.

Write in Department and Division/DDS Code (Your chair or captain can supply you with this).

Fill in a daytime Phone Number.

Fill in the Pledge Type:

  • Cash/Check – Fill in the amount in the appropriate area if contributing through cash or check. Make your check payable to SECC.
  • Payroll Deduction – Fill in the amount to be deducted each pay period and total the amount for the year if contributing through payroll deduction.

Charitable Organization Designation – If you wish to designate your money to a particular charity, enter the five-digit Charity code, the annual amount you wish to contribute to them, and the Charity name. Make your desired designations using the codes from the current list. If you do not wish to designate a charity, your donation will be split among the charities that receive donations during the campaign.

Check off whether or not you want to release your name and address to your charities of choice.

Fill in the address if you want acknowledgment.

If you are making a payroll deduction, you must sign and date the form. The deduction year appears in the authorization in the lower right corner of the form. Deductions occur during the calendar year after the campaign. For example, payroll deductions pledged during the 2022 campaign will occur during the 2023 calendar year.

When you complete the pledge form, you must turn it into SECC Captain or Chair.

   Agency Chairs and Captains should ensure the accuracy of the form as they collect them from employees.


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