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Curry for America |
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CONTRIBUTION FORM
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Corporations, foreign nationals without green cards, federal
contractors, and minors (under 18 years of age) are prohibited
from contributing. Contributions are not deductible for federal
income tax purposes. The maximum contribution per individual is
$2,300 per election. A
couple may contribute up to $4,600 per election. If you
are donating as a couple, with or without a credit card, both
persons must sign below. Multi-candidate
PACs may contribute up to $5,000 per election. This contribution
to Curry for America represents personal funds and is not drawn
on an account or credit card maintained by a corporate entity. |
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Federal law requires us to use our best efforts to report the
name, mailing address, occupation and name of employer for each
individual whose contributions aggregate in excess of $200 in an
election cycle. |
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Name
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Occupation
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Phone (work)
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Cell
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Mailing Address
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City, State Zip
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Spouse Name
(if joint contribution) |
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Phone (work)
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Cell
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Donation Amount
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Card type
Name as it appears on card
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Card number
Expiration date
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Billing Address(if different than mailing address) |
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City, State Zip
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Signature |
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Spouse Signature(If joint contribution) |
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