This memorandum transmits the 2009 CFC Model Pledge Form [83 KB] and accompanying guidance for use by all local campaigns. Changes from the 2008 Model Pledge Form are detailed below. Unless otherwise stated, these changes must appear on all local campaign pledge forms, according to the CFC regulations at 5 CFR § 950.402. Other modifications, except those noted, may not be made without prior approval from OPM.

REQUIRED MODIFICATIONS FOR THE 2009 CFC PLEDGE FORM:

• The "Recognition Options" section is revised requiring the donor to check off the recognition options of their choice.
• The Payroll Authorization date is changed from 2008 to 2009.
• The Revised Date in the lower right corner is changed from March 2008 to February 2009.
• Campaigns must insert the campaign name, local campaign ID, and contact information on the face of the pledge form.
• Under the contribution section, a new line has been added to record the "Date of Contribution" and the Other Cash and Check lines have been combined to Check/Cash.
• Under the payroll deduction section, the "Other" line has been expanded to include a space for Check No.

OPM APPROVAL IS NOT REQUIRED FOR THE FOLLOWING OPTIONAL PLEDGE FORM MODIFICATIONS:

• Campaigns may decide the overall size of the pledge form, e.g., one-up, two-up, three-up and the proportions of sections and text within the pledge form.
• Campaigns may use alternate placements for sections of the pledge form. For example, the placement of the SSN/Employee ID box may be at the top of the form or bottom of the form and may be with or without lines, hyphens or boxes. Another example is that the "Civilian Payroll" information may be moved above the "Military Payroll" information.
• Campaigns may add local giving levels and award recognition options.
• Campaigns should include the CFC Logo either on the pledge form itself or on the cover sheet.
• Campaigns may use cover sheets to the pledge form that contain CFC content in accordance with CFC regulations at 5 CFR § 950.401.
• Campaigns may make stylistic changes to the pledge form such as different fonts, colors, and layout arrangements of required text.
• The checkbox and statement indicating interest in being a CFC volunteer is optional and can be removed.

Requests for modifications, questions and comments on this guidance should be directed to Cherlynn Stevens at casteven@opm.gov. Requests must list each specific modification (additions or deletions) that is requested and include a review copy of the pledge form in its proposed format.