Donations – Burton McCumber & Longoria, LLC

113 W. Pecan Blvd., McAllen, TX 78501-9584 | Phone (956) 686-6331

Name*
First Middle Last
Complete Employee ID #*
Last four of your SS#*
Donation Amount Per Pay Period*
Pay Period Frequency*
- Bi-Weekly
Email*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
I authorize my Payroll Department to process the pledge information entered above for payroll deduction.*
- Agree

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