For more information visit us at https://sfgov.org/sfc/combined-charities

About Giving Through Payroll Deductions

Q: How does payroll deduction work?

A: Donors determine and tell the payroll department on the pledge form how much money will be deducted from every paycheck throughout the year. For example, if an employee selects “$20 per pay period” on the pledge form, then $20 will be deducted from each of the 26 pay-checks, for a total of $520 by year end. The pledge will be deducted from paychecks beginning in January and ending the last pay period in December. Charities will begin receiving donations in quarterly distributions beginning in May. Please advise donors not to contact the agency of their choice prior to May as the charity will have no record of any donation before then.

Q: What is the advantage of donating via payroll deduction?

A: It is easier for an employee to have a smaller amount taken out of every paycheck than to write one large check for the same amount. In the example above, $520 may be too large an amount to write in one check, where $20 per pay period is much more manageable. Your pay stub keeps track of your charitable contribution, provides proof of your donation and is a re-minder to claim a deduction when filing taxes.Most important, payroll deduction ensures a consistent and reliable stream of income to the charities throughout the year whereas one time gifts do not. This makes it easier for them to budget and plan their annual programs and services. This consistent income stream is a main reason why non-profit organizations participate in campaigns such as this one.Please note: cash contributions are not accepted! All cash donations will be returned, with the pledge form, to the department coordinator.

For more information visit http://sfgov.org/sfc/faq

For more information visit us at https://sfgov.org/sfc/combined-charities

Special ThankS To holiday inn San FranciSco - FiSherman’S WarFFor their generous support to 2017 Combined Charities Campaign

For more information visit us at https://sfgov.org/sfc/combined-charities

For more information visit us at https://sfgov.org/sfc/combined-charities

Six Flags Discovery Kingdom

Culinary Institute of America San Francisco

Kabuki Springs & Spa

Target Gift Cards

Holiday Inn Fisherman Wharf San Francisco

Cabernet from Paradigm Wineries

Prize Drawings

See our complete prize list at https://sfgov.org/sfc/prizes

Sample of Prizes & Rewards

Due to wildfires in Northern California some prizes will not be avaliable until fur-ther notice.

ACCCoordinator/CaptainEsperanza Artola

Kristen HallSara PearceAnne Bingham

Arts CommissionCoordinator/CaptainAlyssa Ventre

Alyssa Ventre

AssessorCoordinator/CaptainNicole Agbayani

Tim LandreganAngela Lucas

BOACoordinator/CaptainEsperanza Artola

Alec LongawayXiomara Mejia

BOSCoordinator/CaptainEsperanza Artola

Leah LacoixVictor Young

City Attorney’s OfficeCoordinator/CaptainTeresa Rechsteiner

Lorenzo DonatiLillian ChowLaura Bernabei

Civil Service CommissionCoordinator/CaptainLizzette Henriquez

Luz MorgantiElizabeth Aldana

CONCoordinator/CaptainMaura Lane

David WeinzimmerOrealis AlvaradoRoberto MercadoRodel AjosteTiffanny WongSang TranRuby LiuWendy SarPhillip JoeLisa DuongLeslie YeeEarl LazoEdward de AsisMaura LaneLindsay OrwigMaria KamMaricar GratuitoKevin Lacsina

Janice CraigChun-Chu YeungSherman LukSteve FlahertyDeric LickoQing LiuMaggie WongSteven MunozMicheal WylieRaymond LiangLouis VocciaMonica WuAlice Kassinger

CSSCoordinator/CaptainVilma Argueta

Cynthia GoffMary Ngwe

DBICoordinator/CaptainCarolyn Jayin

Emily MorrisonSusan BufkaTom Hui

DCYFCoordinator/CaptainLinda Morales

Gonzalina Morales

2017 COFFEE CARD RECIPIENTS

For more information visit us at https://sfgov.org/sfc/combined-charities

DPHCoordinator/CaptainFaye DeGuzman

Ron Weigelt

DPWCoordinator/CaptainJeremy Spitz

Carla ShortCuong TruongCarlo AlfonsoMei Cai HeDuong SySally LuChristina OleaLaVonda WilliamsLinda LeeAlexandria ShamaBryan DahlJennifer BlotDavid WangCham HtumYaoquan ZhuShawn Fincher Mellisa NazzalCarmen YnamiChad SuntayPaul RenziOlu OdufaluOphelia LauEugene LingEdmund ShumAlbert KoRussel TaylorKent Minh

