PBC FUND FOR THE CURE PLEDGE

I want to support the PBC Fund for the Cure, and pledge the sum of $__________

$___________ amount enclosed

$___________ balance to be paid

To be billed: ___Annually ___Semi annually ___ Monthly

_____ My employer has a matching gift program

_____ I would like to make a gift of securities

_____ I would like my gift to remain anonymous

Name_____________________________________________

Phone_____________________________________________

Address____________________________________________

City_______________________State__________Zip________

Signature ___________________________________________

Mail to:

American Liver Foundation

"PBC Fund for the Cure "

75 Maiden Lane

Suite 603

New York, NY  10038-4810

All gifts are tax deductible as permitted by law