Lohman Company Campaign Form

Name*

First NameLast Name
Email*
Your personal information is kept confidential. Mesa United Way uses this information to acknowledge your gift, provide necessary tax receipts, and communicate how your gift is helping the community.
Employee ID
Please enter your company ID number.
$5$10$25$50Other
Total Annual Pledge:
Amount per paycheck x 24 pay periods
Optional Gift Designations (Undesignated gifts will support Mesa Unites Fund. Designations total should not exceed annual gift.)

AZ Tax Credit Limits: For the 2025 tax year, the limits set by the Arizona Department of Revenue are as follows: QFCO – Qualified Foster Care Charitable Organization (Helen’s Hope Chest) = $618 for an individual taxpayer OR $1,234 for joint-filing taxpayers. QCO - Qualifying Charitable Organizations (Foster360) = $495 for an individual taxpayer OR $987 for joint-filing taxpayers. STO – School Tuition Organizations (Azura Scholarship Fund) = $769 for an individual taxpayer OR $1,535 for joint-filing taxpayers.
Any other information you need to communicate? (optional)
THANK YOU FOR YOUR DONATION, {name}!
Signature*
Your contribution is tax deductible to the extent allowed by law. No goods or services were provided in exchange for this contribution.
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Optional Gift Designations (Undesignated gifts will support Mesa Unites Fund. Designations total should not exceed annual gift.)