Erika TilneyJin ZhaoLisa MakDaniel BrugmannSu-Wan ChangRichard GrahamMairice WilliamsBen WuEllen WongPeter LuiLesley Wong

DOSWCoordinator/CaptainCarol Sacco

Natalie AlvarezMinouche Kandel

DTISCoordinator/CaptainHao Xie

Marco BrunoKim ThompsonEric ChinMohideenbasha Kamroon-banuLenore CrawfordDeepi VermaHao XiePeter PardiniSam ValdezElain BenvenutiRobin Earle

ECNCoordinator/CaptainArmina Brown

Fred LiedlMarianne ThompsonVicky TanKei LiuRhea AguinaldoRichard KuryloMarhta Yanez

ElectionsCoordinator/CaptainLeo Samuelson

Maggie LauDemetri ChamesIva Joy MaurinJohn Arntz

EnvironmentCoordinator/CaptainMegan Kalsman

Rusununguko MadeMegan Kalsman

GSACoordinator/CaptainPaul Lupion

Joanne CuencaBrian WongHoward ThuKyle SuttonDaniel Powell

2017 COFFEE CARD RECIPIENTS

Agency ContributionRaised to Date

$306,609.00Goal

$1,500,000.00

CONTRIBUTIONS TOTALS

For more information visit us at https://sfgov.org/sfc/combined-charities

Peter O’BrienSteve MulreadyDavid MarquardtAndy MaimoniPaul LupinoSandra DePazGollia AndersonNancy AlfaroMelissa Leon

HSACoordinator/CaptainAngela ChiuMichaela GreeleyJoseph LauChristopher McClennyJill KeelerCatherine Art

Bianca PolovinaRachel CruzMichaela GreeleyGeorgina MoralesDavid McCahonEmily GibbsMaggie DonahueMaria BenozaMichael LeeRosalie PeraRosanna GarciaRandy AdlerAndrew SchreiberIgnacio BelloCatherine ArtTiffany DongAndrea LegoKevin Heaney

John OntiverosDerek HillEileen LeeJennifer WilliamsFanny LapitanJasmine GreenMaria RitnerCummings C NauerRosalba FarrellGustavo GarrardAlexander IsmailBrian Coultersmith

HSSCoordinator/CaptainSertha Gallaread

Elaine GeeMarina ColeridgeMalika AlimSeretha Gallaread

JUV Coordinator/CaptainCecy Ticas

Christopher LaiTony TangRose FuapopoPauline Silva-ReCarla LemusPalminder HernandezDianna JouToni PowllMichele Nieve

LIBCoordinator/CaptainJennifer FiztgeraldWilfred Kong

MODCoordinator/CaptainNathan WebbDawn AndersonHeather Kittel

OCACoordinator/CaptainVictoria Falcon

Jacalyn Hoesing (Jaci Fong)Norman MartinezDavid Salem

OCEIACoordinator/CaptainMelissa Chan

Isis SykesRichard WhippleJamie Richardson

OCII Coordinator/CaptainMocia Davis Stean

April Ward

PLANNINGCoordinator/CaptainNora Priego

2017 COFFEE CARD RECIPIENTS

Chanbory SonThomas DiSanto

PORTCoordinator/CaptainDenise Lum

Claude BustonKevin MasudaAlan GinMatt ValbusaLinda GreenTeri JourgensenAlex ChongMisa PhamDave RauenbuehlerBrandon ChapmanAaron GolbusDenise LumMarilyn YehDemetri AmaroWinny LoiMonico CorralEmeline ZapantaCora SapaenElsa LambSandra OberleJoseph MonroeMatthias Giezendanner

PUBLIC DEFENDERCoordinator/CaptainEsperanza Artola

Kara ChienD. Adam Lipson

PUCCoordinator/CaptainNorma Molina

Mario ValdezWai Ling Chan LukNeil BernardoSerena JiangFan LauRyan CayabyabCheryl MunozIrina P TorreyNora Molina

