How to complete
the 2014 GIFT
FORM …
National (outside the NCR) Government
of Canada Workplace Charitable
Campaign (GCWCC)
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Section 1 – Donor information
Process:
Important Note: As the donor, you do not fill out the Canvasser Number & Organization fields. This information must
be filled by the volunteer canvasser who gave you the form.
Indicate appropriate form of Salutation (Mr., Ms., Mrs., Miss, Dr., Rank or other, e.g. Reverend).
Include full name and home address (Canada Revenue Agency (CRA) requires that the address be completed for
income tax receipts).
 Include the date (Year-Month-Date).
Include Telephone number (Required for credit card donation).
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Section 2 – How to distribute your gift
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BOX 1 – Local United Way
 You may choose to designate a donation to your local United Way/Centraide
Process:
1. If this box is blank, enter
the Identification Number
for your local United Way.
You can find the
Identification Number by
checking your GCWCC
Calendar or by contacting
your local United Way .
2. Indicate what
amounts you would like
to go where (you may
enter amounts for the
United Way to distribute
where it will have the
greatest impact and/or
direct your amounts to
specific impact areas).
3. If you are giving through
payroll, divide your total
gift by 26 and enter the
amount per pay at the
bottom in the ‘Payroll
Deductions’ section.
4. Enter the grand
total for Box 1
donations.
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BOX 2 – Other United Way
 You may choose to designate a donation to any other United Way/Centraide across Canada
 If you would like to give to more than one “Other” United Way/Centraide, you must fill out another gift form per
United Way
Process:
1. Write the name and enter
the Identification Number of
the United Way. You can find
the Identification Number by
checking your GCWCC
Calendar or by contacting
your local United Way.
2. Indicate the amount
you would like to give.
3. If you are giving through
payroll, divide your total
gift by 26 and enter the
amount per pay at the
bottom in the ‘Payroll
Deductions’ section.
4. Enter the grand
total for Box 2
donations.
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BOX 3 – Healthpartners
 You may choose to designate a donation to Healthpartners or any of its 16 member agencies.
Process:
1. Indicate what amounts you would like to go where
(You can choose to divide your total GIFT equally to all
16 Healthpartners member organizations by entering
the dollar amount in the appropriate box or you can
designate your donation to one or more specific
Healthpartners member organizations).
2. If you are giving through
payroll, divide your total
gift by 26 and enter the
amount per pay at the
bottom in the ‘Payroll
Deductions’ section.
3. Enter the grand
total for Box 3
donations .
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BOX 4 – Other Canadian Registered Charities
You may choose to designate a donation directly to one of the 85,000 (+/-) Canadian registered charities of your
choice. Please note that there is a minimum $26 per gift per charity.
Process:
1. Enter the Identification
Number for your local United
Way – your local United Way
will receive the donation and
then distribute it to the
specific charity you
designated to. You can find
the Identification Number for
your local United Way by
checking your Calendar or by
contacting your local United
Way.
2. Indicate the exact name and
BN/Registration # of the charity. The
charity must be registered with the
Canada Revenue Agency and you must
indicate the BN/Registration number of
the charity. This number may be obtained
by calling 1-800-267-2384 or by referring
to the CRA’s website: http://www.cra-
3. If you are giving through
payroll, divide your total gift
by 26 and enter the amount
per pay at the bottom in the
‘Payroll Deductions’ section.
arc.gc.ca/ebci/haip/srch/advancedsearcheng.action. Enter the gift amount for each
Note: If you choose to give to more
than three registered Canadian
charities, it is necessary to list the
Charities with exact names and the
appropriate BN/Registration
numbers on a blank sheet of paper
and attach it with the Gift form.
Also, ensure that the amount per pay
and the grand totals reflect all of
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your gifts.
charity in the $ box on the right.
4. Enter the grand total for
Box 2 donations.
Section 3 – Grand Total and
Leadership Giving
Please verify that the amounts reported at the top of the gift form are an accurate reflection of the designated
amounts in Boxes 1, 2, 3 and 4. In other words, the gift form must balance!
In many locations, the names of Leadership Givers are included in a thank you document and/or Honour Roll. If
you give at this level, you can choose to not have your name included in the document by ticking the box in
section 4 (Please note: The level of leadership giving varies based on the region; for information for your area,
please contact your local United Way/Centraide).
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Section 4 – Method of Payment
What is this:
In this section you can select several options to make a gift.
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2
Important
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Process:
1. Payroll Deduction : If you are selecting
3. Credit Card: If you are choosing to give by credit card, please fill
the payroll deduction option, simply check
the box, indicate the total amount of your
gift and proceed to section 6.
out the appropriate information and submit your form to a
Canvasser.
Important
Please indicate your phone numbers in the event we need to get in
touch .
2. If you are choosing to give by cash or
- Please indicate the type of credit card (Visa, Mastercard, American Express).
cheque, please fill out the appropriate
information and submit your form to a
Canvasser.
- Indicate the credit card number and its expiration date. If the expiration date will
occur in the following year, your local United Way/Centraide will contact the donor
to obtain the new information.
Cash: Attach the money to the gift form.
Cheques/Post-Dated Cheque(s): Make all
cheques and/or post-dated cheque(s)
payable to your Local United Way. Attach
them to the gift form.
- Sign on the signature line.
- You must choose between the one-time (1) payment or the twelve (12) monthly
payments. If you choose the one-time (1) payment, it will be processed once it is
received and verified at your local United Way/Centraide. If you choose the twelve
(12) payments, the payment will be taken on the 15th day of each month, starting
January of the following year.
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Section 5 - Payroll deductions
What is this:
Donors making a gift through payroll deduction must fill out this section, but must not detach the section 6 tear-away piece of the
form. It will be detached and forwarded to your payroll office by a campaign volunteer after your donation information has been
captured by your campaign treasurer. All information that you enter in the section 6 tear-away portion will only be used by the payroll
office in your department/agency. Once the information is entered into the system, your finance office will keep the hard copy of the
tear-away portion on file. None of the information will be shared with anyone outside of your department/agency.
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3
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1. Full Name, PRI,
2. Verify that the amounts reported at the
3. Indicate how much you wish
signature of the donor
and date: The donor's
signature and date of
donation is mandatory
for all completed gift
forms.
top of the gift form are an accurate
reflection of the designated amounts in
Boxes 1, 2, 3 and 4. In other words, the gift
form must balance! Also, enter the
matching codes (for the United Way) from
Boxes 1, 2 and 4 so that the payroll
department knows which gifts are going to
which United Ways.
to donate per pay period (there
are 26 pay periods) and the total
amount. Ensure that the amount
of the donation is divisible into 26
pay periods (for example:
$1,000.22 / 26 pays = $38.47 per
pay).
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Thank You !
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