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“Count Me In!”

Charitable Payroll Deduction Program

AEO FOUNDATION: Focuses on improving the quality of life anywhere AEO Associates and customers live, work,
and play. By donating and utilizing our most valuable assets (AEO volunteers), the AEO Foundation gives back
to communities by supporting student-related programs focused on youth development and conserving our
environment. For more information, visit https://www.aeo-inc.com/aeo-foundation/.

HELPING HANDS FUND: This program was established to help AEO Associates who have suffered a vast personal
tragedy (i.e. a house fire, death of a parent, etc.). The program is funded by contributions made by our very own
Associates and by AEO. The fund is available to all AEO Associates in good standing with the Company. Applications
are evaluated by a group of Associates making up the American Eagle Outfitters Helping Hand Review Committee.
Donations to this fund are not tax deductible.

Please use this form to initiate, change, or cancel your voluntary payroll donation to the AEO Foundation.

__________________________________________________________________________________________________________
First Name Last Name

__________________________________________________________________________________________________________
Employee ID # Store # / Department FORMS

(_________)_________________________________________________________________________________________________
Work Phone Email

PAYROLL DEDUCTION

❑ New Donation to the AEO Foundation
❑ Change Donation (replaces existing donation) to the AEO Foundation
❑ Cancel Donation to the AEO Foundation

Total amount of Donation per paycheck is $ ________________________
(minimum Donation is $1 per paycheck)

________________________________________________ ______/______/______
Associate Signature Date

Please return your completed form to:

AEO Canada Benefits Department
450 Courtneypark Drive West, Mississauga, ON L5W 1Y6
Email: CanadianBenefits@ae.com
Fax: 289.562.8087
FULL TIME AND REGULAR PART-TIME BENEFITS — FORMS 29

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