Authorization

By submitting this form, I understand that I am pledging philanthropic support to UPMC Chautauqua through WCA Foundation. I authorize the above amount to be automatically deducted from my pay each pay period until I notify WCA Foundation of any changes to my pledge. I understand that my gift is deductible for income tax purposes to the full extent provided by law and that I will receive an annual giving statement from WCA Foundation for my tax records.