Local 7076 PAF Card

Political Contributions Committee Payroll Deduction Form

CWA Political Action Fund is CWA's non-partisan political action committee. Funds are used to mobilize union members and families to participate in the political process. Your contribution is optional, but highly appreciated. You must be a CWA member to use this form. If you are not yet a member, please use these forms instead for State of New Mexico, UNM, or UNM Hospital. Please allow up to 24 hours to receive an email confirmation after submitting this form.

First Name *This question is required.

Last Name *This question is required.

Agency *This question is required.

Department *This question is required.

Work Location (Clinic) *This question is required.

Job Title *This question is required.

Employee ID #

Home Address *This question is required.

City *This question is required.

Zip *This question is required.

Personal Email Address *This question is required. This question requires a valid email address.

Personal Cell Phone

Cell phone opt-in Periodic Msgs, Reply STOP to quit & HELP for info; Msg & Data Rates May Apply, See Terms & Conditions

I want to receive updates and news from CWA via cell (text & voice).

1. Enrollment Type *This question is required.

Amount to Deduct Per Pay Period *This question is required.

This authorization is voluntarily made based on my specific understanding that:

I hereby authorize my employer to deduct from my wages the listed sum each pay period and to remit such amount to the Communications Workers of America-Committee on Political Education Political Contributions Committee. (CWA-COPE PCC).

The signing of this authorization card and the making of contributions to CWA COPE PCC are not conditions of membership in the union nor of employment with the Company and that I may refuse to do so without fear of reprisal.

I am making a contribution to a joint fund-raising effort sponsored by CWA-COPE PCC and the AFL-CIO Committee on Political Education Political Contributions Committee (“AFL-CIO COPE PCC”) and that CWA-COPE PCC and AFL-CIO COPE PCC will use my contributions for political purposes, including but not limited to, the making of contributions to or expenditures on behalf of candidates for federal, state, and local offices and addressing political issues of public importance.

Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and the name of employer of individuals whose contributions exceed $200 in a calendar year.

Contributions or gifts to CWA-COPE PCC and AFL-CIO COPE PCC are not deductible as charitable contributions for federal income tax purposes.

Electronic Signature *This question is required. This typed electronic signature is equivalent to a hand-written signature and confirms the choices above.

Signature Date: 12/21/2024