REAL ESTATECoordinator/CaptainRachel Gosiengfiao

Joshua KeeneClaudia GorhamNam LiMarta BayolAmilia MartinezXiao MaiShui Ying LinJospeh StelmakSharon ChoyTom PetersonKonstantine ApostoloulosElleus SaranfinMei Ling ChanJeff SuesChristina VarnerLiz ChangCandy CheungRobert CollinsPeter Kearns

Kyle Dang

REPOCoordinator/Captain

Julieta CreerEloise Bulandi

SFMTACoordinator/CaptainCris LuiEugenia Wong

Frank LauJohn OrkesSung KimCris LuiNilesh RamChris BufkaSheryl HannemarMike FernandezShahnam FarhangiJeanine DuboisGuillermo RiosLuke BaganJamie O’NealLaura SmithRamon GoodeIsheal Martin Jr.Terrell OliverAngela GenochioKate McCarthyVirginia HarmonLaura Munter

2017 COFFEE CARD RECIPIENTS

For more information visit us at https://sfgov.org/sfc/combined-charities

Freddy PadillaLee CrawfordJoel CernaRosa EsquivelBeverly LeeDavid RosalesShawnda TurnerTeresa ChanOlivia EstaresEvelyn BruceWinne XieBradley DunnLorraine PhelanJonathan RewersNestor GuevaraShawn McCormickMercy ZamoraChris NichelMaria ContrerasFerdie LumbadJohnny HeLatha RamadassMichael YoungDana RyanJames LeeJanice WooAndrew LimDoug GriggsArturo PerezCatrena BrownFreeman CheeTimothy JackHector GodinezMark LaCroixEddie EkeHilton LewBrian LimJuan Ortiz

James McMillan Jr.Maya MaloneRobert WatsonJabari ManuelMike TerellShu Fen ChanPagibig AndacaScarlett EuniceMelvyn HenryJeremiah BryantAaron LampkinDonald EllisonFrederick OrantesRita Donahue

SFOCoordinator/CaptainSadia AfandiTeresa Notarmaso

Regina SooAlex TsaiCynthia DurantAndrea CaporaleSusan ManzanoMelissa AndrettaSadia AfandiEsther LeeBrian KramerWilliam MaherYen PangEmylene AspillaTiffany YeeRicky S. SanChristine ArrigaleTimothy O’BrienEva Cheong

Gina LintonChad AndersonElizabeth IriartMaria ReillySamuel ScottAlisa TsujiKai CaemmererAlisa Eagleston CieslewiczConnie WoodMichelle HoyAntonio A. CarcellarJulie TakataTyler TranMaria T. Iyog-O’MalleyEmily YeeIan M. HartTerresita K. SarmonteAlex MannPeter ParucciniKelvin GodshallMaria CruzCarlos TanquilitCheryl NasirKarin YuenAbe JamalCharito LuzLily LeeJudy LimCrystal DavidClarissa MamarilNicole AzurasDonna PottsAudrey LaurenceT RamosErnesto SantosRoger HoosonSherry Phun Kros Opbroeck

2017 COFFEE CARD RECIPIENTS

Regina Marie BangcayaLynn FilarJennifer ValenzuelaAntonio BorjaDiane ChowRinaldi WibowoTrina PasionTania GharechedaghyRussell VallesErica ClineMun Kwan ChiewBeaver YldefonzoSalvador CarrancejaMatthew McCormickRosa PerezRick ThaliTimothy HatfieldTimothy CarlisleLiXin Li (Natalie)Dina QuesadaMohamed ChekirChristian LeiSanjay MehtaPaul FosterNelson ValleRay RicardoJeffrey HoglindJesse BustosEmi AokiPui Chi LukThien Kim TranZhan Zhou ZhangSophia HomLinda PengTiffany IpYingying WnagShirley WestLouise Ho

Hazelle FernandezYvette ArcenalEarl BegleyShannon WilsonAnthony WongDiane TongViviana SoperKevin Van HoyCourtney YoungMichael OrdonaKelly McCrayHoushang EsmaliRonson CheongMaria ArradazaMillet CabreraPeina ChenLuisito Del RosarioFeng Hua LiuAlice KuangLeonora Del RosarioZhen LiArnold AbrenaGuizhe TangDerrick HomerFuxian LiNatalie ReederWan Ku LuoTy KhuuMarieta TanamalQiaoyun WuCarlos ChicasConstance FitzgeraldDeelan McConnMatthew BufkaAriel CajulaoYachi ChenXing Ciao HuangWei Guo Mei

