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The City of Portland, Oregon

Office of Management & Finance

Trusted partner, creating smart solutions for the City and our community.

main: 503-823-5288

Revenue: 503-823-5157

1120 SW 5th Ave, Room 901, Portland, OR 97204

More Contact Info

Paper Pledge Form Instructions

To use the paper pledge form:

  • Click “Your Pledge Form”
  • Click the box in the top right of your chosen umbrella organization(s).
  • Fill in the amount of the payroll deduction.
  • Fill in 1 or 26 payroll deductions.
  • To contribute to a specific agency: write the name of the agency on the agency line and the amount of your contribution under the applicable umbrella organization.
  • Fill in the total annual amount per umbrella organization.
  • Fill in the grand total.
  • Sign bottom left.
  • Return printed pledge form to your Bureau Representative. Click here for a list of representatives by bureau

Alternately, you may print the form before filling in your contribution information.

Do you need a pre-printed paper copy of the pledge form?
See your Bureau Representative or contact Karyl Whelan, 503.823.5879 or karyl.whelan@portlandoregon.gov.

Paper Pledge Form Facts: 

  • If you need a copy of the form for your records, please make a photocopy of your pledge form prior to returning it to your bureau representative.
  • When donating by check, write the check to the umbrella organization with the affiliated charity listed on the memo line. If you elect to make a donation by check to multiple organizations, you will need to include a separate check payable to each of the umbrella organizations to whom you will be donating.
  • Donations by check to affiliated charities are written to the umbrella agency.
  • Check donations will be sent to designated umbrella before December 31, 2014.
  • Looking for your favorite charity? Click here for a list of all affiliated charities.
  • Cash donations are discouraged due to handling and security issues.
  • For payroll deduction, you may choose to deduct for the first payroll period of the year or all 26 pay periods of the year. If donating for all 26 pay periods, it is important to note:
    • The deduction amount must remain the same for each pay period.
    • Deductions begin January 8, 2015
    • Return your completed pledge form to your Bureau Representative.

 Questions?  Contact your Bureau Representative or Karyl Whelan (503.823.5879)