Columbia Gas Payroll Pledge Form 2021-2022

Indicate the amount per pay period that you would like to contribute in the correct pay period line below.

Total Amount
Columbia Gas Donor Information

Minutes of Giving

 
Please double check to make sure the amount per pay and total pledge amount, listed above, matches the Minutes of Giving table below



Columbia Gas Minutes of Giving

Below is a list of Minutes of Giving amounts by salary range. By contribution at least the minimum amount, you will receive one additional vacation day to be used during the next calendar year. Please remember to coordinate the timing of this with your supervisor. Find your annual salary in one of the ranges below. The total pledge amount to the right is your minimum Minutes of Giving amount. Enter the amount on your form under “My Total Annual Pledge.” The amount your total pledge will be per monthly deduction (12 pays) and bi-weekly deduction (24 pays) is also listed for your information. If you are unsure as to your salary range, please contact Jenna MacKay Team Leader HR/payroll, HR Delivery Services, 290 W. Nationwide Blvd, Columbus, Ohio 43215 Phone: 740.415.4713 Email: jbruen@nisource.com

 

Employee Information

Leadership Donors

Loyal Contributor


If you have contributed to the United Way for 10 years or more, please complete the section below.

OPTIONAL - Giving Selections

If you are wanting to split your contribution between different impact areas / United Ways / Agencies, please provide detailed instructions below.
Designations to a specific nonprofit MUST be a minimum of $240 per nonprofit. A portion of all gifts designated to nonprofits (other than United Way) will reflect the current United Way processing fee structure to support administrative costs.
Payment Options
 
[x] Payroll Deductions