Federal law requires us to report the name, address, occupation, and name of employer of each contributor whose contributions exceed $200 in an election cycle. Individuals may contribute a maximum of $2,600 for the general election. Multi-candidate PACs may give a maximum $5,000 for the general election. Contributions from corporations, labor unions, foreign nationals, and federal government contractors are prohibited. Contributions are not tax deductible for federal income tax purposes.
Please Print:
Prefix First name Middle Initial Last name Suffix
________________________________________________________________________
Street Address ___________________________________________________________
City____________________________________________________________________
State ___________________________________ zip code ________________________
E-mail address ___________________________________________________________
Phone number ___________________________________________________________
[__] Check this box if you are Retired.
Employer _______________________________________________________________
Occupation ______________________________________________________________
[__] By checking this box, I confirm that the following statements are true and accurate.
* I am a United States citizen or a permanent resident alien.
* I am making this contribution from my own personal funds, and not those of another.
* I am not a federal contractor.
* I am making this contribution on my own personal checking account and not with a
corporate or business checking account or a checking account issued to anyone else.
* I am at least 18 years of age.
Make checks payable to: Vote Vance
Mail to: Vote Vance, 633 E. North 19th Street #306, Abilene, Texas 79601-3258
© Vote Vance