Enrili BonifacioWilliam MinesBartolome BoadoEduardo DiocanasRenato FranciscoTeresa De DuranManuel CastroHjames SuguitanRavinesh KumarVirginia BelenzoMary Rose CasugayCui Xia RongGery LawZhi Qiang Li

2017 COFFEE CARD RECIPIENTS

For more information visit us at https://sfgov.org/sfc/combined-charities

Wei Yi YuJingming HanVivian ChenJavonda HarrisNastaja von ContaJuan RamosSeverin RizzoWei Jian ZengHiabu KifieCui Hua WuMing Yan ChenEdward FinkSFPDCoordinator/CaptainSara Maunder

John AldenEllen DoleseSherry FletcherStaci WineingerEleanor SalmonElmer SesconMichael ZhangAlvin TongSharon BarkwillJo-Theresa Elias, JacksonLeslie SmithStephanie OtaguroMichael AlexanderNina SariaslaniCarmen BatanKimberly NgGerald LouieDewayne WilsonLauren Newhart

2017 COFFEE CARD RECIPIENTS

TTXCoordinator/CaptainBrittany Williamson

Gustavo BosorquezBianca PintoAngela CooperPhil De La CruzGail WolfeStacey Chinn-IntravongFelipe LeivaJennifer PeneAlvin WongBrittany Williamson

For more information visit us at https://sfgov.org/sfc/combined-charities

For more information visit us at https://sfgov.org/sfc/combined-charities

Agency $ $

2017SanFranciscoCombinedCharitiesCampaign PERPAYPERIOD $20 x 26 pay periods = $520 $10 x 26 pay periods = $260

$5 x 26 pay periods = $130 $ x 26payperiods= $

ONETIMEDONATIONBYCHECKPlease makechecks toagenciespayable to theFederation(s)withwhich theyareaffiliated.

TOTAL CONTRIBUTIONTotalPayrollDeduction $TotalOne-Time Check $

$ ____ For unaffiliated (Donor Choice) agencies see 6 & 7 on back. Attach your check(s) to this form$500 = Leadership Giver. TOTAL ANNUAL GIFT $_______

LastName First Name M.I. Dept # Department Name

Work Phone

DSW#______ (For payroll deductions only)

EmployeeSignature(RequiredforPayroll IDDeductionOnly)

Note: To be thanked by Federation or agency of your choice, please complete the following information, otherwise your gift will be considered anonymous.

Street Address City Zip

Email Address Page of

I would like to remain anonymous

L2000 Local Independent Charities AdministrativeFee1.8% $$$

Total pledges to Federation and Federation Affiliates $A800 Asian Pacific Fund Administrative Fee 9% $

$$

Total pledges to Federation and Federation Affiliates $100 Bay Area Black United Fund Administrative Fee 14% $

$$

Total pledges to Federation and Federation Affiliates $

999 Community Health Charities Administrative Fee5% $$$

Total pledges to Federation and Federation Affiliates $

A-001 EarthShare California Administrative Fee 14.3% $$$

Total pledges to Federation and Federation Affiliates $

10187 Global Impact Administrative Fee 11.64% $$$

Total pledges to Federation and Federation Affiliates $

United Way Bay Area Administrative Fee 15% $$$

Total pledges to Federation and Federation Affiliates $Donor Choice Plan: See Pledge Form Guidelines (5C) on the back of this formbefore completing this section.To designate to an agency not listed, please enter your choice and provide address in this section. The agency must be a qualified tax-exempt organization.

Agency

Address

City/State Zip Phone

$ $Tax ID# .

Address

City/State Zip Phone Grand Total AnnualYELLOW

No goods or services are provided in consideration of the contribution(s) pledged on this form. RETAINPINK COPY OF THIS FORM FOR TAXPURPOSES

Code Agency Name Annual Gift

$

$

$

$

$

$

$

$

NOCASH

ACCEPTEDNO

CASHACCEPTED

NOCASH

ACCEPTED

0.000.00

0.00

0.00

0.000.00

0.000.00

0.000.00

0.000.00

0.000.00

0.000.00

0.000.00

0.00

0.00

0.00

0.00

YOUR DEPARTMENT